The Universal Notebook: Medicare for all

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There is a segment of American society that views government as the enemy and screams “socialism” any time a government program to improve health care is proposed.

Yet, according to a 2016 Gallup poll, 58 percent of Americans (73 percent of Democrats and 41 percent of Republicans) favor federally funded health insurance for all Americans.

I’m with the American majority. I favor Medicare for all.

I start from the fundamental principle that health care is a human right. Our inalienable rights to “life, liberty and the pursuit of happiness” are meaningless unless we have our health.

To withhold treatment because a patient is unable to pay is deeply immoral. Fortunately, the United States recognized the right to treatment with the Emergency Medical and Treatment Labor Act of 1986, which forbids the denial of care based on the inability to pay.

The Kaiser Family Foundation put the bill for uncompensated care at $84.9 billion in 2013. The total U.S. health-care cost is about $3 trillion a year, so covering the uninsured is not the reason the cost of medical care is so exorbitant.

On the other hand, health insurance companies are making record profits and their administrative overhead amounts to about 30 percent of the cost of health care in America.

Health care should not be a for-profit business. Some things are just too important to be left to the free market – things like national defense, transportation infrastructure, public education and health care.

When I was a kid back in the 1950s, opponents of a universal single-payer health care system got hopping mad at the very idea of what they called “socialized medicine” and implied that anyone who supported it was a commie. Fear-mongering and red-baiting were SOP in the 1950s.

Well, times have changed, Sen. McCarthy. Back in 1965, when Medicare was enacted, the American Medical Association was one of its biggest opponents. Now the AMA supports Obamacare and opposes Republican efforts to repeal and replace it with the draconian American Health Care Act, which would take health coverage away from 22 million Americans to give big tax breaks to the wealthy.

When House Republicans floated their health care plan, even Donald Trump concluded it was “mean, mean, mean” and urged Senate Republicans to come up with a bill that was “generous, kind, with heart.”

Senate Republicans failed miserably.

The Senate bill proposes to cut Obamacare subsidies by $408 billion and Medicaid by $772 billion over the next 10 years, while enacting $700 billion in tax cuts, half of which would go to the top 1 percent of households. I seriously do not know how Rep. Paul Ryan and Sen. Mitch McConnell live with themselves.

Nobel Prize-winning economist Paul Krugman explained the Republicans’ rob-the-poor-to-give-to-the-rich plan in The New York Times June 30 by suggesting the GOP had painted itself into a corner, promising to repeal a program that taxed the rich to expand health-care coverage. Repealing Obamacare inevitably means reducing access in order to cut taxes.

“So one way to understand this ugly health plan,” Krugman wrote, “is that Republicans, through their political opportunism and dishonesty, boxed themselves into a position that makes them seem cruel and immoral — because they are.”

Put most simply, liberals like myself see health care as a right and seek to increase the number of Americans with coverage as a matter of public policy. Democrats have been trying to pass some form of universal single-payer health care plan since FDR. Conservatives, as I understand it, see health care as a privilege and prefer to let the free market determine who can afford it.

Obama’s Affordable Care Act needs a lot of work, but it was a step in the right direction. The major problem with it was that fines for not enrolling (or taxes, as the Roberts Supreme Court decided they were) were not high enough to get healthy young people into the system.

That’s why we need Medicare for all. We need a system that covers young and old, healthy and sick, rich and poor.

The 20,000-member Physicians for a National Health Program has a plan that sounds good to me, proposing “to replace the ACA with a publicly financed National Health Program that would fully cover medical care for all Americans, while lowering costs by eliminating the profit-driven private insurance industry with its massive overhead.”

U.S. Sen. Bernie Sanders also has a Medicare-for-all plan that would be worth serious consideration, if we ever get back to a point in this country where doing what’s best for the American people takes precedent over doing what’s best for the wealthy.

It relies, of course, on increasing taxes and decreasing tax breaks, so Republicans will have to be dragged kicking and screaming.

Freelance journalist Edgar Allen Beem lives in Brunswick. The Universal Notebook is his personal, weekly look at the world around him.

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  • Charles Martel

    Wrong again, comrade. While I don’t have the time to personally dissect your article, here are 50 counter-arguments written by someone way smarter than the two of us: http://www.afcm.org/fallacies.html

    • poppypapa

      Thanks much for this, Charles. The arguments and the association are winners; real conversation stoppers.

      I doubt Count Eddie will read it; he doesn’t like having a crucifix held up to his view.

    • poppypapa

      Here’s another gem from afcm: http://www.afcm.org/hcinar.html

      • Charles Martel

        Excellent. Next we have to stop the Islamists. Join us at Act for America.

  • Little crow

    Government is the use of force with consent. Whenever you use government to go beyond its basic function and spend other people’s money instead of voluntary cooperation, you degrade both the recipient and the donor by removing their choices and substituting force, and that is immoral.

  • Little crow

    You can’t have “rights” that require the goods and services of others. How can you have a “right” to health care without making a slave of the doctors and nurses that provide it? Food is even more essential than health care. Do we have a “right” the the food in the supermarket? Do the growers and distributors of food have a “right” to your goods and services?

    For entertaining reading, I’d recommend the “Bill of No Rights”. You can find it online.

    • EdBeem

      Of course you can have rights that require the goods and services of others. Come on, have you ever heard of the draft? That’s the power to require your service in defense of the country in times of war. The American social contract requires us to contribute of our time and treasure “in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity” Taxes are the dues we pay in order to create a civil society in which all may prosper. We do have a right to health care, as I cited in the column. It is spelled out in the Emergency Medical Treatment Act. You don’t have the right to the food in a supermarket, but you have a right to eat. Do the growers and producers of food have a right to the public water they use? Do they have a right to use the public roads to get their food to market? Do they have a right to police protection for their property? Do they have to recall and destroy defective produce if the government says so in order to protect public health? Your view of government is exactly what’s wrong with the Republican Party and the Republican Party is exactly what’s wrong with America. Self interest.

      • Charles Martel

        Wrong again. See this 2.5 minute interview of Milton Friedman by Phil Donahue on “Greed”:

      • Little crow

        The Emergency Medical Treatment Act is a requirement imposed on hospitals, but that doesn’t mean the patient has a new right. Nobody has a right to eat, or to water, or police protection. Those things are nice, but if you don’t get them, you don’t have a legal redress that your rights have been violated. If your wallet is stolen, the police do not owe you a new wallet. If a water main breaks, you’re on your own to find another source. The world doesn’t owe you a living. they’re busy trying to make their own living.

        Your natural rights define your existence. You could be standing alone in the middle of the desert but you still have your rights: your life, your liberty, and your your right to pursue your own interests, as long as you don’t infringe on the rights of others.

        And I’m not a Republican.

        • Queenie42

          Libertarian claptrap. Why don’t you guys all find some island somewhere where you won’t spook the cattle and play your “Lord of the Flies” games away from the majority of folks who use and depend on a robust, well funded and regulated government.
          I’d like to see how long you would last. LOL.

          • Little crow

            The “libertarian claptrap” you describe is a system that built the strongest, most prosperous free society the world has ever seen. You are the beneficiary of a land that people all over the world clamor to emulate. Millions have fled oppression to come here because of it.

          • truther

            “Your natural rights define your existence.” That’s simply false and none of the founding fathers would have agreed with you, to say nothing of any advances in political thought since the 18th century. A great man like Theodore Roosevelt would have adamantly rejected the idea that each person living in this country is on his or her own, utterly devoid of any government obligation to promote the general welfare.

            On a more local note, if the municipal water pipe serving my house breaks then yes, I absolutely do have recourse. The town is obligated to fix it. And if I require police assistance and the town police department says “nah, can’t be bothered, you’re on your own,” then I (or my estate) absolutely have recourse. That’s the fundamental point of this entire nation.

          • Little crow

            I didn’t say you didn’t have recourse; I said your rights haven’t been violated.

          • Queenie42

            That is a very narrow minded and bigoted viewpoint you have there. Haven’t you overlooked the Native Americans nearly wiped out building that “prosperous and free society”? And what about the slaves used to build this Utopia you fantasize about? And the Chinese laborers/slaves that built the Continental Railroad. What about them?
            As to the millions who fled oppression in their own countries, they often faced other oppressions in the unsafe, unregulated sweatshops (think Triangle Shirtwaist factory) while their bosses became the prosperous ones and the dreams of so many went up in smoke, agony and early death. What about them?
            Or does your greedy libertarian philosophy discount and discard these people and call them losers? Like the poor and disenfranchised are called today by your kind.
            Finally, with the throwback to Fascist leadership in power today, I doubt very much if people are doing too much “clamoring” to emulate.

          • Little crow

            I didn’t say it was without its struggles and injustices. Perhaps you can tell me a place anywhere in history that’s done a better job.

            By the way, you just called me a bigot, and last week you called danmaine a racist. I know that you don’t know me and you probably don’t know him. Perhaps you should put that back in your holster for a while.

    • Just Sayin’

      How about your right to a trial by a jury of your peers? It requires the services of the jurors, and the judge, stenographer, court clerk and others, and possibly public defenders. It requires ‘goods’ in the form of a courthouse and place to undergo the proceedings.

      That’s just one example that blows your claims out of the water. Shall I go on?

      • Little crow

        That’s a necessary balance of the rights of the accused vs. the interests of the state to seek justice. A person accused of a crime faces the possibility of losing his liberty, and his rights, and therefore the people have to step up and do their duty to maintain a civil society. That is not an excuse to start creating rights that don’t exist. So nothing’s “blown out of the water”. This has all been covered.

        • Just Sayin’

          Now that’s some serious backpedaling there, now it’s a “Necessary balance” where as before you “Couldn’t have rights that require goods or services.”

          Not only is that total doublespeak, but how does the state not have an equal need to create a “Necessary balance” in healthcare. A person at risk of dying is at risk of losing his liberty, rights, and life, and people still need to ‘step up to do their duty to maintain a civil society.’, unless you think letting people languish in illness and experience a drawn out and miserable death isn’t part of what makes a society civil.

          • Little crow

            We just disagree on what responsibilities a government should have. If you want the government to take on what has originally been the job of the individual, that’s fine. Just leave me out of it. I have the actual right to left alone, without others telling me what I must pay for how I must live. Just remember that the bigger the government is, the less free you are; and when they pay for your health care or other services, they get to call the tune.

            You are basically promoting socialism, which would be fine if people could opt out. But history has repeatedly shown us that socialized medicine is a failure and always leads to either a parallel system based on free markets, or rationing, as it is now in Canada and England. If you and those like minded people want to have a socialist system that only you pay for and let me opt out, I say go for it.

          • Just Sayin’

            You have some interesting ideas on government and rights, but sadly very few of them have much bearing on reality. If you want the freedom to be left alone, without a government taxing you, then move someplace ungoverned. Live without the advantages of public roads, clean water (Unless you filter it yourself), services provided by people who benefit from a public education, and so forth. Then you’ll have the freedoms you claim to have.

            If you live within the borders of a government as a citizen, you benefit from a great many things that taxes pay for, and as such, are required to pay back into the system via your own taxes. You do not have a right to take and not give back.

            Of course, I suppose the third option is to live within the borders of a government as a non-citizen, but you’ll find you’re sorely lacking in rights in that case.

          • Little crow

            When I wrote “opt out” I meant out of socialism, not out society. Sorry if I gave the wrong impression, but I know we have to have roads and taxes and the military and courts. I just don’t think the government should be trying to do everything for everybody for two basic reasons: 1. It doesn’t do most things well because nobody has a personal stake in it, and 2. Because government doesn’t produce wealth, all its money comes from taxpayers and is therefore removed from the private sector, where it is used most efficiently.

            One of the objections to a small government, low tax, free market economy is that it does its job so well. It gives people what they want instead of what a particular group thinks they ought to want; which is actually an objection to freedom itself.

            As for living in reality, I build houses for a living, and when I make a mistake there is an immediate consequence.

          • Just Sayin’

            Oh, you didn’t give the wrong impression. You have a very serious double standard and I’m pointing that out. You say that nobody has the right to ‘tell you what to pay for’, but that’s simply not true.

            If you use public roads, public water, public lands, public education (Even secondhand), then you are benefitting from what government has paid for. You say they don’t create wealth, but they certainly create value and provide support to those who do. That takes money, money provided by taxes, taxes that you have to pay as part of the social contract that is society. I can tell you what to pay for in this instance because it’s part of the basic framework of society and of common decency. The Government absolutely has a right to tell you what to pay for in that regard too, and your hyperbolic statements make it impossible to hold a serious debate with you on the topic.

            Twice now you have said something ridiculously hyperbolic only to walk it back when called on it. If you want anyone to take you seriously, you need to present yourself as someone credible. I won’t waste my time debating someone who keeps moving the goalposts of the conversation.

            Oh, and I have contractors in my family, I know better than to buy that every mistake leads to immediate consequences.

          • Little crow

            You’re misunderstanding me, because I think we agree: Of course we have to pay taxes for roads, etc. and I should use those things and pay for them. I also have to pay for the things that I wish the government didn’t do,whether I like it or not. My point I that I think the government should be smaller and taxes lower so the citizens can use their money to pursue their own interests. That’s what creates a dynamic economy and makes life better for everyone.

            For the last hundred years or so, the Progressives in our government have created a bloated regulatory state (and don’t tell me I’m against all regulations) that often governs against the will of the people and consolidates power for itself.

            You seem to be making the case that our social contract is framed in the government. I think it exists independent of the government in the everyday exchanges between citizens.

            And yes, not all mistakes by builders lead to immediate consequences; some of them come back to haunt me years later, but some of them are immediate, like falling off an icy staging.

          • Just Sayin’

            I think we agree on some semantics, but not in the larger picture. I believe in the government as the holder of a safety net as a good thing. I believe that having them require taxes to help out those of us in most need is to the net benefit of society and morally correct.

            Specifically, I believe in having the government do it, because people (As an agregate whole) cannot be trusted to do it for themselves. Or at least not to do it correctly.

            Not only are there lots of people who are content to let others give, help, or deal with the situation in their stead, but many of those who do donate time and money to help their fellow man do it in ways that are channeled to specific demographics.

            While you can argue it is their right to do so, operating that way on a national level means that there are demographics still being given too little support or none at all. GLBTQ issues are a good contemporary example. At this point they’re mainstream enough to have some people giving to their cause, but is it enough to cover basic needs? Is it being seen on the same level as other charities, such as churches, many of which deliberately fund sources and projects that will not benefit GLBTQ causes due to ideological differences?

            As a larger society we should care for all our members, and our government as an agency that is supposed to be neutral beyond supporting all Americans. That is the correct basis for any organization to gather and distribute support to an entire society, and if equal support is given and supported through taxes, individuals who wish to support causes that mirror their own ideologies are welcome to do so.

  • Chew H Bird

    The issue is really about costs…

    My understanding is overhead expenses, in general, for Federal and State employees are significantly higher than for employees in the private sector. Unions and other “benefits” generally drive up costs associated with government workers.

    The majority of “cures”, (code name: drugs), are developed by private companies (usually assisted by government grants), and sold to “everyone”, at a huge markup, that was uncontrolled by the ACA.

    Insurance costs which have been going up substantially for decades have exponentially increased since the ACA and make up a large percentage of the average household budget.

    The ACA as implemented certainly has provided benefits for the least affluent and that is notable and much needed. However, the failure to create a process that is sustainable and fair to all did not happen. The implementation of the ACA is disgrace to all Americans and the harm done by it it negatively impacting the long term financial health of every taxpaying citizen who is not included in the 1%.

  • poppypapa

    1. A “right” properly understood is the ability to access a good unimpeded by others. “Life, liberty, and the pursuit of happiness” denotes the individual ability to enjoy such goods without impediments from government, other than to protect our ability to do so.

    2. “Promote the general welfare” is not the same as “provide for the general welfare.”

    3, As others have already said, if health care is a right, than so is food, shelter, clothing, transportation, and any number of other things.

    4. The right to a fair trial and similar provisions are there to limit the powers of an otherwise tyrannical government…..or monarchy…which is what the American experiment was designed to replace.

    5. We could talk about rights in the context of abortion, but that would call out more emotions than this article can handle.

    6. Citing Paul Krugman as justification for anything is to demonstrate a complete lack of understanding. Krugman argued for the huge $800 billion stimulus act, because “otherwise, all that cash we have just laying around will go to waste.” If that isn’t the assertion of a bonehead, I don’t know what is.

    7. This article fails to address the underlying issues driving the hyper-inflated costs of our overall health care system. Instead, it says it can all be fixed by having someone else pay for it all.

    8. “Medicare for all” is the equivalent of arguing for “VA healthcare for all” times a factor of ten or more. Is that what you want? Do you want every privately operated health care facility and provider to become operated by government, and all health care personnel to become government employees?

    Oh good; that should make things much better. As demonstrated in recent years, the VA system, which is a single payer system (medicare for all) for veterans, has been a real boon to the well-being of that population cohort.

    Throwing more and more truckloads of money at government operated health care systems will have no more benefit than throwing more and more truckloads of money at government operated schools. The government has absolutely no incentives to perform or survive as an enterprise. Imperfect as “the market” is, it is far better than government at nearly everything.

  • Queenie42

    Here is an article I found by Bill Moyers which may be of interest to some…..
    http://billmoyers.com/story/battles-ahead-opponents-single-payer/

  • poppypapa

    Since Eddie and you other believers in “Medicare for All” favor a taxpayer funded, government managed one-size-fits-all solution to health care, I suppose you would favor the same thing for housing, and personal transportation.

    How about a one-size-fits-all college education, with a one-size-fits-all tuition level?

    Buy-bye, Bowdoin and the like!

    So would Eddie propose that everyone live in houses just like his? Or should everyone live in lowest common denominator housing? And do you remember the Yugo and Soviet Union designed and built “cars?”

    It is beyond me that in a land where “life, liberty, and the pursuit of happiness” are supposedly inalienable rights, people think our elected employees and the larger swamp could design a winning, optimized health care ‘system’ for all 50 states and 330 million or so residents. Not to mention responsibly manage the fiscal underpinnings of said ‘system’ without bungling it to the point of collapsing the economy.

    I suspect any detached review of such single payer systems around the world will show that standards of care are in fact lowest common denominator, not the higher standards most have come to know and expect, all driven by the private sector.

    We should never have gone down this centrally planned rat hole in the first place, since it is abundantly clear, to all but the most misty-eyed statists, that there is no way out of the hole, and all attempts to exit will only make it wider and deeper.

    Elected officials and bureaucrats are no better in this regard than corporations and capitalists, with the exception that they have no personal stake in the success of their proposals; the survival of the government enterprise in the face of competition; nor any worries of job security or loss of benefits.
    ================================

    “It is hardly too strong to say that the Constitution was made to guard the people
    against the dangers of good intentions. There are men in all ages who mean to govern well, but they mean to govern. They promise to be good masters, but they mean to be masters ” – Daniel Webster

  • jack bauer

    Isn’t there any click bait that the Forecaster can use instead of this guy?
    Medicare for all will work as well as the Obamacare website! Remember that p.o.s. which cost a billion was delayed weeks and should have cost $25 million at most?
    If anyone really wants to place their healthcare into the hands of a national bureaucrat then how about moving to Cuba?

  • poppypapa

    Looks like click-bait Eddie has checked out on the discussion.

    He must be busy demonstrating for single-payer journalism.