In 1974, President Richard Nixon was in the process of concluding an agreement on universal health care with Senator Ted Kennedy (D-Mass.). Their initial approaches were completely different: Kennedy favored a single payer system managed by the government; Nixon wanted to expand the market-based system in which employers were mandated to provide coverage, and those who were not, were enrolled in an HMO-type family health plan.
By virtue of their compromise, everyone would receive a national health card providing personal information and guaranteeing basic health care. A comprehensive health insurance plan would cover pre-existing conditions, mental illness, alcoholism and addiction.
Kennedy and Nixon were on the point of finding a compromise when Watergate demolished Nixon and his presidency.
Flash forward 45 years, and the battle continues. But when I see Sen. Bernie SandersBernard (Bernie) Sanders2020 Dems defend Omar against Trump Biden's critics, Warren and Sanders express their support for Stop & Shop strike workers Two dozen Dem senators ask Trump to extend his nuclear treaty with Russia MORE'(I-Vt.)' Medicare scheme for all '- reissued this week with little change and quickly approved by Sens. Kamala HarrisKamala Devi Harris Georgetown students vote overwhelmingly to approve compensation for slavery reparations. Two Dozen Dem Demands Ask Trump to Extend Nuclear Treaty with Russia 2020. Dems Condemn Trump Government's Transgender Military Policy MORE (D-Calif.), Cory BookerCory Anthony BookerBooker on Trump allegedly has forgiven a border official: "This should shake all Americans": an overwhelming majority of Georgetown students approve the payment of compensation for slavery reparations (D-N.J.), Elizabeth WarrenElizabeth Ann Warren2020 Dems defend Omar against Trump Biden's critics, Warren and Sanders express their support for workers striking Stop & Shop workers Georgetown students vote overwhelmingly to approve payment of compensation for slavery MORE (D-Mass.), Kirsten GillibrandKirsten Elizabeth GillibrandTwo dozen senators ask Trump to extend its nuclear deal with Russia 2020. The Dems condemn the transgender military policy of the Trump government. Julián Castro: Presidential candidates should be required to disclose their income tax returns PLUS (D-N.Y.) And others on the far left – I can not help but think that lessons from the past have not been learned
Not to mention the lack of innovative custom solutions of today, such as cancer immunotherapy, robotics and genetically modified treatments, that a single insurance would never cover in a systematic way.
Yet, apparently, Sanders' plan sounds great: no co-pays or deductibles, no premiums, no private insurance. Of course, when you talk about the cost of the transition for the taxpayer, it instantly becomes less popular. Not only that, but the term "Medicare" is an improper term because the process of expanding government-managed health insurance means at all costs to change it, and the last product restricted and rationed will eventually look more like Medicaid than Medicare.
Slogane flamethrowers such as Sanders do not view the private health insurance system as very powerful and deeply rooted in the fabric of our capitalist society, and it will not simply be overthrown and replaced. The health insurance was originally designed in the 1930s to cover catastrophic life-threatening illnesses. Unfortunately, over time, health insurance has turned into a monstrosity inspired by fear and slogan, used by politicians and business people to garner votes and generate profits. , respectively.
While Sanders is seeking to narrow choice and strongly regulate options, the Trump administration, led by Health and Social Services Secretary Alex Azar, seeks to take advantage of the removal of the individual mandate to add and expand insurance options ("lean" plans). association plans) and, above all, to emphasize price transparency.
The health insurance system has deteriorated to such a point that the consumer never knows what costs anything and if there are cheaper alternatives that work as well or better – the price transparency is therefore an important solution. Reducing the role of profit-seeking middlemen is another. One-third offers more generic alternatives to overpriced drugs while preventing pharmaceutical companies from charging other countries less than what we pay.
A fourth necessary fix is to reward or provide tax incentives for healthy behavior, such as exercise or diet, which decreases health care costs. Prevention does not happen in the doctor. it happens even before you get there.
Senator Sanders' plan is outdated, expensive, colossal, and does not match or financially support innovative custom solutions of the future.
Sanders' rhetoric may attract him, but if he or others like him are serious about health insurance reform, they must take a page from the Nixon and Kennedy game book. These two politicians, both deeply committed to a universal solution to health care, took the opposite approach: Kennedy was socialized and Nixon was market-based. Their compromise solution, if it were not for Watergate, would have worked much better in the United States than anything Senator Sanders suggested. It would have worked in the current system by extending it to plug the holes.
The best health solution will come from modification, reform and improvement, not demolition or replacement. The removal of the overloaded buying mandate (these ten "essential" benefits), the costly ObamaCare policies with high barrier franchises and narrow networks limiting access, provide an opportunity to actually expand the pool. Insurance by adding more options that work for more people.
A national health card still makes sense, but not a single payer insurance.
Marc Siegel M.D. is Professor of Medicine and Medical Director at Doctor Radio NYU Langone Health. He is a medical correspondent for Fox News. Follow him on Twitter: @drmarcsiegel.