By Louise Marie Roth
The Hill, November 16, 2018
I was in Canada this past June when I broke my wrist and had to go to the ER. They were fast and professional and the bill was much lower than what American ERs charge you just for walking in the door.
Under single-payer health care, you can see the savings on administrative costs with your own eyes. When you walk into physicians’ offices in Canada, they have a small administrative staff, often consisting of one person behind the counter.
They don’t need to employ extra people to fill out dozens of different forms for various insurers with multiple plans, all with different copays, deductibles and coverage. There are no copays or deductibles and everyone knows the rules for what is covered and how to bill the provincial insurance plan. They don’t need staff to spend hours fighting with insurers about which services or medications they will cover or how much they will pay.
Meanwhile, the U.S. pays more than twice as much per capita for health care ($10,348 in 2016) than Canada ($4,752), Australia ($4,708), or the UK ($4,192), but has lower life expectancy and higher infant and maternal mortality rates even compared to some less developed countries.
As someone who grew up in Canada and moved to the United States more than two decades ago, I have seen firsthand that American health care is expensive, unequal and inhumane – and that there is a better way that costs less, is more equitable and covers all pre-existing conditions. It’s time to solve this problem with single-payer health insurance, so that everyone gets care regardless of their ability to pay.
In this year’s midterm elections, health care was a top issue for American voters and nearly 60 percent favored Medicare-for-all. Now that the Democratic Party is poised to take over the House, it’s time to move forward. The most likely next speaker, Nancy Pelosi, said that all health-care options are “on the table,” and 123 Democratic representatives in the House are co-sponsors of Medicare for All legislation.
Even though the ACA was an inferior solution compared to single-payer, the result is that a growing number of Americans once again lack adequate health insurance.
Of course, Republicans, including President Trump in a recent USA TODAY oped found to have many fact errors, are fighting Medicare for All by calling it “socialism.” But when I ask my students if they would prefer a capitalist fire department, where firefighters only put out a fire if you have up-to-date private insurance or can pay the bill, they think that a taxpayer-funded socialized fire department is a much better idea. They do, however, worry that single-payer health care would not work in the U.S. because of its larger population. They usually don’t know that the U.S. already has socialized medicine in the form of Medicare and Medicaid, which covers more than 30 percent of the population. If federal and state governments can cover more than 30 percent, then why can’t they simplify the whole system and cover everyone?
Single-payer is simply the most efficient and most humane way to cover everyone, including those with pre-existing conditions, which many people have through no fault of their own.
My oldest son had a vascular malformation in his brain and needed brain surgery when he was six. Fortunately he is doing fine now but, as the federal government removes more and more of the protections under the ACA, I wonder if he will be insurable when he is no longer covered under my insurance. Why should he be unable to get insurance or have to pay exorbitant premiums when he did nothing to cause his medical history? Luckily he has an anchor mom – he can always move to Canada. Not everyone has that option.
Dr. Louise Marie Roth is an associate professor of sociology at the University of Arizona and a Public Voices Fellow with The OpEd Project. She teaches medical sociology and is writing a book about maternity care in the United States.
By Don McCanne, M.D.
The author is an academic sociologist from Canada who lives and teaches in the United States. Her lightly edited op-ed is reproduced here since it represents a highly credible, expert view on why the United States should enact and implement a Single Payer Medicare for All system much like Canada’s rather than perpetuate our overpriced and underperforming health care financing system based on ACA.
Would it be that we were all as intelligent and discerning as her, we would make the change now.
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