Public insurance option path to Medicare for all
For some Americans, medical care is a right that government guarantees by producing it and paying for it. Currently, only military veterans enjoy this right. The Veterans Health Administration owns and operates the country’s largest health care delivery system, which provides and pays for the medical care of over 9 million veterans. Its wait times are shorter than those in the private sector and its hospitals provide better care. Consequently, we do have relatively high-quality socialized medicine in the United States, but just for military veterans.
For most everyone else, medical care is a commodity — produced for purchase in medical markets, where the payers are the patients, insurance companies or the government. Production of this medical care stays in the private sector. An example of government as only a payer of medical care is Medicare, which guarantees access to medical care to people 65 years of age and older. Because Medicare pays for, but does not produce medical care, it is not socialized medicine.
The United States is not yet ready for the government producing and paying for everyone’s medical care. “VA care for all” is not a popular rallying cry. However, “Medicare for all” is. Seventy percent of Americans support this type of single payer system. Since Medicare for all would only make the access to medical care a right for all Americans, it would not be socialized medicine.
One way to achieve Medicare for all would be to add a public health insurance option to the Affordable Care Act (i.e. Obamacare). These public plans would compete with the private health insurance for customers. Since the public plans would most likely be more efficient, with administrative costs closer to Medicare’s 2 percent compared to private insurance companies’ 20 percent, more people would buy them. This approach would be politically preferable because people would be choosing public over private health insurance. Even the opponents of Medicare for all would be hard pressed to oppose greater competition and consumer choice in health insurance markets. As public health insurance became more popular, Medicare for all would become more possible.
If we succumb to reparations for descendants of slaves, there are a few things to consider concerning who pays what to whom.
Two obvious nonparticipants would be President Barack Obama and me. Obama shouldn’t be eligible because of his heritage. He may be considered African American, but he’s certainly not a descendant of slaves. As for me, my father was born in Italy as were my mother’s parents. So, Obama shouldn’t get anything, and I shouldn’t have to give anything.
Obviously, there will be millions of exemptions and why should anyone in non-slave states be required to pony up?
Those who get whatever must prove that they are descended from slaves. Those who give whatever must be proven to be descendants of slave owners.
As the Civil War was winding down 150 years ago, something logical and reasonable was tried — reparations in real time. Gen. William T. Sherman’s Special Field Order 15 set aside confiscated Confederate land so that “each former slave family shall have a plot of not more than 40 acres of tillable ground.” It wasn’t in the order, but some families also received leftover Army mules, so it became known as “40 acres and a mule.” Then after President Lincoln’s assassination, President Andrew Johnson reversed Sherman’s order, giving the land back to its former Confederate owners.
Consequently, we are left in an irresolvable pernicious catch 22.
Ettore “Ed” Cattaneo
North Cape May