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El-Sayed and Johnson: A citizen’s guide to Medicare for All

February 16, 2021

Topics: Quote of the Day

By Abdul El-Sayed, M.D. and Micah Johnson, M.D.

Sample excerpt:

When analyzing how health reform proposals do (or do not) address these problems, it is also helpful to keep in mind the “active ingredients” of Medicare for All described in Chapter 3. To review the six key elements of M4A:

  1. Universal coverage. M4A guarantees health coverage to every American.
  2. Comprehensive coverage. M4A guarantees that Americans’ health coverage is comprehensive in terms of the range of covered benefits, the availability of a wide range of clinicians and hospitals, and minimal or no financial barriers to receiving care.
  3. Pricing power. M4A can wield considerable negotiating leverage to rein in the cost of drugs, hospital stays, and physician services.
  4. Administrative efficiency. M4A eliminates the high overhead costs of private insurance companies and reduces the administrative burden on providers and patients.
  5. Progressive financing. M4A allows healthcare to be financed progressively, replacing the regressive financing of private insurance.
  6. Public accountability. M4A would be accountable to the American public, rather than shareholders.

Oxford University Press:
https://global.oup.com… or https://medicareforallbook.com


Comment:

By Don McCanne, M.D.

Abdul El-Sayed and Micah Johnson have produced an excellent primer on Medicare for All. Since further changes in our health care system are inevitable, it is a book that will be useful to everyone. I’ll mention here how it will be useful particularly to the novice and also to the seasoned health care reform activist.

First of all, it is very basic and highly readable, not getting lost in technical health policy jargon, yet it is still very clear and comprehensive enough to cover the subject well.

For those who do not understand the basics of Medicare for All, and for those who have many questions and need to fill in the blanks, this book will do that. It first provides a diagnosis of health care problems in America and how we got here. It then discusses the fundamentals of Medicare for All policy and how such a program would be designed. It discusses the important point of how to pay for it, and then discusses the alternatives, explaining their deficiencies. The book closes with the politics of reform and how we must organize for it – a section that will be of more interest to the activist, though perhaps somewhat disappointing to some because it does not show us a way to get around the work that needs to be done.

For the seasoned reform activist, not much new in policy is revealed, but, importantly, it does bring policy considerations up to date. It is also very accurate, which is important because even some of us who are very well informed may still be carrying ancient misconceptions about health policy, or be buried in ideology that will keep suppressed important variations in health policy. On the positive side, the simple but informative straightforward rhetoric gives us a common language for communicating the concepts which will help avoid diversions into divisive ideology instead of policy. This is not to say that ideology is not important since the book does address “We the People.”

The timeliness of this book is especially apropos. President Joseph Biden has promised us that he will advance reform by building on the Affordable Care Act and maybe by adding a “public option.” Sadly, this reveals how uninformed our president is. Yes, he was involved in the Obama administration’s reform efforts, but his understanding of policy, based on his public statements, seems to be limited to the Obama model. For instance, he has stated that we cannot afford a single payer Medicare for All model when the opposite is true. His reform will increase costs while failing to repair most of the deficiencies such as those implied in the excerpt above, repairs that automatically improve spending in our health care system.

The president is very busy, and I doubt that we can get him to read the book, as readable as it is. If he did, he would recognize that he is headed down the wrong path. It would be especially helpful if his policy staff did read it, but they are all experts in policy and likely believe that they would not benefit from it, not realizing that the ACA approach is branded in their brains, displacing important policy considerations. That must be the case since they are not adequately addressing the profound waste due to our administrative inefficiency, which must be addressed if we are to have a health care financing system that is fully accountable to the public.

Buy it. Read it. Share it. And then act on it.

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About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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