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Let’s Celebrate Medicare by Expanding It

Just after her 65th birthday, a patient limped into my office and apologized for not having shown up in months. She had not been able to afford a visit. Now on Medicare, she was able to address her medical problems. Within a month, she had seen her kidney doctor and an orthopedist. Within a few more weeks, she would have the knee replacement that had been recommended years before. A previously “noncompliant patient,” she was keeping all her appointments – now that she could afford them.

As the nation notes the 48th birthday of Medicare this week, let us celebrate what we have achieved. But let us ponder this as well: This patient – and my many other pre-senior citizen patients with medical needs – would have been better off with coverage earlier. Maybe her kidney failure would not have progressed. She was lucky to have a job she could do while “hobbling around,” she says. Others can’t work due to pain and can’t get surgery because they are unemployed and uninsured.

Access to health care for all

The real celebration of this important milestone would be to improve Medicare and extend it, providing access to health care for all.

Consider these facts:

•  According to a study by the Commonwealth Fund, elderly individuals on Medicare were more satisfied than people with private insurance. (Only 8 percent rated their Medicare as fair or poor compared to 20 percent for employer-sponsored insurance and 33 percent for individual policies).

•  Medicare patients were less likely to have access problems due to cost (23 percent as compared to 37-39 percent for private insurance) and had fewer medical bill problems (21 percent and 39 percent respectively).

•  Traditional Medicare is more efficient with its 1.4 percent overhead (according to the Centers for Medicare and Medicaid Services) as compared to 12-25 percent for private insurance.

•  Lack of health insurance accounts for 45,000 deaths annually in the United States. Behind these statistics are 45,000 human beings whose lives might have been saved had they received medical care.

•  While the Affordable Care Act will reduce the number of uninsured, a recent survey showed that in 2016 about 30 million people, 80 percent of whom are U.S. citizens, would still be uninsured. In North Carolina, that number will be 1,268,000 (which could drop to 790,000, if N.C. lawmakers were to accept the Medicaid expansion).

Improved Medicare for all would be financed by a single-payer system in which one public entity would pay the bills, while the delivery of medical care would remain largely private. The program would eliminate all co-pays and deductibles, and be funded by equitable taxes amounting to less than what most people pay today for insurance premiums and out-of-pocket expenses. The billions of dollars in savings in administrative costs and negotiated drug costs would be more than adequate to provide universal coverage as well as improved services.

Do you think that extending Medicare to all is a liberal fantasy?

GOP doctor pushes ‘single payer’

Dr. David May, the gun-toting Republican chair of the Board of Governors of the American College of Cardiology, recently wrote an article advocating a single-payer system. He notes that it would save money, promote choice, provide transparency in costs, capture data that would allow to us improve outcomes, and allow physicians – rather than insurance companies – to be in charge of health care. He concludes that our current system is un-American and that his proposal is “quite Republican.”

This is a month to celebrate freedom. July 4 marked the anniversary of freedom for Americans from tyranny. Let’s end the month celebrating the freedoms that Medicare gives our seniors: the ability get needed medical care with less risk of financial devastation.

How much better it would be if we extended that freedom to all!

Jessica Schorr Saxe

Jessica Schorr Saxe is a Charlotte physician who is chair of the local chapter of Physicians for a National Health Program.

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