Alaskans should join in defense of Medicare

One of the goals of the incoming Republican Congress is to phase out Medicare and in its place ask seniors to purchase private health insurance. This plan, deceptively called "privatization of Medicare" (it actually is elimination of Medicare) would have a devastating economic impact on Alaska's elderly. Many older individuals would no longer be able to afford health insurance and would risk financial hardship and lack of medical care.

Alaska has a small population pool and some of the highest health care costs in the nation, and as a result very expensive health insurance. The current cost of a private Silver (mid-deductible) health insurance plan for a nonsmoking couple 64 years old is $50,930 per year. Without the Affordable Care Act the cost would probably be even higher since the ACA limits the premium for the oldest customer to be no more than three times that of a 21-year-old customer. Keep in mind that this is the rate for healthy 64-year-olds; private insurance companies would undoubtedly charge much more for couples in their 70s or 80s or those with health problems. We really don't know how high the cost could go since it has been a half-century since people in this age group have had to buy comprehensive medical insurance on the private market. The proponents for eliminating Medicare claim they would offer a premium or a voucher to help defer the cost of private insurance, but it's extremely unlikely it would come close to covering this entire expense.

[At 50, Medicare and Medicaid are still helping millions of Americans]

Medicare was created in the mid-1960s because half of those 65 or older could not afford health insurance. That was at a time when health care costs were dramatically lower than now. In 1960, the average amount spent for health care per person was about $1,200 in current dollars; in 2013 it was $9,600. It stands to reason that if seniors had difficulty affording insurance when health care expenditures were one-eighth of what they are now, then they will certainly have difficulty in our current economy. How many elderly Alaska couples can afford to pay additional costs of $50,000 or more each year for insurance?

There is no rational reason for eliminating Medicare. It has been one of the most successful programs in our nation's history. The Republicans in favor of eliminating the program say they want to "privatize" it in order to improve efficiency or introduce market forces, but just the opposite will occur. Medicare is more efficient than private insurance in providing care so replacing it with private plans would actually increase overall spending. It is true that the spending would no longer come from the federal budget, but instead all those extra costs would be dumped onto the shoulders of our senior citizens. In other words, at the same time that large tax cuts are being proposed for those in the highest income tax brackets our elderly will be asked to bear a greater burden of the budget.

[Trump's health and entitlement picks signal an intent to cut programs]

Medicare succeeds because it has a large patient pool and can use those numbers to bargain for lower prices, the same way Wal-Mart can sell goods at a cheaper price than a small corner store. Most other developed countries use a similar model for their national health system and this is perhaps the major reason why they are so far ahead of the United States when it comes providing better care at a lower cost. Physicians and other providers aren't thrilled about Medicare's low reimbursements since it reduces income, but this is certainly not a justification for eliminating the program.

A major shortcoming in our debate about Medicare and other forms of coverage is that we put all our focus on health insurance and we forget that what people fundamentally want is health care. It is as if we are building a freeway and we spend all our time arguing about the appearance of the toll booth and ignore the structural integrity of the roadbed. A single-payer plan like Medicare certainly has its complexities, but it does a much better job than our current chaotic private insurance marketplace at addressing the basic needs of health care; it allows us to ensure that the foundation of our health care roadbed is strong. We must do all we can to make sure this crucial program is not taken away from us.

Dr. Randall Plant is an Anchorage physician.

The views expressed here are the writer's and are not necessarily endorsed by Alaska Dispatch News, which welcomes a broad range of viewpoints. To submit a piece for consideration, email commentary@alaskadispatch.com. Send submissions shorter than 200 words to letters@alaskadispatch.com.