Medicare for All

Sue Lani Madsen’s Feb. 4 column praises Switzerland’s health insurance system for its competitive marketplace, as if that is its key element. More importantly, the Swiss adopted a modified German system where all insurers are nonprofit, divorced from employers and must accept all applicants and pay all claims without deductibles or co-pays. Patients go to any provider. Premiums are based on income, not age, and whatever the market will bear, and insurance is mandatory. All insurers must offer the same basic policy. Numerous companies compete only on extra benefits and user-friendliness.

The basic plan is essentially a loss leader for other services. Portability is assured and unemployment benefits cover premiums. On a regional basis, insurers negotiate uniform prices with providers. The biggest problem is the lack of cost control. Single-payers have much more leverage than multiple payers, but the Swiss and Germans still spend only 11 percent of GDP (second highest in the world) and get universal coverage vs. 17 percent in the U.S.

If we are serious about lower costs, single-payer Medicare For All (HR 676) is still best. The German system is a good runner-up, but Republicans are nowhere close to either.

Cris Currie

Mead