In medical school I am seeing the tragic results of a profit-driven corporate health insurance system. It’s worse than I thought, but there is an obvious way to fix it.
The private health insurance industry restricts Americans’ choice, dictating which doctors we can and can’t see, which hospitals we can and can’t go to, and which treatments or prescription drugs we can access. That’s what you get if you are fortunate enough to have insurance; too many of us do not.
Despite major gains under the Affordable Care Act, 10% of South Carolinians remain uninsured. Our state ranks 36th in the country for health care, 36th for access to care and 40th for public health.
At least four rural hospitals in South Carolina have closed over the past 10 years, and the state’s Medicaid agency is trying its best to help struggling hospitals stay afloat.
Medical school has helped me further realize that “Medicare for All” is our best solution.
With Medicare for All, Americans would finally be provided total choice of doctors and hospitals.
With Medicare for All, virtually every physician would be in-network, allowing us to choose doctors and hospitals for ourselves without worrying about out-of-network prices or surprise bills. This comprehensive coverage would be free at the point-of-care, with no premiums, deductibles or any other form of unpredictable out-of-pocket costs. No more need to declare bankruptcy because you got sick or were in an accident.
The economy would love Medicare for All, too.
Employers would be freed of the albatross of paying for employee health insurance, and every American would be free to change jobs without needing to change (or lose) insurance and find a new doctor.
Hospitals would fare better financially.
Today, most private insurers pay hospitals on a fee-for-service basis, encouraging them to provide increasingly expensive technological care while neglecting their community’s needs for more primary care, obstetrics, mental health and the treatment of addictions. Hospitals that manage to provide care for people without insurance are financially penalized for helping their community. That’s just not the right way to set up a health care system.
With Medicare for All, there would be no more uncompensated care. By partnering with the government to develop budgets, hospitals would be paid based on the health needs of their communities, ensuring that vital hospitals wouldn’t be improperly forced to close. Special reserves would be set aside for unanticipated public health crises.
And providers would be freed up to spend more time focused on patients instead of fighting insurance companies — whose business model is denying care.
For any American family, private insurance is, at best, an unacceptably risky bet. Even the supposedly solid private insurance plans, for example those Culinary Union plans recently at the center of heated debate in Nevada, are subject to the whims of these companies and do not guarantee coverage for medical necessities. Medicare for All would guarantee comprehensive coverage.
We cannot afford any more of the scam that is this cruel corporate multi-payer maze masquerading as a health insurance system. It is a malevolent bureaucratic nightmare that skims 34% off the top of our national health care spending. And for what? Marketing and outlandish salaries and bonuses for executives, of course, but also unnecessary paperwork for us providers and the sham administrative costs inherent to such a parasitic system. It is inexorably inefficient (and “Medicare for All Who Want It” maintains the same inefficiencies that make our health care system so expensive).
Meanwhile, Medicare’s administrative overhead is less than 3%.
South Carolina, and America, needs single-payer Medicare for All. Everything else is more expensive, wasteful and will continue to take away our health care choices.
Ian O’Connor is a medical student at the Medical University of South Carolina and founder and president of the MUSC chapter of Students for a National Health Program.
