Thoughts on debate topics – Medicare for All

This is the second post on a topic featuring in the Democratic Presidential debates of the past few nights where I think there was a chance that was missed to make some key points.  I decided to offer this one after listening to what I thought was a totally misunderstanding in most of the commentary on this morning’s edition of Morning Joe, although I thought that Kamala Harris during her segment made some important points.  I will post one more piece later on “socialism”

There are problems with Medicare even in its current iteration, and these need to be addressed before expanding it into a Medicare for All plan of any kind. 

First, the reimbursement rate, which is controlled by Congress, is usually insufficient, causing some physicians to refuse to accept patients whose only insurance is Medicare.  Yes, Congress usually gets around to fixing at least partially that reimbursement rate.  This is an issue that by itself needs to be addressed.

Second, the Part D coverage for prescription drugs is a total gift to Pharma as a guarantee of excessive profits, one which they maintain not only by extensive lobbying and campaign contributions, but by direct advertisement to potential patients, advertising that raises the cost of the drugs just as much as does the excessive compensation to executives in the industry.  The bans on importation of the very same drugs from safe countries like Canada and on Medicare negotiating on prices also keep prices artificially high, making Medicare more expensive than it needs to be,

And third, Medicare is incomplete in its coverage, a point which Harris clearly addressed on Morning Joe.   Like much of America’s medical coverage. Medicare tends to cut off at the neck —  that is, it lacks coverage for dental, vision, and hearing.  While it is true that including these would raise costs to some degree, many of those costs would be offset by things like lower cost on Part-D, and further were Medicare to fully fund wellness programs that reduce costs significantly for later treatment.

But let’s talk about the real issues, that are regularly discussed in a distorted way

–  can I keep my doctor?

–  what would happen to my taxes

–  why should those here illegally have access to such health insurance

–  what about all those people are employed by insurance companies

–  would hospitals close because of the lower reimbursement rates (Delaney’s arguments, and he did not disclose that he is invested in the current health care system

–  why would we want “bureaucrats” making medical decision