Provide Medicare for all

Without a strong public option, health reform will be a disaster.

By Bernie Sanders

Real health care reform must come to grips with two fundamental issues. First, with 46 million Americans uninsured, 60 million lacking regular access to a doctor and 45,000 dying every year because of that lack of access, we must join the rest of the industrialized world and guarantee health care to every man, woman and child in our country.

Second, we must contain costs. Despite tens of millions of Americans being uninsured and under-insured, we are spending $2.5 trillion a year on health care, almost twice as much per person as any other major country. In the last nine years, health care premiums have doubled. Without real reform, they are projected to double again in eight years. This is unsustainable for business, for workers, for government and for our entire economy. Clearly, we need health care reform that brings costs under control, and we need it now.

In my view, the simplest and most cost-effective solution to our health care crisis would be a single-payer, Medicare-for-all system that would eliminate hundreds of billions a year in profiteering and administrative costs by private insurance companies. The political reality, however, is that because of the power of the health care industry, that approach has never really been on the table.

The bill now before the Senate contains important and worthwhile provisions. Among many other advances, it expands coverage, improves primary care and disease prevention and institutes long needed insurance reform policies.

The major weakness is the lack of strong cost-containment provisions that could begin to control soaring health care costs. If Congress is not prepared to go forward with a single-payer program, which would be the most cost-effective approach, at the very least there should be a widely accessible public option. A strong, Medicare-type, premium-based public option is an effective way to keep private insurance companies honest by providing them with real competition.

Without that competition from a plan that is national and non-profit, it's hard for me to see why the insurance companies will not continue to rapidly raise their rates — which would be a disaster for consumers and our economy.

Sen. Bernie Sanders, I-Vt., is a member of the Senate Health, Education, Labor and Pensions Committee.

Posted at 12:21 AM/ET, November 30, 2009 in USA TODAY editorial

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