By Jack Mayer, M.D., M.P.H.
Vermont Public Radio, May 25, 2017
Winston Churchill once quipped that, You can always count on Americans to do the right thing – after they’ve tried everything else.
I like that quote because it allows me to be cautiously optimistic that in the end, the current chaotic health care debate may actually result in a Medicare-for-All, single payer system.
We already have a limited form of this in Medicare and Medicaid. Both work very well and provide excellent care for all who are eligible.
I’ve been a Vermont pediatrician for decades and I’ve been advocating for a single payer system since medical school. Obamacare – also known as the Affordable Care Act or the ACA – was a modest step towards universal coverage, but its repeal and the Republican bill to replace it will be dangerous for my patients, because there are multiple problems with the American Health Care Act – or what I prefer to think of as Trumpcare.
According to the Congressional Budget Office, if the proposed Trump/Republican health care plan passes, 23 million will lose insurance, premiums will rise, pre-existing condition protections will be at risk, Medicaid will be slashed, costs will be shifted to hospitals, clinics and states, and huge tax-breaks will accrue to people with incomes over $200,000, as well as big insurance and drug companies – while the rest of us get virtually no tax relief.
Almost every medical organization and AARP opposes this Republican plan.
But any insurance-based system will be dependent on the obsolete medical insurance industry, as it acts as an intermediary between providers and patients, without providing even one iota of care. And this places enormous administrative burdens on providers, while producing dubious outcomes. No other country pays as high a proportion of GDP towards health care and gets less quality and access than the United States.
A single payer plan would simplify the delivery of health care – and would do so with greater equity and fairness. Every other industrialized country provides a system of inexpensive, universal access to health care in recognition that health care is a human right, not a free-market commodity.
Without affordable access, children born into struggling families lose health insurance, and families go into debt or bankruptcy. Untreated children and adults suffer, thousands die.
Perhaps after trying everything else, Americans will finally see the wisdom in a system that would be equitable, simpler, less expensive, and provide excellent care for everyone.