Advice for Stephen Colbert when interviewing President Clinton in St. Louis

I hope Stephen Colbert asks President Bill Clinton about health care on Saturday.

Colbert is a brilliantly satiric political comedian and host of Comedy Central’s “The Colbert Report.”

Last June, Clinton said that if we adopted a health system similar to Canada's or those in Europe we'd have universal coverage and gain “a trillion dollars or more a year for pay raises, for investment in new technology, to create new jobs or whatever.”

Adopting a single-payer system -- in the U.S., for example, improving Medicare and extending it to cover everyone -- is how every other modern nation has done what we seem unable to do: provide high-quality health care to all citizens at roughly half what we pay. Plus, the residents of those nations live longer and healthier lives than we do.

Colbert will interview Clinton Saturday at Washington University in St. Louis during the closing session of the Clinton Global Initiative University being held here April 5-7. They really need to talk about health care.

President Clinton also stated that a single-payer system would dramatically reduce waste in administrative costs and overhead. The approximate annual savings are estimated at $570 billion, according to University of Massachusetts-Amherst professor of economics Gerald Friedman. These savings would come from reduced administrative costs and more favorable pricing of drugs and medical equipment.

Many of these price reductions would be possible due to one simple market reason: increased purchasing power. With Medicare as the single purchaser of health care services in the United States, its expanded market share would empower the kinds of stronger price negotiations done by all other modern countries.

Clinton also made the point that the United States spends over 17 percent of its GDP on health care costs, while Germany, France and Canada each spend just over 10 percent. This discrepancy is even more striking when we consider that our system leaves tens of millions of us without any insurance, while these more frugal countries provide affordable health care to every one of their citizens. That’s part of the reason why they live longer and healthier lives.

This is why I hope Colbert asks him about single-payer health care.

I hope he also asks Clinton about the hottest health care issue sweeping many states today: the transformation of Medicaid.

The Patient Protection and Affordable Care Act (ACA) encourages states to make Medicaid more available to 10 million working poor by paying 100 percent of the cost of their care for three years, gradually requiring states to pay no more than 10 percent by 2020. Unexpectedly, the Supreme Court decided last summer that states could chose to not do this.

Expanding Medicaid is the smart thing to do. In Missouri, for example, it will create 24,000 new jobs in our state in 2014, bring $8.2 billion into our state by 2020, and preserve millions of dollars every year for important services such as higher education.

Expanding Medicaid is also the right thing to do. It would start to provide health care access for around 260,000 poor Missourians today. Most of these folks work full-time at jobs that just don’t provide an affordable health care benefit. They are working, yet they risk bankruptcy with each illness or injury.

Medicaid isn’t the perfect solution, it needs some fundamental improvements, but it’s incredibly better than having no insurance at all. Many lives are at stake, not just in Missouri but across our nation.

For these reasons, I hope Colbert asks President Clinton about health care. The country is listening.

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Arthur Yakov Krichevsky is a Pharm.D. at the St. Louis College of Pharmacy and a board member of Physicians for a National Health Program – St. Louis.