Medicare for ALL – emphasis on ALL.

Medicare for ALL

The power of amalgamation

OK. Todays rant is going to start with three assumptions. (I view them as realities, but you may disagree so please just accept the premise for now so I can make the point I am trying to make).

  • The first is that the current medical system in America is broken.
  • The second is that it is caused by inefficiencies in a free market insurance system.
  • The third is that some form of Medicare expansion is the best solution.

Based on polling, none of those should be too hard of a sell.

Once we arrive at those conclusions, as most of the country has, we have to ask how much of a Medicare expansion is appropriate. The current debate is between leaving the current system in place and allowing people to buy in to Medicare if they choose, and scrapping the current private insurance model entirely in favor of Medicare for all.

Both of these seem tenable at a glance, and on its face honestly it seems like leaving the system in place and allowing a buy in is the least painful approach and should fix the current problems.

But neither of those statements are true.

There are 3 primary reasons that scrapping the current system entirely in favor of a full Medicare for All program is a far superior option.

  1. Administrative efficiency.
  2. Removing the profit motive from insurance (while still allowing caregivers and hospitals to operate profitably and earn the living they have worked for)
  3. The power of amalgamation.

Let’s look at administrative efficiency.

One of the reasons things are so expensive at hospitals and care centers is purely administrative overhead. There are 35 different medical insurance providers in the United States. There are 413 hospital systems that have more than 2 facilities….there are a couple thousand if you count single hospital networks.

Each of the hospital networks and insurance companies has their own system of mark up, and documentation. Quick multiplication tells us that there is a minimum of 14,455 different ways a condition and treatment may be recorded, submitted, and billed under this system.

Suddenly every bill you have had to have resubmitted to insurance makes sense, doesn’t it.

The problem is so pervasive that trade schools have developed education programs dedicated specifically to medical coding… and it is still done incorrectly a huge amount of the time.

In short, even without errors, there is nothing efficient about the current way medical administration is performed. And the current model is rife with opportunity for error.

Going to a single payer system, will convert all of these to the already established Medicare billing system. The only new expense with be a one time transfer of existing accounts. No development needed as almost all of the hospital systems deal with Medicare on some level currently.

As for removing the profit motive from the health insurance industry.

I want to start off on the right foot here. On a spectrum, I am way more capitalist than socialist. I make my living in real estate. I have ZERO problem with what medical professionals are paid (although EMT’s and a few other caregivers deserve more than they get in my opinion). I don’t even have a problem with hospitals operating as FOR PROFIT entities, within reason.

But what is happening now, is not within the realm of reason.

Because insurance companies and hospital networks have cross bred so pervasively, we have people being charged hundreds of dollars for tissue, and even more for aspirin…. and no one but the accountants are really sure who is making the money off of it.

What we are sure of is that this is part of a larger price gouging scheme that stems directly from the existence of insurance billing systems and profiteering from healthcare and it needs to stop.

By making our insurance system publicly owned (as Medicare for All), we can eliminate this kind of profiteering completely. adding a Medicare buy in would simply maintain the status quo in this space.

Finally, the point of this article: the power of amalgamation. 

Amalgamation is just a 10 dollar word that means the pooling of resources. The old principle of things working together to achieve a greater goal than they could otherwise.

The irony of this word being the principle argument for Medicare for All vs. a mixed system….is that amalgamation is the very principle on which the insurance business model functions. Insurance is all about spreading risk and expenses out.

But with a profit motive mixed into that system what has ended up happening, is that companies have created models which limit their (the insurance companies) risk as a primary goal rather than to spread the risk amongst clients.

When you follow that to its logical conclusion you end up with the most successful companies being those with the smallest risk profile per cash intake. So for example a company that only takes on young healthy clients, will have a better profit margin than a company that takes on older clients with health problems.

So it is in the insurance companies interest to not insure older people. It is in their interest to not insure sick people (the people who NEED medical access the most). Long and short, the interests of the insurance companies are in no way aligned with healing people which is the entire purpose of medicine.

Whoa….got a little off track there.

The point of all of that is to show that if we were to adopt a Medicare buy in, what would end up happening…and what has happened already with elder insurance, is that the private healthcare industry will keep the profitable healthier customers, and shove the sick people who actually bear medical expense off onto the Medicare system.

This will cause Medicare to continue to have financial difficulties and make it look like the private sector is a superior model.

BUT. If we adopt Medicare for ALL. We amalgamate the profits from the young and healthy that are insured into the expense of the older more sickly needs (and we will ALL be there eventually)…. and create a system that is tenable and benefits everyone.


One of the main reasons Medicare for ALL is superior to a Medicare buy in, is that like the successful single payer health systems of Europe, expenses are mitigated by efficiencies of a single system, and resources are amalgamated for the benefit of everyone…and there is no reason the ACTUAL medical industry can’t still make a respectable profit doing so….but the profiteers of the insurance industry need to be removed from the equation so that people can get the healthcare they need. It is literally a life and death decision for too many people.

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About Robb

A husband, Dad to 5, and Grandpa to 9. US Navy Vet. 18 Year Postal Employee turned full time Realtor. I enjoy a wide variety of things, but you will find that here I mostly write about Indianapolis, government/politics, recent news, and whatever book I am reading or have just finished at the moment.
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