By Liv Osby
Greenville (S.C.) News, April 29, 2018
There was the uninsured truck driver in his 50s who skimped on his blood pressure medication because of the cost and wound up having a stroke.
And the housekeeper in her early 60s who couldn’t afford health insurance on her meager wages and had no way to pay for breast cancer treatment.
Over the years, there have been thousands of other patients like these, said Dr. David Keely, a family physician who spent his career caring for people who had trouble affording health care.
“I’ve seen it over and over,” he told The Greenville News. “Either their illness got worse because they were unable to afford their medication or they presented uninsured with hardly any money and had a medical condition that had to be treated.”
Now semi-retired from a community health clinic in rural Rock Hill, Keely is trying to make healthcare something that all Americans — poor, uninsured and underinsured included — can access by establishing a chapter of Physicians for a National Health Program in Greenville.
“The goal is to mount an awareness campaign about the inequities (of) our current system,” he said, “and try to get a grass roots movement to … make our health care system better with the ultimate goal of single-payer financed, privately delivered universal care.”
PNHP is a nationwide nonprofit made up of 20,000 physicians, medical students and health professionals who support single-payer national health insurance.
Also known as Medicare for All, it would operate the way Medicare insurance does now, paying for care by private providers. It would cover doctors, hospitals, mental health, dental and vision care, prescription drugs and more, according to the group, and be funded by the savings from replacing the current system.
Surveys show most Americans favor the idea of Medicare for All, including 75 percent of Democrats and 46 percent of Republicans, according to PNHP.
Affording health care
As the first physician in his family, Keely started a practice in Chester County to repay his obligation to the National Health Service Corps, which helped pay his tuition to medical school in return for practicing in a high-need area.
Seeing the hardships his patients endured, Keely attended a PNHP presentation where a speaker said that 45,000 people in the United States die every year because they lack access to affordable health care.
“It was the equivalent of a jetliner crashing every other day and nobody surviving,” he said. “I thought ‘That’s immoral.’ ”
So Keely helped launch a chapter of PNHP in the Palmetto State. Called Healthcare for All – South Carolina, it has branches in Charleston, Columbia and Florence.
And now a regional group is getting started in Greenville.
“There are many reasons why a single-payer system would be better for us,” said Greenville psychiatrist Dr. Patrick Mullen, who is among the supporters.
For example, he said, dealing with only one insurer instead of many would be less complicated and save money.
Desperate need
“One simpler system to deal with — and I don’t see how it could be any more complicated than it is,” he said. “And I can’t think of anything bad from the standpoint of the health of the population.”
One of the group’s first events in Greenville is a May 2 presentation by Dr. Ed Weisbart, assistant professor of clinical medicine at Washington University in St. Louis, Missouri, and chair of the Missouri chapter of PNHP.
A family physician who volunteers at safety net clinics, he’s also seen his share of patients in desperate need.
One 63-year-old woman supporting three grandchildren stopped taking her blood pressure medicine to make the rent so the family wouldn’t be homeless, he said.
Another patient with warning signs of a massive stroke couldn’t afford an expensive test and surgery, so she rolled the dice and waited until she was eligible for Medicare about six months later.
“That’s not what should happen,” Weisbart said. “If she had had this stroke, and then been disabled, it would have been even more expensive to take care of. It’s not even a good business strategy to have people make these trade-offs.”
Yet all over the country, Weisbart said, people are going bankrupt and losing their homes because of medical bills.
Four in 10 Americans are fearful of having to pay for a serious illness, according to PNHP. Even the insured have difficulties, said Weisbart, noting that he and his wife pay $2,000 a month in insurance premiums and have a deductible of $12,000.
‘Opened my eyes’
Michelle Hunt and her husband have three young daughters, and the 6-year-old has been battling severe asthma most of her life.
The doctor just prescribed a medicine that costs $245 a month in addition to her $115 rescue inhaler, Michelle Hunt said. But with insurance premiums of $550 a month, that was going to be hard for the Rock Hill couple.
“I reached out … to see if there were any other cheaper medications, but there weren’t,” she said. “We have found a coupon that will bring it down to about $200. So I guess we will have to cut back on other things.”
Among them is her own allergy medication, which costs about $50 a month, she said. They may also cut out cable TV and other things they can live without. Her mother has also offered to help with the costs of Emily’s medicine.
“This is something she has to have to breathe better,” said Hunt, 38, a risk management administrator for a telecommunications company.
“We’ve never had anything like this happen before,” she said. “But even with insurance, this really opened my eyes. We need something to help out with these costs.”
Covering everyone
Weisbart said insurance overhead makes up 15 to 20 percent of health care costs. In addition, he said, the average independent physician has $85,000 worth of staff that does nothing but deal with insurance.
“I see this as a problem that’s affecting Americans and I believe the most prudent way to solve it is to take Medicare, improve a few things, and provide it to everybody,” he said.
Most research shows that a single-payer option – which is not socialized medicine but an insurance plan – would result in a dramatic savings or at least break even with everyone covered, including the 28.8 million Americans who are uninsured now, he said.
“Other countries with single-payer systems spend half of what we do,” he said, “and they live longer.”
Keely, who still spends about 20 hours a week as a volunteer physician, said he isn’t unrealistic about the headwinds the group faces, but adds that the current system is unsustainable.
“We don’t think we have our heads in the wrong place, but it’s certainly a marathon and not a sprint,” he said. “It’s heartening to be able to reach people and get them be able to say, ‘I just hadn’t thought about this and what you say makes sense.’
“That’s what keeps me going.”
