Guest Columnist

A public option isn't enough for Iowans

Rally attendees, led by event organizer Kelsey Landhuis (right) and her sister Shaina Lanhuis, 24-year-old University of
Rally attendees, led by event organizer Kelsey Landhuis (right) and her sister Shaina Lanhuis, 24-year-old University of Missouir student, begin a march through downtown Cedar Rapids to advocate for medicare for all Americans on Saturday, May 20, 2017. (Michaela Ramm/The Gazette)

What’s our biggest health care issue? Cost.

Many of us worry whether we can afford to go to the doctor we like or get the care we need. And there’s numerous proposals by current Democratic candidates for President aimed at addressing that concern, but only one that truly gets to the heart of the problem.

Proposed solutions like John Delaney’s “BetterCare,” or Pete Buttigieg’s “Medicare for All Who Want It,” or introducing a new public insurance plan alongside the for-profit insurers (the “public option”) may sound nice, but do not control costs. And it leaves open the door for private insurers to game the system by offering bare-bones plans to healthy individuals, further burdening our public system. Only an all-in system will truly control costs and address the insecurity we feel within our current system.

In the name of political expediency, these plans rely upon false choices that maintain the fragmentation, waste and bureaucracy of the present health care industry.

Hundreds of insurance companies, and thousands of rules and protocols established by those companies and corporate hospital systems, require a massive billing and payment collection bureaucracy that generates billions of profits while restricting care.

That’s not a caregiving system, it’s a moneymaking industry based on corporate greed. They restrict what doctors we can see, which hospitals we can go to, what treatments our doctors can do, and which prescriptions are covered.

It’s clear that “access” is not health care. There is a fundamental difference between guaranteed health care, and universal access. Just ask those 57 million Americans with insurance plans whose deductible is so high they cannot use it.

And by the way, what are “basic health care needs” and who decides? Under Medicare for All medical professionals are in charge, and patients do not have to know and navigate a landscape that is confusing: whether to opt out of “BetterCare” or keep their employer plan, or accept a tax subsidy, or sign up for a plan with a limited provider network, or just throw up our hands and hang on.

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The health care industry gives us very few choices. And the choices they do provide are designed to enhance their bottom line. Yes, like now, seniors could “choose” a Medicare Advantage plan but those plans restrict choice of providers, and the expanded benefits under those plans cost taxpayers 14% more than traditional Medicare.

Is it a surprise that very few Medicare beneficiaries with serious health conditions use these plans? No, because they are marketed to people who have routine, relatively inexpensive care needs. No wonder those private Medicare Advantage plans are the most profitable products the insurance industry sells. How is it reform to continue to divert resources from health services to profits?

The answer to the cost issue is not more taxpayer dollars going to for-profit insurance companies and confusing patients with false choices. To lower costs requires we eliminate the fragmentation, waste and profits of the health care industry.

Only Medicare for All does that. And at least Sen. Bernie Sanders wholeheartedly, and honestly, acknowledges that fact.

Cherie Mortice is a retired teacher who lives in Des Moines and is the board president of the Iowa CCI Action Fund.

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