Republican myths handicap their thinking and, when they control of all three branches of government, they handicap the rest of us.

Take the belief that private industry is always more effective and cost-effective than government. Few health care providers refuse to take Medicare patients. Most health care providers find it easier to deal with Medicare despite the fussiness of Medicare about the paperwork (it is a government agency after all) because Medicare is in the business of paying legitimate claims. Private insurance is in the business of maximizing corporate profits. That's a huge difference.


When the Tea Party political movement first arose, there was the picture of the woman parading with the sign saying "Keep government hands off my Medicare." In our lifetimes in this house, we have never experienced Medicare denying a legitimate claim, but in the days when we dealt with one of the biggest insurance companies both our orthopedic surgeon and ourselves got very frustrated with the company denying his choice of treatments. Why did we have that cheapskate insurance? Well, the big company absorbed the smaller one of our choice and we had to wait until the open season to select an insurer with a better record of payment.

Salaries of government executives from the president on down are limited to be no more than the salary of the president. Hence the overhead cost of the Medicare program is a mere fraction of the overhead cost of private insurers. Check the salaries, bonuses and other benefits of those private insurance companies. And add in their advertising expenses.

Medicare is supported by financing through a trust fund like old-age Social Security. These trust funds are supported by a dedicated payroll tax and invested in safe government bonds. Every few decades that payroll tax needs to be adjusted to keep the trust funds solvent over the long term. The last time this happened, we had a sensible president (Ronald Reagan) and a sensible speaker of the House (Tip O'Neill). This time we have a totally erratic president and a speaker who wants to expose the trust funds to the vagaries of the stock markets.

In the words of that Tea Party lady, "Speaker Ryan keep your hands off my Medicare." (But adjust the FICA tax as needed, please, for my children's sake.)

Republicans need to remember that Obamacare is based on Romneycare, which in turn was based on a blueprint for health care promulgated by the ultra-conservative Heritage Foundation. All three plans are designed to keep private insurers in the health care market. Frankly, I don't own any stocks in the health care insurance sector. If they close their doors over time, I won't weep.

When we compare ourselves to other Western nations like the United Kingdom, Canada, France, Germany, etc., they all have similar or slightly better life expectancies but spend less than half as much as we do per citizen on health care. They all have some form of socialized medicine. We have too many citizens who work hard but can't afford to seek medical care. It is the premiums, the co-pays, the deductibles, the cheapskate policies chosen by many employers that deny them health care in fact. Many times the really poor seek care in the emergency rooms, the most expensive form of care, raising the costs for the rest of us, or they just don't get care at all.

My interim solution to the health care payment system is a public option for Obamacare administered by the Medicare folks but financed by premiums paid by the insured persons. Private insurance can't meet that competition even if there is no tax subsidy.

But Republicans won't consider such an approach. It is too simple and too guaranteed to work.

Wealthy sheiks may use the Mayo Clinic, but that doesn't help the hard-working woman who cleans houses and can't afford to put teeth in her mouth. She's a citizen, the sheiks aren't.

John Culleton writes from Eldersburg. His column appears every second Tuesday. Email him at cct@wexfordpress.com.