In Part 1 of his 3-part ‘Real News’ interview, Gerald Friedman, a professor of economics at the University of Massachusetts in Amherst, explains how a single-payer plan in Maryland would cover everyone, improve outcomes and make business more competitive:
from the transcript:
PAUL JAY: So before we dig into some of your research, just sort of give us the bigger picture of why this would make sense for Maryland.
GERALD FRIEDMAN: Well, the big picture is that health insurance provided by competing private companies is inherently inefficient and destructive of people’s health. I mean, that’s a strong statement, but I think it is well founded.
The problem with private health insurance is that it’s not like selling shoes. If you’re a shoe company, you want to sell more shoes, you want to make a better quality shoe at a better price to attract more business. Health insurers don’t want more business. They want to get rid of sick people. Eighty percent of your costs as a health insurer are incurred for about 20 percent of your people. You know, in some places it’s 90-10—90 percent of your costs go to 10 percent of the people. If you can find those people, identify those people, and figure out a way to get them to go away, go to a different company, then you will be in a position to lower your prices and increase your profits. That is what health insurers try to do.
In Part 2, Gerald Friedman explains how a single-payer plan in Maryland would cover everyone, improve outcomes and make business more competitive:
from the transcript:
PAUL JAY: So let’s dig in into your study and what you found. So you have a section on savings, and point one is administrative costs. So explain what you found there.
GERALD FRIEDMAN: Okay. Well, first of all, there are the administrative costs of the health insurers themselves, who devote a great deal of energy and resources to, first, screening people and supervising what doctors do in order to drive away people who will need extensive care.
The average health insurer in Maryland has what they call a medical loss ratio of 85 percent. Now, the medical loss ratio is the proportion of health insurance premiums that are actually paid out to provide the health care. In Medicare, the medical loss ratio is 98 percent.
Wall Street doesn’t like high medical loss ratios. To them, to Wall Street, a high medical loss ratio means that you have too many sick people, you’re not running enough profit. They like the medical loss ratios to be low. We, the consumers of health care, normal people, we like a high medical loss ratio. We want the money we put into the insurance plan to be paid out in benefits.
And in Part 3, Gerald Friedman details how to pay for single payer health insurance:
from the transcript:
PAUL JAY: Alright. So in the last segment, we went through your report and we looked at the savings, which came to just over 24 percent over existing insurance coverage and health care expenditure. But that doesn’t cover everything, does it? And then so what isn’t paid for out of these cost savings, and how are you going to pay for it?
GERALD FRIEDMAN: Okay. Well, first of all, the cost savings are there. There are also extra expenses, as we were saying, with the Medicaid rate fix. Also, we would be covering everybody. Now 15 percent of the population of Maryland is currently without health insurance. Extend health insurance to them, they’re extra expenses. Also, the plan for the Maryland Health Security Act does away with copayments, deductibles, and all of those expenses. We expect that people would use health services more.
As you may or may not be aware, I am a proud citizen of the teetering-on-the-precipice-of-disaster burg of Baltimore, Maryland. Home of Earl Weaver, William Donald Schaefer, Brooks Robinson and numerous other dead or dying Caucasian nonagenarains who were last nationally relevant in the 1980′s. As part of our tireless quirky charm (hence the name “Tireless Quirky Charm City”), our election cycle for mayor falls on odd-numbered years. I’m sure there’s a boring explanation somewhere, but basically I’m saying (by way of padding) that our mayoral election is this year.
So far, the present Mayor, whose predecessor resigned following a conviction for stealing Target Gift Cards from needy children, has been a stalwart champion of the little man. And of course, by “little man” I mean WalMart and European-style open wheel rally races (the sport of the working man- of Monaco). And lest I forget, there are the least fortunate in our nation, development firms with sufficient capital to buy “bundles” of vacant housing. Ya know, Joe Lunchpail and Johnny BuyALargeChunkOfRealEstateWithCash.
Meanwhile, a few prominent challengers (Otis Rolley and Jody Landers) have emerged, both with visions. Blurry, baffling visions in which a city that constantly kvetches about being flat broke can solve its problems buy making massive cuts to the revenue stream of the same. Rolley has been quoted as wanting to cut the property taxes by fifty percent over eight years. Of course, anti-tax horseshit aside, this raises a more nagging question- how would this benefit the nearly 50% of the citizenry who don’t own their homes?
Look, I understand that for people who owned black and white TVs and phones with dials, owning a home is the end-all-be-all of human existence. But for most young working people, the idea of coming up with ten to twenty grand for a down payment is as laughable as the idea of running a European-styled motor race through the downtown of a majority-black city. As such, it is completely tone deaf in an era when ALL city residents are receiving reduced services due to allegedly slumping revenues to parade around promising tax cuts that will in no way benefit a large segment of the city’s population.
You know who WILL benefit from a big cut in property taxes? Tom Clancy. And of course, all of his millionaire buddies who own waterfront condos. Condos that, I’m sure, have private security and ADT to compensate for the fact that there won’t be any cops around if there’s an issue. And who needs public schools when you have private tutors? Tutors who, hopefully, don’t mind that the welfare of their city is being flushed down the drain because every single one of our city’s politicians is still in the thrall of Reagan’s siren song of trickle down drivel. I really dearly wish that I lived in a world where HALF of the voting population would merit at least a passing mention from one so-called “serious” contender for the top job in Baltimore.
Oh, by the way, did I mention that ALL of these guys are Democrats? Of course they are.
Austerity-Mania has gripped the entirety of the nation’s political class (read: “rich white people”), and sadly allegedly liberal Maryland is no exception. Despite resisting the Republican Wave of 2010 and handly re-electing a (supposedly) liberal Democrat Governor, Maryland’s proposed 2011 budget is long on cuts in both education and public works, and extremely short of tax increases for the wealthy and corporations.
Fortunately, the resurgence in the labor movement sparked by the action in Wisconsin has also caught on here in Maryland- as many as 15,000 rank and file, leadership and progressive activists took to the streets of Annapolis and demanded that Democrats who ran on their reputation as the party of labor “Keep the Promise” and balance the budget in a way that doesn’t decimate their ranks and the collective future of the state.
Governor O’Malley, always the opportunist, appeared and quickly reminded the collected crowd (some of whom greeted him with jeers) that the Democrats value labor not for their contributions, but for their campaign money and their votes:
“Look we have tough decisions ahead of us,” O’Malley said. “But we are committed to staying at the table, and figuring this out together” with the unions, he said.
Note there were no promises to preserve pensions or find a way to balance the budget without vicious slashing of education funding and public works. While the above link claims that the crowd was disarmed, I was there and I can report that the majority in attendance were not sold. In fact, it was widely reported that union leadership had resolved not to allow politicians to participate and that the Governor’s staff simply “insisted” that O’Malley be allowed to address the crowd.
Regardless, to see a crowd in Annapolis of this size should give progressives hope that despite the platitudes of centrist hucksters like O’Malley and OFA, there is a legitimate and robust progressive movement being born in this nation- one that is not dependent on the Democrats and their agenda of surrender- one that will hopefully turn back the insane tide of austerity and redistribution of wealth to the richest Americans.
I stole the idea for this post, but I don’t think John will mind. Below are a few shots I grabbed at the action on Wednesday at the capital. In Annapolis. So if nothing else you can tell your friends that today you learned that the capital of Maryland is Annapolis.
As I mentioned in a previous post, Maryland is possibly the bluest state in the union. Despite no immediate threat to collective bargaining (save for some attempts by municipalities to cover their fiscal mistakes with union wages), over 100 souls braved the winter weather (a flash snow storm that rolled in the night before) to show their support for their brethren in the midwest.
And my favorite shot, in reference to the aforementioned weather…
Perhaps, for once, when people say that “the time is now”…well, maybe the time really IS now.