Medicare for all and Tricare

single payer
Photo Credit: Michael Fleshman

Medicare-for-all is shaping up to be a major focus for Democrats looking to replace President Donald Trump in the 2020 election. Still when Kamala Harris came out in favor of eliminating private insurance companies – a staple in most single payer systems, Democrats recoiled.

That begs the question do Democrats really know what they are pushing for when they are demanding a single payer system? The closest resemblance to a single payer system in the United States is Tricare, the health insurance military members are given (For those that want to be technical, Tricare Prime).

And as such I think that it’s the perfect way to evaluate how a single payer system would work in the United States. Yes, I understand the funding will be different, but most Americans DO realize that going to a single payer system would result in an increase in taxes – and by how much is still up for a bit of debate, although countries in Europe provide a good estimate for this.

Now as a military member I had Tricare for several years, so I know a few things about how it works from a user’s perspective.

The cost to the user has to be the biggest advantage in a single payer system – now I understand that we will all be “paying” for it in a national single payer system through taxes, but the difference is it doesn’t matter if you get cancer, you won’t get a bill. It’s stress free, you no longer have to worry about if your health or a freak accident is going to bankrupt you. You don’t have to worry about copays or deductibles, you just know your covered.

My kids have a variety of (small) medical issues, their therapies never cost me a dime on Tricare. When I talked to their doctors about what they needed I never had to ask about the cost, instead I got to ask about what the best treatment options were without having to worry about if I could afford it.

Furthermore, with Tricare preexisting conditions don’t matter. Now to get on Tricare as a military member preexisting conditions are a thing, they won’t let you join the military if you have a multitude of different health concerns, thus excluding you from Tricare. However, for spouses or kids, it doesn’t matter what they have – as soon as they marry the service member everything is 100% covered. With a single payer system, you don’t have to marry a military member to get this kind of full coverage if you have a preexisting condition. Simply by being an American you would have healthcare.

Still the biggest drawback on a single payer system is your ability to choose your doctor. In Tricare you are assigned a primary care doctor who handles all your day to day care and refers you out to other specialists if you need them. While that works great if you have a good primary care doctor, if he isn’t any good it can lead to a lot of headaches. While you can change your primary care doctor it can be a pain.

In a civilian single payer system there would have to be a system to address who you can see, if not everyone is going to want to see the top doctor every time their nose runs. I think a system where you have a choice between 3 primary care doctors – think a family health doctor, that can refer you out to specialists is the way to go. Of course, being limited on who you can see is a definite drawback of the system.

With this information and my personal experience on Tricare I am a strong activist for a single payer system. It is insane that in the United States there are people that lose every dime in their savings account or go into massive debt because they fall and break their arm. It’s even crazier that there are people with cancer that can’t get treatment because they can’t afford it. They are sentenced to die because they can’t afford the care that could save their life. People deserve better, and in America we have the option to give them better, it’s beyond time we did so.