By Garrett Adams, M.D., M.P.H.
Louisville Courier Journal, April 15, 2019
American health care is in continuing crisis. Access is declining,Ā and costs are out of control. Medical bankruptcies, unheard of in other developed countries, still plague us. Even though the U.S. spends nearly twice as much per capita on health care, our health outcomes are far worse than other comparable nations. For example, way more American women die of pregnancy-related complications than in any other developed country, and the rate is rising.
Statistics are people with the tears wiped dry.
Whatās wrong? Corporate profiteering. Corporations squeeze the insured, you, for every nickel to pay their dividends and increase cash value. Insurance companies raise premiums, deductibles and co-pays; they deny claimsĀ and contrive to insure only healthy (cheap) people.
The patchwork of private insurance costs our nation billions in administration, billing and collecting āĀ amounting to a full third of health care expenditures. Hospitals track every pill and bandage and charge patients and hundreds of different insurers for each item. Physicians spend an average ofĀ nine hoursĀ a week with a jumble of plans for billing, preapproval and payment. It is taking a toll on the profession in burnout, early retirement, depressionĀ and suicide. Patients are angry and frustrated by the bureaucratic maze of filing claims, with justifiable claims often rejected.
Medicare Advantage, which privatizes Medicare, is burdened with fraud and poor cost control. Insurance companies selling Advantage plans bilked the government for an estimated $70Ā billionĀ between 2008 and 2013.
The U.S. system isnāt about improving health care; itās about profit. Single-payer changes the dynamic; with single-payer the system becomes patient-oriented, not profit-oriented.
Single-payer means ONE payer, the government, pays the bills while health care delivery (doctors and hospitals) remain in private hands. The wasteful bureaucracy of private health insurance goes away. The government becomes the insurer. Coverage is unhooked from employment, allowing workers to change jobs or start new businesses.
What about workers for insurance companies, such as Humana, when single-payer replaces private insurance? The new system will need their administrative experience. Moreover, single-payer legislation specifies that displaced workers be provided retraining and two years of salary. Many, who are health care workers themselves, will move back to actually providing care. And, like all of us, they and their families will have all medically necessary care as a right!
In 2003 the first single-payer bill in the U.S. Congress was tagged the Medicare-for-All bill. The name stuck. Today there are many āMedicare-for-Allās.ā However, only two are single-payer plans, one House and one Senate version. They provide for publicly financed, nonprofit national health insurance that fully covers medical care for all Americans.
Drug companies, for-profit hospitals, insurance companiesĀ and others invested in profit-based care are campaigning vigorously against single-payer, spreading misinformation and fearmongering. Industry-aligned anti-single-payer individuals are posing as ordinary citizens spreading misinformation about single-payer.
Donāt believe the lies. National health plans work extraordinarily well in every other industrialized nation. Canada, Scotland, Sweden, Taiwan,Ā and Japan (among dozens of others) cover their entire population for a fraction of what the U.S. spends (wastes!) and enjoy longer lifespans and better health outcomes. How will we pay for it? An American single-payer plan will pay for itself by redirecting wasted administration and profiteering funds into patient care. Consider the vast difference in cost: From 2007 to 2014, spending in private plans grew nearly 17 percent per enrollee, while Medicare spending decreased 1.2Ā percent per beneficiary.
Congressman John Yarmuth has represented the 3rd District of Kentucky in the House of Representatives with honor and distinction since 2006, and he has always been a single-payer champion. As chairman of the budget committee, he called for Medicare-for-All hearings. He knows that a majority of Americans support single-payer, but he has recently withdrawn his support. Chairman Yarmuth should continue to represent the will of the people and give single-payer his wholehearted endorsement.
Single-payer will have an immediate healing effect on all our people, and it will arrest our surging wealth inequality. Rev. Dr. Martin Luther King, Jr. said, āOf all the forms of inequality, injustice in health care is the most shocking and inhumane.ā With single-payer, in one transformative action, on at least one level, everyone becomes the same, and we seriously commit to a true democracy with justice for all.
Dr. Garrett Adams is a founding member of Physicians for National Health Program – Kentucky and a member of the group’s national board.
