Americans can handle the cost

Previously, I stated that national Medicare insurance, administered by the Medicare administration and covering total medical costs for every citizen cradle-to-grave, would cost Americans $3 trillion. I proposed that the next inquiry should be how this cost is paid. The important fact to bear in mind is that we already pay $3.2 trillion for a health care system that leaves 28 million uninsured, pushing the cost for treatment of these individuals on to hospitals which then pass the cost on to the rest of us in the form of higher hospital charges.

Another reader has stated that my initial idea of a 20 percent Medicare tax on earned income would be an insupportable burden on the less wealthy. A family with household income of $20,000 would have to pay $4,000, which is way more than such a family could pay and still manage to survive. In principle I agree, but I read that average family medical expense (2014) including insurance, is $4,300, which would be the benefit received by the average family under Universal Medicare and suggests that even low-income taxpayers should bear some portion of the cost, even if it is as low as 5 percent. (2.65 percent is the current employee Medicare tax)

Obviously, then, the method of payment based on individual taxes will need to be proportional, like federal income taxes, where the wealthier pay at a higher rate depending on their income. However, individual income taxes will only satisfy part of the cost. Perhaps the largest part would come from the corporate sector and this invites the question of whether employers should pay anything at all.

Employers currently contribute to the health insurance premiums of 149 million individuals, which includes employees and their families. The average premium of an employer sponsored family plan is $16,834, of which the employer pays $12,000, almost 3/4ths. However, 45 percent of all employers, call them free loaders because they benefit from the payments made by everybody else to maintain our health system, such as it is, provide no insurance.

Since it is in the financial interest of employers to have healthy workers, I see no reason why all employers should not contribute based on the number of employees at a rate roughly equal to what most employers now pay for employee insurance. This would spread the burden by including the free loaders.

Regardless of the final allocations, Americans can handle the cost for a system of national insurance because we are already paying more than that for a confusing, unfair, incoherent, system, that leaves 28 million uninsured and which is 1/3rd government insurance anyway. The next section will deal with whether the benefits outweigh the costs and whether we want such a system.

Patrick Radcliff

Vienna

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