Rishi K. Saxena, M.D.

Guest Columnist

Rishi K.Saxena, M.D., has been a practicing physician in Murfreesboro for 20 years.

I have been a practitioner of medicine for more than 25 years and have interactions with thousands of patients .

I will outline in this article that Medicare for All can be a viable option for reducing health care costs as well as making sure that every legal American resident get basic health care at affordable price.

First few facts about health care as it stands todayL

40-50% of American get their health care from the government via Medicare, Medicaid, veteran healthcare, Tricare healthcare, etc.

Medicare overhead is around 2% while private health insurance overhead is around 10%-20%.

Medicare offers the broadest selection of providers, hospitals and there is no pre-certification needed to get appropriate testing done without the need for making a call from doctor's office before testing.

Contrary to popular belief, private insurance offers a limited choice of doctors and hospitals. Prior to testing doctor's office patients often need to call their insurance company and get approval for which test the doctor orders.

Sometimes a patient has to wait 48-72 hours to get a test or medicine approved by the insurance company. Insurance companies also have high deductibles, sometime as high as $10,000 and co-pays of $50 so most of the money comes out-of-pocket from the patient for health care.

Questions regarding long waits in countries which have single payer system like the U.K. or Canada are that they spent around $4,000-$5,000 per capita for their health care versus the U.S. spending around $10000 per capita for health care.

If you provide decent funding than people don't have to wait for proper health care in our country.

Regarding ways to lower cost of delivering good health care to all Americans include:

Drug companies mark-up drug prices to 300%-400% in this country compared to Canada, U.K. and India. Medicare could negotiate prices for medicine on behalf of U.S. taxpayers and we should not pay higher costs of medicine than other countries.

Hospitals have been overcharging Medicare because of a strong lobby and that cost could be negotiated and lowered.

Tort reform will cut down cost of defensive medicine practiced by doctors just to avoid lawsuit and it will cut-down cost of healthcare tremendously.

By streamlining and lowering overhead cost from 20% to 2%-3%, we will cut-down health care cost tremendously.

Here are my suggestions regarding implementing such a program:

For American residents above age 65, eliminate Medicare part B and D (outpatient care and medicine cost). It will help lot of senior citizens who have to choose between food and medicine and government could institute a small co-pay for outpatient office visits and medicine ($5-$10) to avoid overutilization of services.

People who are poor (below poverty limit) or disabled could continue to have health care services provided through Medicaid .

Legal U.S. resident who are not part of an above group can get Medicare coverage by paying an additional 5%-7% of their salaries or adjusted gross income to use Medicare as their health care provider of choice. This 5%-7% number could be changed based on expenditure of providing health care to this group.Over time with improving efficiency in delivering such care, costs will go down.

In summary it is possible to provide affordable healthcare to all Americans.

Rishi K.Saxena, M.D., has been a practicing physician in Murfreesboro for 20 years.