July Lunch — Healthcare Discussion

If you missed July\’s Democratic Lunch, you missed an informative presentation and discussion on Healthcare proposals. What follow is a summary of Sandra Coyner\’s talk.

Democrats need to start with what we really want healthcare in America to be, then compromise. Don’t compromise first.  That was the advice given by Sandra Coyner, a retired professor, is a and a State Board member of HCAO (Healthcare for All Oregon, a coalition of over 120 member organizations working to educate Oregonians about the possibilities and benefits of a single-payer healthcare system. She explained several approaches to fixing one of the biggest problems in the country right now.

“What are the problems?” she asked.

“It’s too expensive.  It’s not universal. It’s unfair.  Care for the mentally ill is pitiful.  Outcomes are not as good as they should be.”  Those were replies from some in the group of about 25 people attending.

So what’s the solution?  Medicare for All?  Coyner explained this approach expands and improves Medicare, then makes it available to people of all ages, not just those older than 65.  This has been a successful program that everyone loves, she said, paid for not with taxes but by working people who pay into it.  This plan is similar to what Canadians have, not government run healthcare like Great Britain, but government-run insurance.  There’s a big difference, Coyner pointed out.  Medicare for All helps people by paying for healthcare, not by running it or requiring medical providers to work for the government.  Medicare works well because administration costs are low, but a big issue is equitable pay for doctors.  Discussions are on-going about what to include in an expanded and improved Medicare. Dental coverage? Eye care?  Long term care and mental health are very expensive and will probably have to be dealt with separately, Coyner said. Medicare is not to be confused with Medicaid, which is 100 percent paid for by taxes so people who can’t afford insurance can get health care.  However, equitable pay for doctors is even more of an issue with Medicaid, and Democrats need to have a discussion about improving that, she advised.

Some people advocate for a Single Payer Plan and while others talk about an All Payer Plan.  What’s the difference?  The All-payer plan is what Germany has now.  They keep insurance costs low by requiring everyone to have it.  They have a lot of payers, so premiums stay low but everything is regulated under an All Payer Plan, something Coyner doesn’t think would go over well in this country.  Single Payer is similar with only one insurance provider collecting premiums and paying for healthcare, greatly reducing administrative costs but a Single Payer plan wouldn’t run the country’s hospitals and doctor’s offices like an All Payer Plan does.

Universal Coverage just means everyone gets insurance, while a Public Option Plan is allowing people to buy into Medicaid.  This idea is being explored in Oregon right now, and there’s no indication people on Medicaid get compromised care.  Insurance companies are afraid of this plan because it could lure away their customers, Coyner said.  Many people are afraid of any kind of plan because of the costs, that doctors won’t get paid enough to buy in, or that it will require higher taxes.  Coyner said the math is on the side of moving to a more universal health care plan.  Studies show that right now, a middle-class working family of four with an income between $75,000 and $125,000 pays a third of their income for health care, if you calculate what’s deducted from their pay by their employer, what they pay for premiums and co-pays and medicine.  Many don’t realize while they may pay a higher tax, or the more favorable term “payroll deduction” going just for their medical coverage, it will still be less than what they are paying out now.  Advocates for any of these plans all want doctors to be equitably paid, and that has to be part of the equation, but doctors could be relieved of burdensome education costs, and having to hire an administrative staff that just takes care of insurance eligibility for patients.

Some people asked if transitioning from what we have now to a new system of healthcare would be a mess.  Coyner said it might, and it would take a long time, and most of us present probably won’t be alive when it’s done.  However, it was pointed out that it only took a year for Medicare to be implemented, back where there were no computers.

Again, while all these plans give Democrats something to argue about, it is important to stay focused and start with what the best plan for the country would be.  There will be compromise, Coyner said, but we shouldn’t start with a compromise.  And, she warned, we all have to stay friends because the 2020 election is Democrats to win….or lose.

Note: Coyner mentioned her campaign includes the Mad As Hell Doctors, who travel around using humor and songs.  Their work can be seen here: http://madashelldoctors.com/videos/

Those interested in getting involved in Health Care for All-Oregon can visit HCAO.org for more information… and join our Healthcare Caucus.