PNHP

Hospital and Group Practice Profit Motive Poses as Big a Threat as Insurers

Hospital and Group Practice Profit Motive Poses as Big a Threat as Insurers

Recent Changes in Physician Practice Arrangements: Private Practice Dropped to Less Than 50 Percent of Physicians in 2020, AMA Economic and Health Policy Research, May 2021, by Carol K. Kane

“2020 was the first year in which less than half (49.1 percent) of patient care physicians worked in a private practice—a practice that was wholly owned by physicians. This marks a drop of almost 5 percentage points from 2018, when 54.0 percent of physicians worked in physician-owned practices, and a drop of 11 percentage points since 2012. In 2020, almost 40 percent of physicians worked directly for a hospital or for a practice at least partially owned by a hospital or health system.

The shift toward larger practice size, which has been ongoing for many years, also appears to have accelerated between 2018 and 2020. The percentage of physicians in practices with at least 50 physicians increased from 14.7 percent in 2018 to 17.2 percent in 2020.

Fifty percent of physicians were employed, 44.0 percent had an ownership stake in their practice, and 5.8 percent were independent contractors in 2020. The employee percentage was up from 47.4 percent in 2018 and 41.8 percent in 2012.”

Comment:

By Steffie Woolhandler, M.D., M.P.H. and David Himmelstein, M.D.

The rapid shift from private practice to employment by large corporate organizations – a shift that’s even more marked among doctors under 40, 70% of whom were employees by 2020 – has important implications for health care reform. Insurers’ profit-seeking is the main threat to the clinical independence of doctors in private practice. But pressure from employers seeking to bolster their bottom line is an additional threat – sometimes the main one – for those whose paycheck comes from a hospital, health system, group practice or private equity firm. Private practitioners lose income if they offer free care to an uninsured patient, open their practice to Medicaid patients who bring scant reimbursement, or advise patients to hold off on undergoing a lucrative procedure. Employed doctors risk losing their jobs for repeated offenses against their organization’s profitability.

Hence, this latest AMA survey data highlights the importance of eliminating profit incentives that bend clinical priorities in both non-profit and for-profit health care institutions. For-profits should be banned, as Medicare used to do in its home care program. Non-profits should be paid global operating budgets and prohibited from retaining any surpluses or using the money not spent on patients for outrageous executive compensation or profit-based bonuses for employees.

http://healthjusticemonitor.org…

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Learning from COVID-19: Public Funding of Drug Development

The covid-19 vaccine patent waiver: a crucial step towards a “people’s vaccine”, BMJ blog, May 10, 2021, by Gregg Gonsalves and Gavin Yamey

“An IP waiver would allow other producers to step in and make raw materials for export for all the current vaccines, industrial parts, and components. It would also simplify agreements for eventual production of more doses. But an IP waiver alone will not solve the covid-19 vaccine access challenge. Two further steps will need to be taken to reach a people’s vaccine. Step two is a transfer of technical know-how from vaccine makers in the global north to regional hubs or directly to manufacturers in the global south. Step three is vast subsidization of manufacturing in LICs and LMICs.

Thousands of lives can be saved immediately through a donation model. But at the same time, we need to get going now on a people’s vaccine, since the ramp-up of vaccine manufacturing will take time. Companies in LICs and LMICs are hungry to get going. When the WHO recently announced it was seeking LIC/LMIC manufacturers who want to produce mRNA COVID-19 vaccines, it was inundated with proposals. Right now, the world’s scientists and politicians need to pull together to figure out how to get the next steps done. Technology will need to be transferred to a set of potential new producers, which will require experts to be mobilized for this task, many at the originator companies themselves. New financial resources must be mobilized to support building new factories or retrofitting old ones and to coordinate supply chains and other operational tasks at a global scale. The sooner we start, the faster we bring an end to the pandemic.”

Comment:

By Adam Gaffney, M.D., M.P.H.

Two weeks ago, England saw zero deaths from COVID-19, a testament to the efficacy of vaccines and to the NHS’ efficient vaccination campaign. Similarly, with a majority of its population vaccinated, Israel (but not the neglected Occupied Palestinian Territories) has seen a remarkable retreat of SARS-CoV-2. And the US appears to be following — my state of Massachusetts announced zero COVID deaths on May 10th. Meanwhile, the pandemic is continuing its horrifying course in nations including India and Brazil. Global vaccine apartheid is, in part, to blame for these divergent paths.

COVID-19 vaccines should have been delivered and distributed, on the basis of need, to every nation on Earth; instead, rich nations (including the US) have signed contracts with pharmaceutical firms allowing them to horde vaccine supplies far in excess of population needs.

As public health experts Gregg Gonsalves and Gavin Yamey noted in the British Medical Journal, vaccine donations to low-income nations could save lives immediately. However, as they also argue, controlling the pandemic worldwide requires ramping up global production of a “People’s Vaccine” unrestrained by patent protection.

Intellectual property regimes have long resulted in artificial shortages of needed pharmaceuticals. The COVID-19 pandemic is no exception, but this could have been avoided.  As Physicians for a National Health Program’s 8-point COVID-19 response plan noted more than a year ago,

“…the US should eliminate intellectual property constraints like patents and trade agreements that might restrict the low-cost production and distribution of essential drugs and vaccines, including those developed from publicly-funded research.”

The Biden administration took a step in the right direction last week when it endorsed a waiver of patent rights on COVID-19 vaccines. However, as Gonsalves and Yamey note, this is not enough. While removal of patent protections allows generic drug manufacturers around the globe to cheaply produce small molecule pharmaceutics, the production of more complex biologic agents, including vaccines, additionally requires a transfer of technology, e.g.. the knowhow and trade secrets that go into the production process, as well as financial support. But this is something that we can do — indeed, it should have begun already.

Some have questioned the utility of this approach, or decried “patent busting” more broadly. However, as James Love’s Knowledge Ecology International (KEI) has shown, “companies with pre-existing drug and vaccine manufacturing capabilities can start producing COVID-19 vaccines relatively quickly, if technology transfer is made.” KEI has compiled a database of outsourcing agreements involving technology transfer for COVID-19 vaccine production, and concluded: “In almost all of the cases where information is available the manufacturer said that they were going to make the first delivery, or actually started delivering [vaccines], within six months from the deal announcement date.”

The lessons to be drawn from this episode should extend beyond the pandemic. A drug development system driven by windfalls from intellectual property ownership is neither just nor efficient — nor is it necessary. We already publicly-fund much of the basic research that underlies drug development; we could publicly-fund the whole pipeline — including clinical trials — as well. As PNHP’s comprehensive pharmaceutical proposal, published in the British Medical Journal in 2018, set forth, we need a path of full public funding of pharmaceutical development by the National Institutes of Health. Such a program would deliver agents that would be in the public domain immediately — for the benefit of the entire global community.

http://healthjusticemonitor.org…

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Introducing the McCanne Health Justice Monitor

We are excited to bring you the first HJM blog post. Please read on to learn about our mission and (we hope) support us in the fight for achieving health justice.The COVID-19 pandemic laid bare the inequities, inefficiencies, and fragility of U.S. health care financing. Millions lost job-based health insurance at the same time as they lost income, with people of color and those with the fewest resources hardest hit. According to recent polls, two-thirds of Americans believe that the government has a responsibility to assure health coverage for all. The time is ripe for fundamental health reform, an integral part of the progressive social agenda.

In pursuit of this vision, we are launching the McCanne Health Justice Monitor, a continuation and expansion of Don McCanne’s Quote of the Day (QOTD). Don single-handedly produced that informative and inspiring daily health policy update for over 20 years. His more than 5000 posts tackled a broad range of health policy issues, always ending with a call to common sense: “Let’s do single payer, already!” (or words to that effect – Don never repeats). Don offered a guide to understanding myriad policy developments as a tool in the pursuit of justice, a goal that can be attained only through single payer reform. Recently, Don chose to step back from his daily labors, and offered his support for our team to build on his efforts. Our debt to Don and our vision for this new undertaking are reflected in our name.

The McCanne Health Justice Monitor will continue and expand the QOTD mission. We will retain a focus on the failings of the U.S. health system and, of course, single payer reform. We expect to increase coverage of other areas vital to a progressive agenda for health, including racism and racial inequities, climate and environmental justice, and the global health injustices affecting low- and middle-income nations. Since no individual could match Don’s efforts, we have assembled a group of health policy experts as core contributors, with each contributing several items per month. We will also feature guest contributors on a broad range of topics.

There is no time like the present to replace the unequal and unjust U.S. health care system with a simple, practical, and humane single payer system. We will endeavor to regularly bring you informed and responsible policy updates and views on how to achieve health justice.

http://healthjusticemonitor.org…

Stay informed! Subscribe to the McCanne Health Justice Monitor to receive regular policy updates via email, and be sure to follow them on Twitter @HealthJustMon.

Demonstrators push for ‘Medicare for All’ at west Toledo rally

Rallygoers say a single-payer healthcare system would save over $400 billion in administrative costs every year, allowing everyone in the country to be covered.

WTOL CBS-TV (Toledo, Ohio), May 22, 2021

“Everybody in! Nobody out! Everybody in! Nobody out!”

That was the chant outside of ProMedica Toledo Hospital in west Toledo on Saturday as demonstrators advocated for the adoption of single-payer healthcare in the country.

Typically, in a single-payer healthcare system, there is one government-run insurance carrier that covers everyone in the country regardless of their ability to pay.

Rallygoers marching along Monroe Street chanted and carried signs to show support for and demand hearings on “Medicare for All” which they say would save over $400 billion every in administrative waste according to the Congressional Budget Office.

‘The Medicare for All Act of 2021’ was introduced in March in the House of Representatives and has over 110 cosponsors, all Democrats.

Marcy Kaptur, who represents parts of Toledo and other areas of northern Ohio, stretching to Cleveland, is not listed as a cosponsor of the legislation.

State Senator Teresa Fedor (D-11th District) and Toledo City Councilperson Nick Komives (D) participated in the event.

“We’re looking at bigger broader picture of making sure that dental, vision, and regular checks are all part of Medicare. It shouldn’t cause bankruptcy. It shouldn’t cause stress about the cost of going to see a doctor,” said Dennis Slotnick, Region 2 coordinator of the Single-Payer Action Network Ohio.

‘Medicare for All’, was originally popularized during Vermont Senator Bernie Sander’s presidential campaigns.

The demonstration was organized by Single-Payer Action Network Ohio, a non-profit coalition that advocates for fundamental reform of the health insurance system.

https://www.wtol.com…

Medicare for All Explained Podcast: Episode 56

Interview with Rosie Bean

May 15, 2021

Medicare for All would ease some of the barriers facing both LGBTQIA patients and patients with disabilities, says activist Rosie Bean, who details their own six-year ordeal applying for Social Security Disability Insurance and the significant impact it made on their life once benefits were approved. Under a single-payer program, they say, accessing medical care would be “a simple process instead of a very complicated process.”

Additional episodes will be uploaded twice monthly. Subscribe in iTunes, or access a complete archive of the podcast, below.

https://medicareforallexplained.podbean.com

How an Expanded Medicare for All System Would Work & Transform Health Care in the U.S.

Interview with Dr. Micah Johnson and Phillip Kim

KALW San Francisco, Your Call, May 12, 2021

On this edition of Your Call, host Rose Aguilar took questions about what an improved and expanded Medicare for All system would look like. How will it work and how will we get there?

The U.S. spends more on health care than any other industrialized nation, but it ranks last in health care access and quality, according to the Health System Tracker. One in 10 Americans have no health care coverage at all. More Americans lack access to health care than citizens in any other wealthy country. Health care advocates say Medicare for All is the only solution.

Full audio:

https://www.kalw.org…

Guests:

Dr. Micah Johnson, physician, health care researcher and co-author of Medicare For All: A Citizen’s Guide

Phillip Kim, community organizer with the California Nurses Association / National Nurses United campaign for Medicare for All

Web Resources:

Jacobin, Jonathan Michels: Winning Medicare for All Would Have Massive Implications Beyond Health Care

Data for Progress, Sanjay Kishore & Micah Johnson: EXPAND COMMUNITY HEALTH CENTERS TO HEAL THE NATION

CNN, Abdul El-Sayed and Micah Johnson: Medicare for All would have ensured the US had a better pandemic response

CapRadio, Sammy Caiola: With Latest California Single Payer Health Care Bill Shelved, Advocates Push Newsom For Support

Stanford Medicine: Jump in cancer diagnoses at 65 implies patients wait for Medicare, according to Stanford study

Covid-19 Vaccinations: A Shot in the Arm for Universal Healthcare?

The national vaccination program has all the features of a single-payer health care system including no copays, no premiums, no insurance company blocking payment, and universal, affordable healthcare for all.

By Peter Arno, Ph.D. and Philip Caper, M.D.
Common Dreams, May 4, 2021

As millions of us get vaccinated against SARS-CoV-2, we will get a first-hand glimpse of what a single-payer, Medicare-for-All approach to health care might mean, at least at the federal level. At the national level, the development and distribution of the vaccines have features of a single-payer approach to health care that set the program apart from business as usual in our private market-oriented health care system.

Vaccines are not usually profitable for pharmaceutical companies. It was therefore necessary for the federal government to subsidize the development and distribution of the Covid19 vaccines, mainly through Operation Warp Speed. As a result of these subsidies, none of us have to pay to receive the vaccine. Moreover, there are no documentation requirements to show eligibility and no disputes with insurance companies before or after vaccination. According to guidelines from the Centers for Medicaid and Medicare Services (CMS), “Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost.” Additionally, providers “may not seek any reimbursement, including through balance billing, from a vaccine recipient.” We will all be covered automatically with no out-of-pocket costs.

The national vaccination program has all the features of a single-payer health care system including no copays, no premiums, no insurance company blocking payment, and universal, affordable healthcare for all. The vaccine is being treated as a public good, not a private commodity, and its priority process is determined by medical need, not by ability to pay. Notably, given all this, the vaccine rollout has drawn no allegations of “socialized medicine” by those opposed to government-financed health care.

One cannot deny that administering the vaccine is a massive undertaking and undoubtedly it had a rocky start, but it has improved dramatically over the past few months. The question remains: will our first-hand experience of the federal response to the pandemic (delayed though it was) dispel the usual objections to single-payer health care? Or will most Americans conclude that the public health crisis caused by this pandemic is a one-off exception?  Since we all need access to medical care at some point—whether because of a pandemic, a variant in our genetic code, getting hit by a bus, or being struck by cancer or heart disease—it is clearly short-sighted to regard it as an exception.

Much depends on how many of us get vaccinated and experience the desired community protection and sense of solidarity underlying a universal health care model. If the outcome is positive, increased political momentum for a single-payer health system may be one of the most important results of this horrific pandemic. We’re all in this together, and what we’re learning is that government is not the problem; it’s the solution.

Peter Arno, PhD, is a Senior Fellow at the Political Economy Research Institute at UMass-Amherst and the National Academy of Social Insurance. Dr. Philip Caper is a physician and founding member of the National Academy of Social Insurance, and currently serves on the Board of Maine AllCare.

https://www.commondreams.org…

Why the “Public Option” Cannot Work (and Single Payer Can)

Single payer gets rid of expensive middlemen/health insurance companies but leaves our current healthcare providers in place – however, with more freedom to deliver care.

By Anita Kestin, M.D., M.P.H.
Uprise RI, May 4, 2021

The current COVID crisis has unmasked and magnified the many problems in our present system for health care coverage. Many politicians recognize the need for change, but rather than advocate for what every other industrialized nation in the world has (Single Payer universal healthcare), they push for something that cannot solve our health care problems: the “Public Option.”

Our current system of paying for health care is:

  • needlessly complex,
  • confusing,
  • wasteful,
  • tied to employment,
  • administered by private (often for-profit) companies,
  • not universal, and
  • onerous (for patients, providers, and employers).

In contrast, Single Payer (Medicare for All) is a vastly superior method of payment for coverage:

  • simple,
  • universal,
  • cost-efficient, and
  • has the leverage to negotiate prices for drugs, devices, and services.

KEY POINT: Single payer gets rid of expensive middlemen/health insurance companies but leaves our current healthcare providers in place – however, with more freedom to deliver care.

The Public Option might seem like an attractive “middle ground” fix for our broken system of paying for health care. The Public Option, however, leaves in place all our current problems.

  1. Continuing Skyrocketing Costs. There is no compelling evidence that the Public Option will lower overall costs. Numerous studies, however, have determined that Single Payer would save money for all but the wealthiest individuals, in addition to lowering the price tag of health care for businesses and providers. These analyses even include one study1 done by the Mercatus Institute, a conservative think tank that set out to prove that Single Payer would be more expensive and wound up demonstrating the opposite!
  2. Complexity. The Public Option merely adds complexity to our overly complex, wasteful system by grafting another insurance option on to our current set of insurance plans.
  3. Waste. It has been estimated that 33% of all “health care” dollars spent in the US is not used for actual spending on health care.2
  4. Unsustainability. The Public Option would allow Private insurers to continue to “cherry pick” the healthiest members for their plans and to shunt sicker patients to the Public Option. This will make the Public Option increasingly costly to maintain and send it into a death spiral.
  5. Insufficient Market Share to Negotiate Lower Prices. In contrast to Single Payer, the Public Option would not have the leverage to negotiate effectively for lower drug and device prices that would be more in line with what other Western countries are paying for these items.
  6. Limiting Choices. Health insurers currently limit your choice of healthcare providers and services. Single Payer gives consumers back their ability to choose the doctors and hospitals they want. 3 The only choice the Public Option gives you is one more plan with inadequate coverage.
  7. Delay implementing the only system that can work The near-certain death spiral of the Public Option plans merely delays enactment of Single Payer. The delay will continue to subject many to increased morbidity and mortality as insurance companies will be able to continue to deny care and consumers will continue to forgo needed care due to concerns about copays and deductibles.
  8. Forcing health care providers to focus on insurance requirements rather than care. The Public Option will leave in place all of the insurance red tape associated with our current system. In contrast, Single Payer will allow doctors, hospitals, and pharmacies to focus on health care, rather than on reimbursement.
  9. Injustice. Single Payer coverage would provide everyone with the same coverage and thus will eliminate an important source of discrimination based on race, identity, and income.
  10. Profit-Driven Decisions. The Public Option would leave private health insurance companies accountable to their shareholders. Single payer would make the health care payment system accountable to the public – all of us!

Support single payer by: 1) using this simple form to email all your federal and state elected officials and 2) signing an open letter of support. For more information, email: pnhp.ri@gmail.com.

Dr. Anita Kestin is a member of PNHP-RI.

https://upriseri.com…

References

  1. Charles Blahous. “The Costs of a National Single-Payer Healthcare System.” Mercatus Working Paper, Mercatus Center at George Mason University, Arlington, VA, July 2018.
  2. https://www.nejm.org/doi/full/10.1056/nejmsa022033; and https://www.politifact.com/factchecks/2012/may/11/jennifer-williamson/do-we-really-spend-nearly-third-health-care-dollar/
  3. https://upriseri.com/dr-anita-kestin-single-payer-oped/ March 10, 2021.

Medicare for All makes economic sense for WNC

By Theresa Hash and Ellen Kaczmarek, M.D.
Mountain Xpress (Asheville, N.C.), Letters, May 4, 2021

The COVID-19 pandemic shines a bright light on the inadequacies of our current health care system. Affordable health insurance does not mean guaranteed health care. What has become painfully clear is that we need a health care system that provides services regardless of income, background or job status.

The best use of tax dollars (our money) is to adopt a single-payer improved Medicare for All (M4A) health care system like every other major industrialized country. They cover more people for less money and have superior average health outcomes compared to the U.S. In 2017, the U.S. spent $3.3 trillion on health care. This equaled about 17% of U.S. gross domestic product, spending of about $10,000 per person. By contrast, peer countries spent between 9 and 11% of GDP on health care, averaging $3,400 to $5,700 per person.

We pay more and get less.

Twenty-two studies, from conservative to liberal, have documented that M4A would significantly reduce overall health care spending. M4A can only save money with a two-prong approach — cutting wasteful insurance industry bureaucracy and negotiating prices with hospitals, medical equipment companies and drug companies. Plans such as subsidizing COBRA, shoring up the ACA or adding a public option only add to the bureaucratic insurance industry, do nothing to decrease costs and do not guarantee care — a big waste of our tax dollars.

How do we pay for M4A? While details are negotiable, with the proposed M4A Sanders bill, employees would pay a flat 4% payroll tax and employers a 7.5% payroll tax, with the first $1 million being exempt. The remainder would be funded by closing tax loopholes and adding progressive taxes on corporations and the wealthy. Ninety-five percent of American families would pay less than they do now for insurance, deductibles and out-of-pocket costs. Average savings per employer is estimated at $8,850. We would pay less and get more health care.

According to the Chamber of Commerce, 96% of establishments in the Asheville metro area have 50 or fewer employees. With the first $1 million in payroll being exempt from proposed M4A taxation, our small businesses and local economy would benefit greatly with M4A. Local businesses would have a more level playing field and compete for talent on wages, quality and service.

M4A would inject a new dynamism into the local economy. Workers could go where their skills and preferences best fit the job. Entrepreneurs, gig workers, artists, farmers, young people, part-time employees and retirees would all have health care. Wages and job quality would be boosted by employers redirecting health care costs. There would be no medical debt bankruptcies, drug rationing or skipped doctor visits, and continued coverage during job loss.

M4A would also help eliminate racial inequities in health care and could be a beneficial part of Asheville’s reparations planning. Reimbursement rates under M4A could also be adjusted to incentivize providers to deliver services in communities with unmet medical needs, particularly in our rural and low-income urban areas. Asheville-area workers and families — regardless of race, gender or job status — would become a healthier, more financially secure local workforce.

What about local government? Health coverage, the source of most labor disputes in this country, would be off the table in union negotiations. Rising health insurance costs would no longer be passed onto employees, and M4A would eliminate future funding payments (other post-employment benefits) for retiree health benefits that are a huge financial strain on all government levels. Local governments will have more funds available for wages, infrastructure, capital improvements and public health.

Medicare for All makes economic sense for WNC. Our tax dollars should pay for actual health care, not insurance.

Theresa Hash and Dr. Ellen Kaczmarek are the co-chairs of HealthCare for All WNC.

https://mountainx.com…

Medicare for All Explained Podcast: Episode 55

Interview with Dr. Ronald Wyatt

May 1, 2021

Addressing systemic racism should be an urgent priority for the U.S. medical profession, says Dr. Ronald Wyatt, following up on his recent op-ed in The Washington Post. He says institutions need to start by acknowledging their ongoing role in medical apartheid. “People need to understand the history, not revise it and not rewrite it.”

Additional episodes will be uploaded twice monthly. Subscribe in iTunes, or access a complete archive of the podcast, below.

https://medicareforallexplained.podbean.com

Healthcare system profits from the sick and dying

By James Fieseher, M.D.
New Hampshire Union Leader, April 29, 2021

TO UNDERSTAND the fundamentals of America’s health care system, imagine you are sinking in quicksand, descending slowly up to your chest with only a few minutes left before you disappear. Already the weight of sand against your chest makes it difficult to breathe. Nearby, a man stands on solid ground, but he asks for money before he’ll throw the rope he’s holding.

How much would you give to save your life? Would you even have to think about it?

The man with the rope represents our wealthy health insurance companies. The rope is our hospitals, doctors, and medications with their ability to keep us alive. The quicksand is made up of all the infirmities that afflict our health.

We are hostages to our health. Our health not only determines whether we live or die, but the quality of our lives. Private health insurers understand this and leverage their role as medical “brokers” to hold us hostage to our own mortality.

Making a profit has become the primary goal of our health care system. There are individuals within the system who are truly concerned for your health, of course, but the people pulling the strings: the presidents and CEOs of the pharmaceutical, insurance and for-profit hospital systems know that the bottom line is to make more money.

Missing from the quicksand analogy are the simple things we would do if this were an actual quicksand bog. We would post signs warning of the danger. We would set up guardrails and fences to decrease the chance of someone falling in. Finally, we might post some type of lifeguard to monitor the area and rescue those who fall in despite our efforts.

We could do much more to prevent illness and disease. We would put more emphasis on warning of the dangers of smoking, processed foods, high carbohydrate diets, and work harder to avoid cancerous toxins in our environment.

Instead, common sense is drowned out by health care industries investment in advertising and political lobbying to maintain the lucrative status quo. In our analogy, a portion of the money we spend getting out of the quicksand is spent lobbying against warning signs and fences.

Americans spend little on preventive care. Common diseases such as obesity, diabetes and hypertension can often be avoided by aggressively pursuing healthy lifestyle changes. Many of our cancers, especially those that affect our children, have been strongly linked to pollution.

But our for-profit health care industry knows that there is more money to be made by treating an ongoing health condition than in prevention of disease. The U.S. has many of the finest medical schools and best trained physicians and practitioners on the planet, yet our health care system ranks 46th in the world, behind countries like Barbados and Guadeloupe.

Those who want to keep our health care the way it is insist that creating a “free market” of health insurers will lower costs through competitive bidding. In our quicksand analogy, that would be akin to having more guys on stable ground with more ropes. Not only would we still be without adequate preventive care, but for-profit medical insurers have a limit as to how low those bids can go.

Public health measures are not a form of socialism. Health care in the public interest doesn’t change our political or economic policies, it makes our health care system more efficient and cheaper.

Most doctors and medical practitioners, especially those in primary care, find the practice of profiteering from the sick and dying anathema to their Hippocratic Oath. Everyone should be paid fairly for their products and their labor, but not excessively when it comes to our health.

We can all live longer, healthier lives while simultaneously increasing our “disposable income” and still live in a capitalist society simply by reforming our health care system. Removing the profiteering motive from our health care industry will refocus it to the true purpose of health care: preventing sickness and disease and quickly and cheaply caring for the ill.

There is no bottom to the quicksand pit, nor is there a bottom to the greed in the health care industry. If we don’t make changes, the quicksand of medical profiteering will bankrupt our country. A national plan to provide health care to all would free capital to grow a more vibrant economy.

Every comparable industrialized nation has a different, more effective model of health care than the United States and every one of them manages health care as a national policy. We should too.

Currently, there is a wide disparity of health care models in the U.S. that is based upon socioeconomic and regional (remoteness) differences. We need a system that provides the most benefits while still being cost-effective. Forging the right plan will take patience and the need to listen to a lot of voices to maximize the winners and minimize the losers.

Doing nothing is not an option. The physical and economic health of ourselves and our children depend upon it.

https://www.unionleader.com…

COVID-19 vaccine rollout in the face of racial inequities in health care system

By Arika Shaikh and Kalyani Ballur
The Augusta (Ga.) Chronicle, April 29, 2021

Should race determine who gets the COVID-19 vaccine? The answer is no. However, despite recent vaccination efforts, clear disparities exist in America’s vaccine distribution plan.

A New York Times analysis from March reported that the vaccination rate for Black Americans is half that of white and the gap for Hispanics is even greater. Furthermore, CDC data showed that approximately 66% of those who received the vaccine were white, 11% were Hispanic, 9% were Black, 5% were Asian, and 1% were American Indian with other groups having low rates as well.

With greater exposure to the virus working in front-line jobs and having high rates of comorbidities such as diabetes and obesity, people of color are at even more of a risk for severe COVID-19 infection. It is clear that the communities that are being the most affected by the pandemic have the slowest vaccination rates.

There are multiple variables that come into play with vaccine access and distribution. They span from the level of the federal government to individual communities. One analyst compares the vaccine rollout similar to purchasing tickets to a concert: it depends on availability, access, and responsiveness.

Initially with the vaccination guidelines, it was not taken into consideration the specific health makeup of the African- American community. The average life expectancy of African Americans falls below 75 years of age, which was the cutoff for the first phase of vaccine eligibility. From the beginning, this put Black populations more at risk to severe COVID-19 infections. One factor that contributes to the unequal distribution of vaccines is the lack of vaccination sites in underserved communities, who have limited access to transportation and Internet. The privileged are more likely to benefit from mass vaccination centers due to higher access to transportation and greater flexibility in their work schedule to wait in the lines. From a historical standpoint, there has been an ongoing mistrust of the health care system in certain communities which has projected into vaccine hesitancy, especially in the hard hit populations.

On multiple levels, there need to be changes to address the inequities with the vaccination rollout. The Biden administration has recognized these issues by shipping vaccines to community centers, especially in underserved communities, rather than to the state, hoping to minimize the inequities in vaccine distribution. While this is a step in the right direction, there is much work ahead that needs to be done and done quickly with COVID cases rapidly increasing.

Looking in our own community, Augusta University Health system is partnering with local religious institutions to provide awareness and greater access to underprivileged populations. Recently, the Medical College of Georgia partnered with 100 Black Men of Augusta to specifically work with minority communities to address concerns and myths about the vaccine. This is a greater call to action for academic institutions and local communities to work together to bridge the vaccine inequities.

Although these racial disparities have come more into light with the recent pandemic, these issues have always been prevalent in our community. One of the biggest contributors is the inequity with access to health care insurance.

As medical students and members of Students for a National Health Program (SNaHP) at MCG, we seek to dismantle this infringement of basic human rights through our proposal of Medicare for All. Establishing a national health program will ensure equal access to health care for all populations and improve health outcomes. At the local level, we have proposed this resolution to benefit the Augusta community. If you would be interested in joining this initiative, please support us by signing our petition.

Arika Shaikh and Kalyani Ballur are first-year medical students at the Medical College of Georgia. They wrote this on behalf of the advocacy group Students for a National Health Program. Views are their own and do not reflect those of their institution.

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