It's OK to Be Angry About Capitalism by Senator Bernie Sanders

Author:Senator Bernie Sanders [Sanders, Bernie]
Language: eng
Format: epub
Publisher: Crown
Published: 2023-02-21T00:00:00+00:00

We Can Afford a Healthy America

The major reason the current health care system in the United States is so expensive is that it operates on an uber-capitalist model that is geared to the needs of insurance companies, not patients. Squeezing as much profit out of patients as possible requires an enormously complicated and bureaucratic system that runs up hundreds of billions in administrative costs. In hospitals that often lack an adequate number of doctors and nurses, there are basements full of people who never see a patient. All they do is bill, bill, and bill. During the height of the COVID pandemic, hospitals were shutting down elective medical services because they didn’t have enough patients. Somehow, however, the health care industry never shuts down its billing.

Getting rid of all that insurance-industry bureaucracy and all that billing would result in enormous savings for Americans, argues Dr. Gaffney. As he recently told the Senate Budget Committee in written testimony, “In 2017, 34 percent of healthcare spending was devoted to administration in the US—approximately twice the proportion spent on administration in Canada’s single-payer national health insurance system. Much of this administrative expense stems from the wasteful bureaucracy inherent to private health insurance. Compared to a public insurer like traditional Medicare, private insurers inflict numerous added costs, including profits for shareholders, bloated executive salaries, product and benefit design, marketing, and burdensome processes for disputing claims (needed to maximize profit).”

Dr. Gaffney went on to say that “reducing insurance overhead for the overall US healthcare system to that of traditional Medicare could unlock enormous savings—funds that can then be used to cover the costs of a generous coverage expansion for all. And indeed, the CBO [Congressional Budget Office] has estimated savings from such a reduction in insurance costs at over $400 billion annually.”

Under Medicare for All, doctors and nurses and hospitals could eliminate bureaucratic hurdles that waste tens of billions a year. In the United States, noted Dr. Gaffney, “physician practices spend more than $80,000 annually, per physician, to cover the costs of interactions with insurers—almost four-fold higher than Canada.”

Billions can be saved by addressing the profiteering and the bureaucracy associated with the insurance industry. Tens of billions can be saved by taking on Big Pharma. That would happen under a Medicare for All system, which would do what every other major country does: negotiate prices with the pharmaceutical industry. Instead of paying the highest prices in the world for prescription drugs, we could save hundreds of billions over a ten-year period through the plan for tough negotiations with the drug companies that my legislation outlines. Just doing what the Veterans Administration does in terms of negotiating drug prices would cut prescription drug expenditures in half.

All these savings add up.

In 2020 and 2022, the Congressional Budget Office (CBO)—the non-partisan agency that analyzes budget issues for Congress—considered four options for moving to a single-payer system. They found that in all four scenarios a single-payer program would save the American people between $42 billion and $743 billion every year, beginning in 2030.

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