U.S. health care spending reached $3.65 trillion last year, a number that has residents nationally and in Southwest Colorado examining how the health industry could be reformed.

Medicare for All is an alternative to the status quo that could help control health care costs for consumers, expand coverage to more Americans and reduce administrative overhead for doctors, said Guinn Unger, with Healthcare Durango, a nonpartisan educational group.

“The current system is not built to deliver health care to you, it is built to deliver profits,” Unger told a small crowd Saturday at Durango Public Library.

Medicare for All, as proposed in a pending bill in the U.S. Senate, would replace private insurance by expanding Medicare, government insurance for those 65 and older, to everyone. The benefits available through Medicare would also expand to include comprehensive drug coverage, and dental, vision and hearing benefits.

If Medicare for All expanded, health care providers, such as doctors and hospitals, would still be run independently from the government, Unger said.

Exactly how Medicare for All would be paid for is unknown, but it would likely include a tax hike of some kind, he said. An increase in taxes would replace the other costs Americans pay for insurance, such as high deductibles, premiums and co-insurance, Unger said.

The cost of Medicare for All would likely be in line with what the U.S. would spend on health care anyway, and it would cover the 28.5 million Americans who don’t have health insurance, he said.

The cost of instituting Medicare for All over 10 years could be at least $32.6 trillion, according to a study by the Mercatus Center.

The increase in spending would be driven by medical inflation, which is about 6% per year, not by the transition to a government-run payment system, Unger said.

It’s also possible if Medicare for All paid for everyone’s health care costs, Americans could see costs drop.

For example, Congress could repeal a measure preventing Medicare from negotiating drug prices with pharmaceutical companies. In some cases, negotiating prices could cut the prices for some drugs in half.

“The price of EpiPens would come back down, the price of insulin would come back down,” Unger said.

Medicare also provides far more efficient administration of health care benefits than private companies, he said. Medicare’s administrative overhead is 2%. Private insurance companies spend 20% on administration, he said.

While consumers would benefit from a Medicare for All system, those working in the private health care industry would have to find new jobs, Unger said.

“In my opinion, we would need to help those people,” he said.

Despite some major unknowns about Medicare for All, it has found strong support in some national polls. A Reuters poll in March found 64% of a national sample of 2,936 Americans would support the measure.

Strong polling numbers for Medicare for All reflect a frustration with the high cost of health care, Unger said.

“People are just getting to the point where they can’t afford it,” he said.

mshinn@durangoherald.com