OPINION: Medicare-for-all or private insurers? Why not both?


Ricky Barker, Columnist

Health care a most pressing issue for many Americans. It’s a topic mentioned repeatedly on campaign trails. Candidates offer different solutions, but with such a complex issue, it’s hard to know what the best idea is. Candidates constantly raise the question of which health insurance structure is best for the American people.

In the fourth Democratic presidential debate, Sen. Elizabeth Warren faced a multitude of questions lobbed at her from several candidates. One of the most pressing and interesting questions came from candidate Pete Buttigieg comments about Warren’s support of a medicare for all plan. 

Buttigieg claimed “no plan has been laid out to explain how a multi-trillion-dollar hole in this Medicare for all plan that Senator Warren is putting forward is expected to get filled in.”

Warren’s plan for health care is “Single Payer Medicare for All,” which essentially means all health care financing is done through a government-run public institution. This does not apply to delivery of care, so hospitals, doctors and dental practices would all still be privately run. Health care would be paid through tax payer dollars, instead of directly out of pocket. Warren’s plan is the alternative to only private insurance companies running health care financing.

 It does not necessarily have to be one or the other, as Buttigieg claimed during the Oct. 16 debate, when he said “I don’t think the American people are wrong when they say that what they want is a choice.”

 Buttigeig supports a two-part plan system, which he calls “Medicare for all who want it.” His plan opens an affordable option in government health insurance for those who need it or want it. This still leaves private insurance companies or insurance through employers to those who would prefer that.

This is an excellent idea. It’s been proven successful elsewhere in the world. Several countries have similar plans featuring a two-tier system like Buttigieg suggests

Canada is a great example. The neighboring country has a public health care system paid through tax dollars; however, this only covers hospital care and doctor visits. If citizens want more options like vision care, dental benefits or outpatient prescriptions, they need a privatized plan. Two-thirds of all Canadian citizens are on a private plan, while the rest are covered by the public plan, according to the Commonwealth Fund, a U.S. research group for healthcare.

Denmark, like Canada, has a basic public health care plan but also provides private plans that offer more options. Private expenditures accounted for nearly 16% of health care spending in Denmark in 2013, according to the Commonwealth Fund.

England is another good, although slightly different, example. England has a public health care plan with a broad range of coverage funded through taxes. However, wait times for treatments or benefits can be long. So, private health care plans offer quicker access to care when the patient needs it. About 11% of the population uses expedited private health care plans.

A two-tier system could be exactly what the U.S. needs right now, giving more options open to Americans while guaranteeing the most vulnerable get the health services they need. Consider here in North Carolina, 10% of all citizens are uninsured. North Carolina have the ninth largest uninsured gap in the country, the difference between being able to afford private health care and qualifying for government Medicaid. 

That could be fixed with a plan like this. It takes the best from both systems and adds to each to make both plans better for citizens,  a perfect middle ground for Americans in the divisive fight for health care.