Is ‘Medicare for all’ the solution?

Enloe Medical Center CEO Mike Wiltermood doesn’t like to be seen as taking a stance on health-care financing. It’s not his job to have opinions, he said, but rather to make the best of whatever system is in place.

But he also has an insider’s awareness that the financial pressures in health care are getting heavier as the baby-boom generation retires, and that the current system isn’t working well.

“I readily acknowledge that things have to change,” he told an audience of about 100 people Tuesday (March 7) at the Enloe Conference Center.

Wiltermood was moderating an Enloe-sponsored forum that was ostensibly about “the future of Medicare” but turned out to be more about the importance of making Medicare available to all Americans, not just seniors, as the way to solve the country’s health-care crisis.

Two of the three speakers—local family-practice physician Ken Logan and Dr. Bill Keene, the executive director of the California chapter of the national organization Physicians for a National Health Program (PNHP)—were strong advocates of a single-payer system such as Medicare, and the third, Nina Weiler-Harwell, Ph.D., the associate state director for advocacy for the American Association of Retired Persons, appeared to lean that way, though AARP so far has not backed any single-payer proposals.

Wiltermood said in his introduction that an effort had been made to include a panelist who favored a market-driven approach to health insurance, but it had been unsuccessful.

Logan has been a primary-care doctor in Chico for 30 years. He currently is a contract physician at Chico Family Health Center and regularly volunteers at the Shalom Free Clinic.

From his standpoint as a physician, Logan said, “Medicare is good.” In terms of coverage, efficiency and payment to providers, it’s better than the four largest private insurance plans in this area.

And for patients, he added, “it’s the most user-friendly and least obstructionist program available.”

Nina Weiler-Harwell’s focus was on the current threats to Medicare and how the program can be preserved. The biggest issues are rising costs and the desire of some legislators to reduce the federal budget deficit by cutting Medicare.

In response, she said, AARP has mobilized its millions of members to lobby Congress to forestall cuts, successfully to this point. At the same time the organization has a long list of steps that could reduce costs and make the program more sound. They include, among others: better coordination of care; reducing waste and fraud; better use of health-information technologies; and using pilot programs to drive major changes to Medicare.

Weiler-Harwell noted that one large group of patients—people who are eligible for both Medicare and Medicaid and suffer from chronic conditions such as heart disease or diabetes—is responsible for 83 percent of health-care spending in this country.

“If you’ve got the money, you can get really good health care in this country,” Bill Keene stated.

Otherwise, anyone dependent on private insurance is in a crap shoot. As he put it, “You have the choice to pay less for something that’s inadequate or pay through the nose for good care.”

Not only that, 50 million Americans don’t meet the requirements for private insurance and simply go without, and 45,000 Americans die each year for lack of insurance. He called it “death by insurance company.”

He said PNHP, which nationwide has 20,000 members, most of them physicians, applauds the intent of President Obama’s health-care reform, but said it simply won’t solve the problem.

For example, 25 million people would remain uninsured, and millions more underinsured. Costs will go up, and “insurers will find ways to game the system.”

Private insurance is the problem, he said. Its administrative expenses comprise 30 percent of its costs, whereas Medicare’s are only 3 percent. We could save $400 billion annually by extending Medicare to all, he said.

Health care is a human right, he insisted. We have to stop thinking of it as a commodity. It’s really much the same as public education, which we all support with our tax dollars even if we don’t have children in school.