Single Payer Health Care or Medicare For All?  Probably Will Not Be Happening for Some Time.  What I propose in the interim.

Many people who self pay for their health care are at a great disadvantage compared to those who get employer provided health care tax free.  Besides the great tax disparity the self pay face there is another advantage many of these individuals do not enjoy.  Large corporations in major segments of the economy can pass their employees' health care costs to the public in the price of the product if the competition has similar employee overhead.  An example familiar to Michiganders would be the auto industry.  An individual or small company with many competitors can not pass their health care costs to the market as easily.  Therefore, they can only afford less expensive health care coverage that is not as good with larger deductibles and co-pays.

Just about all of the campaign rhetoric about health care is focused on those who have to self pay for their health care.  That is what Obamacare is all about.  What to do about the unfortunate who have to self pay and especially those who have to pay a disproportionately large share of their income for health care.  I am fighting against the disparity the self pay face by having to pay for their health care with after tax dollars. 

What does it mean when candidates use the above terms which are different concepts in my opinion on how health care should be paid and delivered. 

Briefly, single payer means that the government is paying for your health care, and it is financed though taxes.  It should be free and all citizens would be included and covered by a national single payer health care plan. 

Medicare for all means that you are paying for part of your health care, and the government is paying the larger amount in order to make it affordable for the majority of participants.  Currently Medicare Part A, hospital care, is covered by the government.  Part B, physician fees, out patient labs fees, other charges are 80% covered by the government.  You have to pay a premium to get Part B coverage, and also pay a premium if you want the other 20% covered.  Medicare Part D, drug coverage, requires another premium.  Medicare Parts A,B,D are fully to partly covered by the government, but are not cheap.  Medicare Part C, Advantage Plans, is Medicare coverage offered by private insurance mostly funded by the government and partly by the individual.  The government's share of Medicare is funded through taxes, and is projected to go broke some time in the future. 

Medicare For All would require smaller premiums than current private health insurance if the current Medicare premium structure remains.

Many do not want to fund the subsidies that Obamacare offers.  What about the much greater funding that would be required for Single Payer Health Care or Medicare For All?

I favor National Health Care coverage for all.

Until Single Payer Health Care or Medicare For All arrives I am trying to eliminate the disparity the self pay face when they pay for health care with after tax dollars by allowing these medical expenses to be fully subtracted from gross income before federal and state income taxes are calculated.  I have also proposed a plan to protect all Michiganders from healthcare fee gouging that Medicare for All would provide, and a plan to mandate employer provided healthcare benefits for some part time employees. 


Ted Golden, M.D.