Letter: Affordable health care should be a government duty


Editor of the Reformer,

There has been increasing talk among Democrats for "Medicare for all." This is something many of us have been preaching for years. There are, however, a few important facts and details that have essentially been absent from the conversation.

First and foremost, the opponents of the plan continue to cry that taxes will have to increase to pay for it. That is very true, but what they neglect to mention is that while you might see a significant increase in your taxes, it will be more than covered by the savings you will have from not having to pay for private insurance. Furthermore, with everyone being covered, the risk pool will be significantly diluted by the sheer numbers alone with a subsequent decrease in premiums.

I also think premiums (i.e. taxes) should be progressive, just as income taxes are, with the wealthy paying proportionally more, and with those on the lower end of the economy paying less, and in some cases nothing at all.

In order for this to work, however, changes need to be made. Most important, fee for service should be gone. Fee for service is one of the biggest reasons for the rising costs. It basically incentivizes doctors and hospitals to perform more services, in many cases marginally justifiable. Every doctor should be on salary. Primary care physicians should be paid the same as specialists. The only possible difference should be based on physical location, depending on local costs of living. In other words, docs in New York City would get proportionally more than those in Brattleboro.

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There are changes that can be made in the system itself, mostly with reimbursement, but with such a large pool, these would be minimal.

One of the most poignant things about Medicare is that people who are enrolled in it like it. In fact, the only people who don't like Medicare are doctors and hospitals, because it's their oxen being gored. But, as I indicated earlier, with the large pool, comprised mainly of healthy people, even the doctors and hospitals will thrive.

I have often said that if the state of medicine at the time of the writing of the Constitution were that of the year 1900, health care would be in the Bill of Rights. Health care should be the right of every citizen of this country, and affording such health care should be the duty of our government.


Bob Fagelson

Putney, Feb. 1


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