By Mark A. Krehbiel, M.D.
Salina (Kan.) Journal, Jan. 6, 2016
The divisiveness in the world today seems very troubling to me. Information technology gives us the ability to respond immediately to situations that arouse our emotions. The “oh my gosh!” or “can you believe that?” are common utterances that feed our senses to join the bandwagon, laugh it away, become upset or even angry.
Of course, there are exceptions to every rule, but I truly believe that as humans we have core values that most of us can agree upon. We believe in individuality, equality and the right to be comfortable and work hard to achieve goals. Most would agree that volunteerism and helping those in need are strong core values.
We are entering a new year with many questions and fewer answers about how to solve our differences. I find it interesting that our president’s low approval rating is very similar to President George W. Bush’s rating at the same point in his administration. Although both men had different styles and different agendas, I believe they both have similar core values and tried their best to do the right thing for our country and the world. Apparently, there are many Americans who think things could be better. We forget how blessed we are to live in this country of opportunity and freedom.
Many of us think our health care system needs improvement. The Affordable Care Act was an attempt to get more uninsured Americans better access to health care. I laud Barack Obama’s attempt, but disappointing facts remain. Many of us, insured, underinsured and uninsured, are not happy with the system.
As it turns out, the insurance companies and pharmaceutical companies are the big winners. Insurance coverage costs are rising. Insured customers are not using their insurance because of high deductibles. There are still millions who cannot get the care they need. Our nation still ranks very low in infant mortality and other health care outcomes. If you live in Canada or Cuba, your life expectancy is longer than if you live in the U.S.
As one of only a few industrialized countries in the world that does not have universal coverage for all of its citizens, now is the time to continue reaching for that goal. The insurance companies and pharmaceutical companies need to be taken out of the driver’s seat. Let doctors and hospitals do their jobs without worrying about payment.
There are now more employees working in billing and administration than there are the number of beds in U.S. hospitals. In contrast, there are three people working in billing at one large Toronto, Canada, hospital.
The solution is one insurance company. A single-payer system or Medicare for all would achieve truly universal care, affordability and effective cost controls. By taking private insurance companies and administrators out of the equation, it is estimated we would save $400 billion (that is with a “B”) annually.
Many are concerned about another government-run system. The fact is that regulations now exist from the Centers for Medicare and Medicaid Services that basically tell hospitals and physicians what they need to provide, what they can charge and how much they get paid. The insurance companies just take a percentage off the top.
Some states are thinking of trying this system. Colorado, Oregon, Massachusetts and Vermont have all been discussing this. Although admirable, we need the whole country behind such a change. More than 60 percent of physicians are in favor of such a system. Other polls have shown that two-thirds of Americans would favor this.
The system as described would cover all doctor visits, deductibles, medications, hospital charges, nursing home services and ancillary health care needs. It would be paid for by a tax that for most of us would be less than we now pay for insurance.
If you agree with any part of a single-payer system, would like to take the hassle out of deciding on your health insurance annually, or just need some health care and a way to afford it, just check out legislation already before Congress. H.R. 676, the Expanded and Improved Medicare for All Act, has more than 60 sponsors. It explains how this would work.
In this politically charged environment and election year, this might seem to be an insurmountable task. However, I truly believe that with enough groundswell of support, like many past, slow-moving social change events, this will become a reality. There are many reasons for covering the basic needs of health care for all of us Americans. Mostly, I believe, because it is the right thing to do.
Dr. Mark A. Krehbiel has practiced medicine in Salina for nearly 37 years.