The Affordable Care Act (ACA) or Obama Care, as it is disparagingly known, is about to become history. It has not been a best method for a national health care system anyway. The problem built into the ACA is that it is insurance company based. Healthcare insurance company profits and costs unnecessarily increase the overall cost of health care for people and unnecessarily complicates the system.
Now is the time to rethink how to remake national health care into a least cost and best care system. Medicare and the Centers for Medicare Services (CMS) has been a positive force in reining in health care prices for many years now. Medicare is a single payer system that is not insurance company based.
It has been in just the last few years since the Affordable Care Act was implemented, injecting health care insurance companies into the system, that prices have spiraled out of reach for more and more people.
A single payer system for national health care has long been the most cost effective proposal for a national health care system, for at least two reasons. The first is it takes out the cost of health care insurance companies. Secondly a national health care system has the power to balance the power of what has become a profit centered health care industry. And best of all is it will cost individuals the same or likely much less than the current mish-mash of Obamacare as insurance company profits and costs are taken out.
Here are some calculations that support that contention:
The current Medicare payroll tax rate is 1.45%. The current civilian labor force, age 16 years and older, 2011-2015 is 63% of a total population of 323,127,513. Per capita income in past 12 months (2015 dollars) 2011-2015 is $28,930. (IRS)
The current average outlay for health care is now, $4,410.49. (28,930*1.45 = $419.49 in Medicare tax plus $3,991 in health Ins. costs, See table below). The best ACA Platinum plan has a premium of $4,360.00. That is a cost of 15.07% plus 1.45% for Medicare withholding tax for a total of 16.52%
If the ACA was replaced with a single payer system and Medicare payroll taxes were raised to 15.25% the single payer system would collect $902,120,372,021.00 or $902 billion. (4,410.49/28,930 = 0.1525, or 15.25%), (323,127,513*63.3% = 204,539,716* 4,410.49 = 902,120,372,021) According to CMS, private insurance plans paid $802 billion in health care claims in 2014.
Although this data does not take into account the wide variations of ACA coverage, it clearly shows that a single payer national care system would not cost people more.
The most significant benefit would be that by taking out health care insurance company profits and costs, there would unquestionably be a reduction in the individual costs per person for health care coverage under a single payer system.
“The five largest health insurance companies – WellPoint, United Health, Aetna, Humana, and Cigna - … earned over $3.3 billion in profits [between April and June 2011].” “Profit in the health insurance industry is the single greatest barrier to building an efficient, sustainable system of healthcare in this country.” (Sachin Shah, a physician affiliated with Doctors for America)
The Mayo Clinic is a wealthy non-profit institution whose CEO makes around $2 million a year. The CEO of Blue Cross/Blue Shield of Illinois, a non-profit insurance company, made $16 million in 2012. (Forbes)
We should begin now to gear up the Centers for Medicare Services to handle an increase in participants, then plan to raise the Medicare payroll tax to 15.25% at the end of 2017 and at the end of the current year health insurance contracts, throw the ACA baby out with the bath water. In that way a smooth transfer to a single payer can occur with no one losing heath care coverage and everyone in this country will have the best healthcare coverage at the least cost.
_________________________________________________________________________
References
