Save lives and money by expanding Medicare to all

With media attention focused on the debt-ceiling drama in Washington, and with so many Americans rightly preoccupied with the frightening level of joblessness and bleak state of the economy, it might seem strange to urge a national celebration of Medicare’s 46th anniversary this Saturday, July 30.

After all, if we’re to believe top lawmakers, Medicare is part of the problem, right? Aren’t we supposed to be talking about raising the eligibility age from 65 to 67, reducing benefits, increasing seniors’ co-pays and deductibles or, even more dire, abolishing the program altogether and handing seniors vouchers to buy private insurance?

Wrong. Despite its market-obsessed detractors and those who would weaken the program in the name of deficit reduction, Medicare is the solution, not the problem. More precisely, an improved Medicare for all – a single-payer health system – is the right prescription for treating not only our health care woes, but our ailing economy as well.

How so?

The biggest albatross around the neck of our health care system is the private insurance industry, which remains firmly entrenched under the new federal health law.

Thanks to companies like UnitedHealthcare, WellPoint, Aetna, Humana and Cigna, our nation’s patients, businesses, and health providers are chronically tormented by skyrocketing premiums, denials of care, endless paperwork and bureaucracy, and the spectacle of obscene CEO salaries and insurance company profits.

And what does this so-called system get us? Fifty-one million people who have no coverage at all; 45,000 annual deaths linked to lack of coverage; a million personal bankruptcies annually (62 percent of the total) linked to illness or medical debt; and World Health Organization indicators that put us in 37th place globally, even though we spend twice as much per capita as any other nation.

Waste in our system is staggering. Research shows about 31 cents of each U.S. health care dollar is currently spent on administration, over half of which is unnecessary. That translates into $400 billion wasted annually. If we recaptured that money and applied it to clinical care – as we could under a single-payer system – we’d be able to assure everyone comprehensive, first-dollar, high-quality coverage.

So how does this relate to Medicare? As it happens, Medicare is an excellent model for a more rational, single-payer alternative to our present dysfunctional arrangements.

Medicare works. Patients go to the doctor or hospital of their choice. It’s efficient: its overhead is less than 3 percent, less than a quarter of private insurers’. Costs rise more slowly in Medicare than in the private insurance sector.

Medicare isn’t perfect, of course. The program can be empowered to negotiate with drug companies for lower prices. The deductibles and co-pays can be eliminated. Its funding can be augmented from general revenues or a miniscule tweaking of the general payroll tax rate.

But thanks to Medicare, the health and economic security of millions of seniors, the severely disabled, and our nation’s families have dramatically improved. It should not be weakened or destroyed. Those who advocate doing so will reap a whirlwind of popular rage, as GOP Rep. Paul Ryan, an exponent of ending Medicare, has found out.

In such an environment, the obvious approach of President Obama and Congress should be to join the American people in embracing Medicare, not to cut it. But right-wing ideologues, with personal assists from the president himself, have forced a debate on the wrong issue: the debt ceiling, as opposed to enhancing the health status of the American people.

The paradox in this flawed debate is that the solution to our nation’s fiscal problems would be greatly simplified by the creation of a streamlined, efficient and high-quality single-payer Medicare-for-all program. Data suggests that if we had a single-payer system like other industrialized nations, we’d currently have a federal budget surplus.

The 46th anniversary of Medicare should be a time to celebrate its achievements and to strengthen it by expanding it to all.

Quentin D. Young, M.D., is national coordinator of Physicians for a National Health Program ( and former chief of internal medicine at Cook County Hospital in Chicago.

Not-for-Profit Hospitals unfairly receiving Tax Exemptions

In this era of tight public funds afflicting virtually every state in the nation, there is one revenue source that has been all but neglected in the public debate: the subsidy of “not for profit” private hospitals by exemption from sales and property taxes being the typical form.

This has been reexamined by the remarkable Illinois supreme court decision in the Provena Covenant case: the Court ruled that the Provena hospital group failed to meet the charitable health care provision required to enjoy the property ands sales tax freedom they had enjoyed.

Illinois law requires non profit hospitals to provide charity care (free or reduced care) which eases the financial toll on government- and nothing less- to qualify for property tax exemption. When non profit hospitals fail to provide charity, some poor, uninsured, and underinsured patients find themselves in public hospitals funded by public dollars and stretched beyond capacity. This failure to meet legal requirements results in the loss of tens of billions of tax dollars across the nation at a time of great national need.

Other patients afraid to incur debt they can’t repay, delay their medical treatment, adding to its eventual cost and jeopardizing their health outcomes if not their lives.

In the current recession, budgets at every level of government are strained and people are in peril. The Illinois Supreme Court has decided that non profit hospitals must deploy the public funds they are given to support the public health safety net both the poor and the taxpaying public deserve.

Dr. Quentin Young is the Chairman of the Health and Medicine Policy Research Group

Dr. Quentin Young’s Reply to Robert Gibbs

[Dr. Quentin Young is National Coordinator of Physicians for a National Health Program]

August 10, 2010

Mr. Robert Gibbs
1600 Pennsylvania Avenue N.W.
Washington, DC 20500

Dear Mr. Gibbs,

I’m writing you concerning remarks attributed to you and reported widely today. When I first read your interview, my reaction was incredulity. The quotes you offered reflected the worst Tea Party disinformation. I and many others strongly believe these intemperate and mendacious attacks on progressives dissatisfied with some of the administration’s incredible concessions to the militant right-wing Republicans are extremely destructive.

Both the content and the formulation you ascribe to the “professional left” must make Karl Rove proud. One right-wing party is more than enough for this troubled nation. For the spokesman for the other party, the administration, to embrace the hard-right’s position is alarming. Your statements take a page from the infamous (and discredited) House Un-American Activities Committee.

I believe that unless you retract the insulting description of deeply committed citizens, you will drive off those of us who supported the President’s campaign and have anguished over the fruitless lurches to the right that have characterized the first half of the President’s first term.


Quentin Young, M.D., M.A.C.P.
Chicago, IL

cc: President Barack Obama