How to Manage Medicare for All
You may have seen the cartoon I shared earlier about the relative simplicity of a single-payer system compared to the complexity of our current system. The message is “KISS” – Keep It Simple, Stupid. But how can government manage medicare for all, and won’t the government screw it up?
I believe government can do what any well-managed company does, sometimes better. Start with knowledge of Why American Healthcare is So Expensive to begin with. Then agree on an objective and measure progress against established goals, adjusting as necessary to achieve them. And hold those responsible accountable.
PRIMARY GOALS: (1) 100% population coverage and (2) cut overall costs in half to match the average of other advanced nations spend on healthcare. Establish timeframes for those goals, such as in 4 years so voters can decide how well each administration achieved those goals and vote for new leadership if warranted. An important secondary goal should be to improve measures of health outcomes, such as average longevity, infant mortality, etc., realizing that these may take longer to be affected.
KEEP IMPROVING: Once one objective is reached, established another. The cost savings benefit of becoming mediocre (rising from near bottom to average instead) would be over $1.5 trillion PER YEAR. That’s based on current spending of $3.5+ trillion/year, which currently is twice the average. But don’t stop there. With the confidence of meeting the first objective, establish another that’s more aggressive, such as matching Singapore, the current world leader. Meeting that new goal would save us over $2.5 trillion/year.
TRICKLE DOWN: Those are just cost savings from reduced healthcare spending. No one seems to be talking about the downstream benefits of a healthier workforce. I’m talking about increased health span (not just lifespan) and worker productivity, as well as the higher wages expected when workers no longer depend on employer group insurance and become free to seek better jobs elsewhere or start their own businesses.
PUBLIC HEALTH FOCUS: As the nation takes on the role of public health insurance, we will naturally begin to notice the many factors that impact our success, and we’ll begin focusing on wellness and prevention. Along with that may come policies aimed at obesity, poverty, gun violence, toxic contamination, addiction, disease management, public education, and the many other factors impacting public health.
