Analysis by Reporting San Diego
Sep 13, 2017 (San Diego) Senator Bernie Sanders (I-VT) is proposing a reform to the medical system that would reform the medical system. This would place the American delivery system closer in line ro the rest of the industrialized world (and many developing countries). The United States is an outlier. Nor is the system the most efficient in the world, or the best. However, it is the most expensive. This is a problem. It is also a system that places medicine as a business decision, not a right.
This bill is likely dead on arrival, in a republican controlled Senate. Regardless, those on the hard right, such as Senator John Barraso, are making the rounds repeating easily debunked talking points regarding the British or Canadian health care systems. Why? They realize that sooner or later a more efficient, less expensive health care system will have to take shape. Why? Even with the Affordable Care Act, a medical system that values profit over everything else, will collapse under its own weight.
Given patient outcomes, and the fact that Remote Area Medical runs clinics for the very poor in Appalachia, an argument could be made that the system is already collapsing. Any system that cannot competently serve those who are very poor, is one that will fail in case of a major epidemic disease.
There were improvements with the ACA. More people are covered under health insurance. Some things that make sense in a healthcare system, but not in a business model, have now been forbidden. For example, not insuring people with preexisting conditions.
The system, as proposed, would replace the current for profit system, with a single payer system in four years. This would extend Medicare to the whole population, making healthcare a right. In The first year it would extend this to all over 55 and 18 and younger the second year to all over 45, the third year all over 35 and in the final year to every resident of the country.
How to pay for this is not resolved yet. Like the California plan, shelved by Speaker Anthony Rendon in California, this is the sticky point. We know public health spending is not done by the government. However, the US spends the most in healthcare
Healthcare run by a single entity should be cheaper and more efficient. Now, the system as proposed by Sanders would run $32 trillion over ten years. However, as the system exist right now, the U.S. Is on track to spend $42 trillion.
Who supports this: Here are the Democrats who have endorsed it.
- Senator Tammy Baldwin (D-WI)
- Senator Richard Blumenthal (D-CT)
- Senator Cory Booker (D-NJ)
- Senator Al Franken (D-MN)
- Senator Kirsten Gillibrand (D-NY)
- Senator Kamala Harris (D-CA)
- Senator Martin Heinrich (D-NM)
- Senator Mazie Hirono (D-HI)
- Senator Patrick Leahy (D-VT)
- Senator Ed Markey (D-MA)
- Senator Jeff Merkley (D-OR)
- Senator Brian Schatz (D-HI)
- Senator Tom Udall (D-NM)
- Senator Elizabeth Warren (D-MA)
- Senator Sheldon Whitehouse (D-RI)
The reality is that the country now believes in single payer. The government has a role in healthcare. It is a matter of time. If we fail this test, well, consider this, Costa Rica has an efficient single payer system. It is hardly just Canada or England. The question is how we get from this point to that point.
We know that this is dead on arrival. We also understand that those committed to keeping healthcare in private hands will continue. But we expect to see this become a defining issue for the 2018 midterms and the 2020 presidential race.
This also will divide Democrats. Neither Leader Nancy Pelosi or Senate Leader Chuck Schumer support this. For a few this does not go far enough. In our view the 2018 midterms have now started.