I have been intending to write to explain some of the nuances of a single-payer healthcare system, commonly referred as “Medicare for All.” Confusion and attempts at distortion abound, but a short essay can, unfortunately, only serve to lay the groundwork for more homework on the part of every voter.

There have been various proposals, some of which have been gaining publicity and votes in Congress. The most talked about is Sen. Bernie Sanders’ Medicare for All, very close to the “Expanded and Improved Medicare for All Act,” HR 676. Both have features championed for years by Physicians for a National Health Program (pnhp.org — a site well worth perusing) that the group refers to as “Improved Medicare for All.”

In essence, these would extend Medicare to all citizens, funded by a variety of taxes, eliminating copays and deductibles while expanding coverage to include dental and vision care. Note that private insurance and the payroll deductions for it would be phased out.

Yes, taxes would be higher, but other costs would be lower, with a net total cost less than what we now pay. How is this possible? Consider that Medicare has an overhead of 3 percent compared to 15 to 30 percent for private insurance companies. Consider the effect of lower drug costs, negotiated on a national scale. Consider the amount of profiteering in healthcare that would be eliminated. You get the idea. And you might also get an idea of who might be opposed and how much money they have.

There also have been a number of alternative proposals, like offering Medicare to anyone over age 55, and Medicare X, which would “offer” Medicare to those not previously covered. However, these plans would not automatically cover everyone, would not necessarily cover pre-existing conditions, and might not include dental and vision care. Obviously, careful evaluation of any proposed legislation is required. Unfortunately, it can be difficult to separate fact from fiction.

I wish it were possible to have a totally non-partisan discussion but there is too much baggage attached to the long history of Medicare to allow that. Please understand that the Republican Party has opposed Medicare and Medicaid forever. They characterized Medicare as “socialized medicine” that would strip us of our basic freedoms.

Since it was enacted into law, however, they have been faced with the fact that it is popular with the American people, forcing approaches that could not include outright repeal, rather focusing on ways to privatize it (Medicare Advantage) or pay for it with vouchers that would limit government spending.

To summarize, as Paul Krugman, a Nobel Prize-winning economist, wrote recently in the NY Times: “If you believe that Medicare is a bad thing and the government shouldn’t protect people with pre-existing conditions, vote Republican. If you want to defend Medicare and ensure coverage even for those who have health problems, vote Democrat.”

He was writing this in response to an op-ed article in USA Today on Oct. 10 by President Trump which was widely fact-checked and found to be without them (like “Democrats would eviscerate Medicare”), accusing the Democrats of everything the Republicans have actually been attempting.

Please do not take my word for it, or President Trump’s or Paul Krugman’s. Evaluate the claims carefully by seeking out independent fact-checkers and reputable news sources. The citizens of our country deserve no less when you enter the voting booth.

Dr. Kluzak, an Idyllwild resident, is board certified in Anatomic Pathology, Obstetrics and Gynecology. He also is a freelance photographer for the Town Crier.

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