The most underrated argument for single-payer health care

If there’s one constant in modern American life, it’s paperwork and bills — and it’s rarely worse than it is for health care. If you need some medical procedure, you are virtually guaranteed several hours of tedious form-filling, made much worse by the knowledge that if you mess up, your insurance might not cover it, and the provider will take you for all you’ve got.

Eradicating this needless anxiety is perhaps the most underrated argument for Medicare for all. Universal health care would make living in American society tremendously simpler and less stressful. Even for upper-middle-class people who would pay stiffly higher taxes, the price would be well worth it.

As is, America’s highly fragmented mixture of private and public payers in our health insurance system has created a hellishly complicated billing process. Even simple procedures have to reckon with tens of thousands of different insurance plans, all with different coverage details. Complicated procedures can easily generate multiple pages of different billable events, every one of which has its own separate code.

Unsurprisingly, mistakes are absolutely rampant on both the provider and the insurer side, resulting in many mistaken bills and wrongly (or, quite often, deliberately) denied claims. The end result is a huge industry of people doing nothing but pushing paper in circles — and millions of ordinary people who are forced to become amateur claims adjusters to avoid losing their life savings due to bureaucratic error.

This is why America’s medical administrative expenses are nearly triple the average of rich countries in percentage terms — a major engine behind the cost disease that is slowly destroying even supposedly good private, employer-provided plans. The Kaiser Family Foundation found that in 2017, the average single-person premium for such insurance was $6,690, while for family coverage it was $18,764. That is an increase of 49 and 55 percent, respectively, compared to 2007 (not adjusted for inflation).

Cost sharing has also increased sharply. The fraction of employer-sponsored policies with a general deductible has increased from 59 percent in 2007 to 81 percent in 2017. The average size of those deductibles has similarly increased from $616 in 2007 to $1,505 in 2017. ObamaCare, which was mainly focused on the uninsured population, slowed but did not stop these trends. Premiums and deductibles still increased by 19 percent and 37 percent, respectively, between 2012 and 2017.


– The Week

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