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.
See Sue Run (or deficit polling and taxing workers to fund programs for people who could get by without help) [New]
The National Journal polled Americans on questions surrounding the federal budget deficit (linked from Jon Walker). Did Americans blame the safety-net programs for the deficit in the federal budget?
As important, the survey found Americans unconvinced that safety-net programs represent a major source of the deficit problem. When asked to identify the biggest reason the federal government faces large deficits for the coming years, just 3 percent of those surveyed said it was because of “too much government spending on programs for the elderly”; only 14 percent said the principal reason was “too much government spending on programs for poor people.” Those explanations were dwarfed by the 24 percent who attributed the deficits primarily to excessive defense spending, and the 46 percent plurality who said their principal cause was that “wealthy Americans don’t pay enough in taxes.” While minorities were more likely than whites to pin the blame on the wealthy avoiding taxes, even 43 percent of whites agreed.
Given that diagnosis, it is perhaps not surprising that relatively few respondents said they would support major reductions in safety-net programs to reduce the deficit. Fully three-fourths of those polled said Social Security should be cut “not at all” to reduce the deficit, and exactly four-fifths said the same about Medicare. Nearly two-thirds even agreed that Medicaid should be entirely spared from cuts; just 5 percent said it should be cut a lot. There was more receptivity to retrenching food stamps and housing vouchers for the poor (only 51 percent said they should be entirely spared), but even so, just 9 percent said they should be cut “a lot.” Twice as many said defense should face big cuts.
And the accompanying graphic:
The 53% who think “the government taxes workers too much to fund programs for people who could get by without help” left me wondering who exactly are those “people who could get by without help.” Because Wall Street, Big Oil, Big Banks and so on certainly don’t need any government help. Another portion will define “people who could get by without help” as those that receive help from safety net programs. Probably many of those exclude themselves from those who get government help that they don’t need. B. Deutsch at ‘Alas! a Blog’ (linked by Meteor Blades), used data from Suzanne Mettler’s “Reconstituting the Submerged State: The Challenge of Social Policy Reform in the Obama Era” that was published in Perspectives on Politics on September 2010 (pdf) and built a revealing table showing how little many people know about the government programs that they receive a boost from:
Percentage of Program Beneficiaries Who Report They “Have Not Used a Government Social Program” Program “No, Have Not Used a Government Social Program” 529 or Coverdell 64.3 Home Mortgage Interest Deduction 60.0 Hope or Lifetime Learning Tax Credit 59.6 Student Loans 53.3 Child and Dependent Care Tax Credit 51.7 Earned Income Tax Credit 47.1 Social Security—Retirement & Survivors 44.1 Pell Grants 43.1 Unemployment Insurance 43.0 Veterans Benefits (other than G.I. Bill) 41.7 G.I. Bill 40.3 Medicare 39.8 Head Start 37.2 Social Security Disability 28.7 Supplemental Security Income 28.2 Medicaid 27.8 Welfare/Public Assistance 27.4 Government Subsidized Housing 27.4 Food Stamps 25.4
Deutch based a cartoon on the data he gathered: