Opinion

Medicare for all would help keep costs down

I have just read the article entitled “Have health care? Brace yourself” in The Hour. It seems like you guys think that if we just make the insurers limit their rate increases to 10 percent everything will be fine and dandy.

I have news for you. Until we get to the real cost drivers of medical care, e.g. outrageous hospital charges, excessive drug costs, doctors ordering too many tests, and we consumers not taking responsibility for our own health eating too much of the wrong foods, drinking too much and not wearing seat belts, costs are going to continue going up at a rate greater than inflation no matter what insurance companies do.

Pricing health insurance is actually pretty simple. To build an insurance rate you start with claims that have been incurred in the prior year. These claims are increased by inflation in medical care expenses into the next year to understand what costs are expected to be. To the expected claims are added the expenses of administrating the program (you can hold insurers feet to the fire on this although it is a minor portion of the total) and a small margin (usually 2 to 5 percent) for possible adverse claims fluctuation. The result could easily be a 28 percent increase given that the population of insured people at present is not at all a cross section of the population.

The governor attempted to introduce cost sharing for the state employee health plan and was rebuffed by the unions. This group, which is substandard from a health perspective, could use cost sharing to reduce excessive costs.

Although I am not a big fan of Bernie Sanders, his idea of Medicare for all is not bad in many respects. Where his idea does not fly is in the funding of coverage. What if the government required Medicare for all, but kept funding as it is for the present health care system? In other words, employers, including states and municipalities would pay the government for Medicare on their employees the way they pay insurers now. Insurers could write supplemental coverage. State governments could provide Medicare for Medicaid recipients; governments could provide supplemental coverage should they choose to do so. Of course individuals could buy in at any age.

The benefit of such a system is that everyone would know what they are getting, costs would be well controlled at Medicare reimbursement rates; drugs should be included at VA reimbursement rates. Insurers could write supplemental coverage to both individuals and groups.

C. Winfield Swarr

Norwalk