Medicare for All: Last Week Tonight with John Oliver (HBO)
we thought we talked about an issue that has dominated the Democratic primary and I'm not talking about why Tom Styer doesn't look richer but why doesn't he though his skin sallow his clothes don't fit right and he seems to only have one tie what is this man doing with all this money no we're not talking about that instead we're gonna talk about this it's the hot buzz phrase for Democrats running for president
Medicarefor all we will have
Medicarefor all we have a chance for
Medicarefor all now there's a lot of talk about
Medicarefor all what does that mean question from a great judge and an even greater human being and to answer the question from Ruth Bader Ginsburg's inevitable successor what is
Medicarefor all well right now we have what's called a multi payor system what that means is maybe your health care is covered by private insurance purchased by you or your employer or maybe it's covered by a government program like
Medicareor Medicaid or maybe you're one of the 27 million Americans with no insurance in which case you the basic idea behind
Medicarefor all is that all of this would be replaced by a government-funded single-payer program and the goal of universal health care coverage is extremely appealing both Bernie Sanders and Elizabeth Warren have put out versions of
Medicarefor all but other Democrats have been much wary of it and conservatives absolutely hate the idea we...
Medicarefor all this is the end of America as we know it economically I think literally 90% of hospitals would go under tomorrow right
Medicarefor all I lived in England short nationalized health care is a disaster when rich famous people get sick they don't fly to Canada they don't fly to Cuba they come here because we have the best medicine in the world no I will give that man this America does have one of the best health care systems in the world for rich famous people unfortunately too many people are born in this country with a terrible pre-existing condition called not being beyond sir some of us many of us in fact are still launched and and for so many Americans our system is badly broken and I'm not just talking about the 27 million without health insurance but the nearly 44 million more who are under in short people with high deductibles and co-pays that can end up bleeding them dry the majority of people who file for bankruptcy cite medical expenses as a factor and you probably already knew that deep down from just how often you see GoFundMe campaigns online from worried parents of six children or your friend who got a pineapple stuck up his ass and needs help paying the doctors to stop laughing and get it out and incidentally for all the heartwarming success stories that you see a study found 90% of crowdfunding campaigns for medical expenses fail to meet their goal and when they fall short it can be crushing what just one family...
struggles to raise $10,000 for expenses rising from their two-year-old daughters eye disorder Sheila's fundraiser isn't going as well as they'd hoped about a month in it only raised six hundred ten dollars early morning on the day of Sheila's surgery her parents are still trying to get the word out okay so we're gonna make her sign hashtag eyes for Sheila very good think about what you're looking at there it's a pretty dystopian society that we're living in if your physical and financial well-being depend on whether your crowdfunding campaign can get a signal boost from jiff ponder Pomeranian and good luck with that by the way I'll be trying to get into post our gerrymandering piece for months now and he won't do it come on jiff pond throw us a bone you the point is any solution that might put an end to that is worth at least considering surely and to be honest I personally think there is a lot to be said for
Medicarefor all so
tonightlet's take a look at it not the politics of whether it can pass but what it actually is and whenever the subject comes up you tend to hear three major criticisms of it concerning costs wait times and choice and let's start with cost because critics will tell you that
Medicarefor all will simply increase the federal budget too much this sicko socialism would cost roughly thirty two point six trillion dollars over ten years even if you doubled tax collections from individuals and corporations yes...
that means you'd be paying twice what you already do in taxes that still doesn't cover the tab my god free health care is expensive look I I know that sounds dramatic but Sarah Palin's fourth attempt at cloning herself actually has a point there
Medicarefor all would undeniably be expensive but that fact needs a lot of context around it for starters where it would increase the federal budget yes but it would also eliminate employer spending on premiums and you're spending on outer pocket pocket costs now would those balance each other out that is a good question the answer is no one can possibly know for sure there are just too many variables involved the Times asked five prominent experts to estimate national health care spending under Bernie's plan and they compared that to what we spend now and the results range from it would actually cost us less - it would cost about the same - it will cost a of a lot more and I know that extra shading does not look like very much but believe me it's a of a lot but good look let's say just for argument's sake our overall spending did go up we would be getting a lot for that money remember 27 million more people would be covered and they'd be covered well Bernie's plan is incredibly generous it covers vision dental long-term care and drugs in fact
medicarefor all is a misleading title because
Medicarerequires some co-pays and out-of-pocket expenses and Bernie will excitedly tell you his plan...
eliminates those under the
Medicarefor all bill that I wrote premiums are gone co-payments are gone deductibles are gone all out-of-pocket expenses are gone he's right hospital bills are gone co-payments are gone cellphone payments gone flat tires gone Geico commercials gone all the things you hate in this world will be gone and all that will remain is universally accessible health care and Laura Dern finally life as it should be Bernie's plan isn't just more generous than most current private insurance plans it's more generous than the policy of any single-payer country on earth and there is a good case to be made that even if national spending wound up higher we might wind up wasting less right now a lot of our health care spending doesn't go to health care it goes to administrative costs that come with having a vast insurance industry that is clearly wildly inefficient and consolidating all health insurance under one roof would give the government far more leverage to negotiate prices down because look it is no secret prices for procedures and drugs are out of control in the United States it is so bad one insurance provider in Utah recently started offering some of its participants cash if they were willing to travel a little further than their local pharmacy to fill out their prescription it's called pharmaceutical tourism here's how it works PE HP puts patients on a plane and flies them to San Diego from there a private car takes them across...
the border to Tijuana Mexico where their prescription is waiting for them the only difference the prescription costs roughly half the price PHP will give people willing to travel an additional $500 back cheaper for us to pay for the drug down there send them down there and then given them $500 that's crazy giving you $500 to go to Mexico to buy drugs it's not what your insurance provider should be doing it's what your sketchy friend Meredith should be doing cuz she wants to make Briana's bachelorette party a total rager I go myself but I have outstanding wines under
Medicarefor all the government would be a much stronger negotiator now you wouldn't want it to set prices so low than it stifles innovation or bankruptcy doctors but that is a balance that you would need to strike overall you can't definitely say that it would be more expensive but even if it was I personally would argue that it's worth it and either way cost is a lot more complicated and issue than just going on TV and saying 32.6 Tyrolean dollars like Tina Fey doing her best dr. evil impression anyway the next major criticism of
Medicarefor all concerns wait times specifically that it would result in rationing and delays to care if you think it's fun to wait in line at DMV you're gonna love Bernie Sanders wait times for
Medicarefor all it leads to the kind of care that people now have in England or Canada where you have to wait in line just take a look at Canada or the UK...
it means long waiting lines it means people not getting the health treatments they need okay i s that no one likes waiting in line for anything I get it most people see the line at Trader Joe's and either abandon their cart or pull the fire alarm and sneak out with their groceries undetected unless I'm not saying I've ever done that I'm just saying I've had a show to do
tonightwho wants some peanut butter pretzels but as we've cost comparisons of wait times are very complicated for one thing the International wait times that you hear about most often are for non-emergency surgeries such as knee replacements and while yes people in other countries do sometimes have to wait slightly longer for some care it's not like Americans aren't having to do that right now anyway Americans are just sometimes forced to wait due to the expense about half of US adults say they or a family member put off or skipped care in the past year because of the cost and about one in eight say their medical condition got worse because of that delay as for the uninsured they can won't wind up having to wait on a literal line seeking care with AIDS groups like remote area medical an organization that travels the country setting up mobile clinics to treat people for free and which draws massive lines wherever it goes having got their place in line many can't add for the night before dawn this was the moment they were waiting for number one come on down number two...
number three one by one patients are let in for their chance of a visit to a doctor a dentist and an optician at first Graham focused on communities in remote areas of developing countries but Stan says he gradually came to realize the depth of need in the u.s. today Oh 80% or more of what we do is here in the United States it's unbelievable to me that is the case normally Americans hate it when a British person comes over to diagnose what's wrong with you believe me six seasons of YouTube comments have made that very clear the internet is me and for all critics talk of wait times abroad it is worth knowing less than 10 percent of Britons or Canadians say that their health system needs to be rebuilt completely compared to 23 percent of people here in the United States in fact when London hosted the 2012 Olympics the opening ceremony featured a four and a half minute celebration of the National Health Service featuring swing dancing doctors and nurses and children jumping up and down on hospital beds as per Canada they adore their health service so much that when they had a contest for the greatest Canadian of all time this was the result the greatest Canadian as decided by you is Tommy the mother of all national titles goes to the father of
Medicarefamily Ingenix but we're going to ignore that if it was the nineteen thirties and that one perfect look there is the final big criticism of
Medicareparole which involves choice specifically that it would take away our...
ability to choose the sort of health coverage that we receive when I hear that health care is a right what I hear is health care will no longer have choices under
Medicarefor all your choice of health coverage disappears Americans are still Americans we're not socialists we're not communists we like choice and we like to have choice in health care especially what Americans are Americans it's true and they do like having choices it's why the number one rated series on Netflix is 40 minutes of looking through the menu for something good it's basically America's national pastime and the fact that is a full cosine on that concept but the fact is the fact is our current system limits Americans choices far more than it expands them for starters as a practical matter most of us don't choose our health insurance we get what we get through our employer and because of that choices like changing jobs can become significantly harder and not just that oftentimes your choice of doctors and hospitals is severely limited by which ones your insurance will cover going out of your insurance network can be prohibitively expensive that is why people bend over backwards to stay in-network and even when they do that it can still all go horribly wrong while campaigning in 2018 Democratic congresswoman Katie Porter's appendix burst her first thought how much would it cost I didn't call an ambulance cuz I knew it could cost a lot if you call an ambulance...
specifically had my manager drives me back to the closest hospital but to the in-network hospital even though the hospital was in her Network the surgeon who helped save Porter's life was not and she got a bill for nearly three thousand dollars exactly you can get by taking an ambulance you can get by going to the wrong hospital or you can get by going to the right hospital but getting the wrong surgeon the American healthcare system gives you so many choices as to how you want to get it truly is become a suture and I'm gonna care for all that scenario would not happen no doctor would be out of network because there wouldn't be a network at all and the truth about Americans current illusion of choice is that too often because of cost the choices our current system forces people to make are ones like this I prioritize the hard stuff over the insulin because the hard stuff is more immediate I know over time you know diabetes will kill me but it'll take a longer time and I know that without the heart failure drugs I only have 13% function of my heart I don't want play with that that's obviously terrible a humane health care system should not require people to pick their favorite organ although for the record if you're ever asking me my favorite organ I'm going spleen every time now I know the brain in the heart get all the attention but I'm telling you when it comes to filtering blood you can't go wrong with the spleen hash tag on the...
spleen staing hashtag yes Lee so so those are those are the three main criticisms of
medicare-for-all and I should say it is not just people on the right who raised them some Democrats have reservations to Pete Budaj for instance prefers a different concept to
Medicarefor all but with a catchy similar name my healthcare vision is
Medicarefor all who wanted let every American have the choice to walk away from the corporate private plans and toward something better but when they're ready because I trust Americans to make that right choice okay well hold on there you trust Americans to make the right choice you know Americans choose to drink Bud Light right which doesn't taste like beer so much as it tastes like if clear somehow died and was discovered in this apartment three
weeks later but but what Buddha Church is referring to when he says
Medicarefor all who wanted is basically the public option that is where the government doesn't replace the private insurance system it just introduces its own plan that would compete with it and it would definitely be an improvement over what we have now the problem is it would leave so much of our current insurance infrastructure with all of its problems intact so that's kind of like being offered either a sandwich or a slightly smaller sandwich with guac I mean I guess I'll take the second one if you're asking but honestly the lack of guac wasn't really my main concern and I'm not saying any of this...
would be easy a lot would have to be figured out from how to impose the taxes to pay for it in an equitable way to the consequences of eliminating the entire private health insurance industry which by one estimate could displace 1.8 million workers that is a legitimate thing to be concerned about and any plan would have to be designed and rolled out very very carefully that is why both Warren and Saunders talked about the need for transition plans for workers in their proposals and I get that big change is scary it is human nature to prefer the devil you know over an uncertain alternative but the devil you know is still a devil and and it is easy to forget that I on Britain a lot on this show I'm not gonna stop anytime soon but one thing Britain does well is the National Health Service it's not perfect of course I'm not gonna swing dance on a bed about it but I will be honest with you I've never had a bad experience and I don't know anyone who has but since moving to America I don't think I have met anyone who doesn't have at least one insurance industry horror story at this point the u.s. national anthem should just be everyone in the stadium yelling about their insurance company for two and a half minutes so for what it is worth personally I am in favor of some version of carefully designed universal health coverage and I will own all the things about it that are difficult including the fact that politically it would be incredibly hard to get...
passed but in return anyone who is resistant to significant change is going to have to own all the flaws of our current system one in which when Americans get sick they can find themselves comparison-shopping with a burst appendix flipping a coin between life-saving medications and praying they can come up with a catchy enough hashtag to cover their care although for what it's worth on that one until we fix this mess if anyone gets a ruptured spleen please feel free to use hashtag yeah that's all yours good luck with it