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Impact of Medicare for All

Health care was part of the Democratic presidential

Health care was part of the Democratic presidential debate Tuesday night in Des Moines, Iowa. From left: businessman Tom Steyer, Sen. Elizabeth Warren, D-Mass., former Vice President Joe Biden, Sen. Bernie Sanders of Vermont, former South Bend Mayor Pete Buttigieg and Sen. Amy Klobuchar of Minnesota. Credit: AP/Patrick Semansky

Your article “Debating Medicare for All” [Business, Jan. 12] states that the U.S. health insurance (not care) system imposes a hefty tax on the middle as well as poor classes, even those in the Affordable Care Act (Obamacare) with copays, out-of-network costs, uncovered prescription drugs, and uncovered dental, vision and hearing-aid costs.

One of the biggest expenses in U.S. health insurance, administrative paperwork, is 31% of total U.S. health expenditures compared to 16.7% of Canadian expenditures.

A study published Jan. 7 in the Annals of Internal Medicine, “Health Care Administrative Costs in the United States and Canada, 2017” concluded the following: “U.S. insurers and providers spent $812 billion on administration, amounting to $2,497 per capita (34.2% of national health expenditures) versus $551 per capita (17.0%) in Canada.” If the United States brought spending on health care administration to Canadian levels, the study found, it could save $600 billion a year on total national health care.

Expansion of the very successful Medicare system to cover all Americans would cost millions of administrative jobs for those currently working in corporate health insurance, but it would yield tremendous savings.

It’s time to put patients’ health care before corporate profits, and for U.S. health care to finally enter the 21st century.

Ed Ciaccio,

Douglaston

Editor’s note: Ed Ciaccio is a nonmedical member of Physicians for a National Health Program, a nonprofit advocacy organization.

As a retired physician, I appreciated “Debating Medicare for All,” which projected financial problems for the health systems on Long Island if universal Medicare comes to fruition.

Besides the impact on hospitals, I would anticipate cutbacks in benefits for seniors, who contributed for multiple decades to Medicare and would be forced to bear the cuts to keep the plan functioning. As of 2019, it has been estimated by Medicare trustees that the plan can remain solvent only till 2026. Adding increased financial stress to an already struggling system does not seem prudent.

Robert A. Klein, MD,

Garden City

As a practicing pediatrician and president of Allied Physicians Group, a partnership of 33 pediatric practices, I read your article relating to Medicare for All and single payer with great concern.

Medicare for All sounds wonderful, but when you look at where our current Medicare for seniors system is headed, it is clear that it will not work.

Most seniors are happy with their Medicare and most physicians who provide them care accept it.

However, Medicare payments to physicians and hospitals are significantly less than most commercial insurance. In fact, most providers could not maintain their practices and hospitals will struggle if they relied solely on Medicare levels of reimbursement. 

Perhaps more support for pediatric care and pediatricians’ recommendations relating to health and lifestyles would be a better investment for steering our nation toward a less costly health care system.

I am fortunate to see patients from birth through young adulthood — before lifestyle and environmental effects begin adversely impacting their health. Pediatricians emphasize healthy diets and lifestyles that, if followed, would avoid many costly and chronic diseases. Investing in quality pediatric care and health early in life will provide a tremendous return for all.

Gary Mirkin,

Great Neck

I think that the hospital executives quoted in “Debating Medicare for All” are being disingenuous in prophesying that Medicare for All would destroy hospitals.

First, research-and-development money does not come from insurance companies but rather from the National Institutes of Health, pharma and biotech companies, and venture capitalists. Many countries with single-payer systems are innovative and have much better outcomes than the United States in many medical areas.

Second, we would need to overhaul our system. Much waste in our health care system needs to be reined in, including the practice of paying executives at so-called nonprofit hospitals multimillion-dollar salaries. Yes, there would be increases in waiting times for noncritical procedures, and tough choices must be made (many are already being made by insurance companies motivated by profit).

It would be worth it to ensure that no American has to go bankrupt due to medical expenses. One lesson we could learn from Canada’s Medicare is that it was phased in over years, province by province. Here, it could be expanded by age groups or other criteria until all are covered.

Suzanne Mueller,

Great Neck

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