The U.S. health care system was an important issue in the last midterm election, and it is coming to a head in the 2020 election.
A poll by RealClear Opinion Research conducted earlier this year showed that health care is the leading issue of concern to voters at 36 percent - surpassing the economy (26 percent), immigration (15 percent), education (11 percent), and foreign policy (3 percent).
Here is what else respondents said:
• The system is broken; we need a completely new system: 28 percent;
• The system is not working well; we need to improve the system we have now: 39 percent;
• The system is good but not perfect; we need to continually make improvements: 29 percent;
• The system is working well; we should not make any significant changes at this time: 4 percent.
Our health care costs lead the world by a significant margin. The Center for Medicare and Medicaid Services reports U.S. health care costs total $3.5 trillion annually, which is an average of over $10,000 per person.
According to data from the U.S. government’s “National Health Expenditures Highlights 2017,” costs for health care exceed 17 percent of the country’s gross domestic product.
Multiple Democratic presidential candidates are providing visions for improving health care that they would seek if elected. “Medicare for All” is the most talked about of the universal health care proposals that the candidates have presented.
There are several reasons for the attraction to a Medicare health care model. For example, according to the U.S. government’s National Health Expenditure Data, with adjustments for inflation, Medicare costs are down 1.8 percent and private health insurance prices are up 16.5 percent in a sample period from 2009 to 2016.
It has indeed been the case that increased costs of the U.S. Medicare program have consistently been lower than the increased costs of private insurance since Medicare’s inception.
This is significant since the elderly under Medicare have chronic and complicated conditions at a greater rate than the general population.
Proponents of the Medicare for All proposals point to lower administrative costs, increased bargaining power of the government in services and pharmaceuticals, reduced profiteering, comprehensive budgets negotiated between the government and health care institutions, better access to address chronic and catastrophic conditions coverage and improved access to home care and community long term care.
The claim is that these factors will lower costs and improve outcomes.
Another reason for interest in a Medicare-like system is that the U.S. Medicare system has strong favorability among users. This popularity is not surprising since interest in universal health care existed even before Medicare was enacted.
The first proposal for universal health care dates to 1904, with subsequent efforts by Presidents Teddy Roosevelt, Franklin Roosevelt, and Harry Truman. Covering the elderly was considered a logical first step.
Current polling shows around two-thirds of Americans would like to see Medicare cover all Americans.
When asked if the change would eliminate private insurance, the support drops to 55 percent. Nonetheless, respondents all felt they need more education on this approach.
There is enough to this idea to be worthy of further examination. Watch for future columns on this issue.