By Judith L. Albert, M.D.
Pittsburgh Post-Gazette, Letters, August 4, 2021
I read with interest your recent opinion piece (July 11, “Unhealthy and unequal”). The author profiled in your piece, Brian Alexander, captured the essence of the failed health care “system” by describing health care as “first of all, not a system, but a haphazard labyrinth of chance.” I am in complete agreement that what we have is not a system, but not due to chance.
Actually, our health care insurance is working exactly as planned: private, for-profit health insurance companies collect premiums and make a profit by denying care to their subscribers. Americans bought the lie that health care could be governed by the market, but marketplaces are designed to ration goods, in this case medical care, based on the ability to pay. Nonprofit hospitals are constrained by these market forces: If their patients have comprehensive insurance coverage to pay for care, then the hospital does well.
Hospitals can invest their “excess revenue” in fancy buildings and equipment to attract more wealthy patients. If jobs, and therefore health insurance, leave a community, as in so many rural and rust belt areas, then community hospitals must provide care for free or for the lower reimbursement rates paid by Medicare and Medicaid, an unsustainable proposition that leads to insolvency.
Enough of the “stop-gap” reforms! What we need to establish is Medicare for All, a publicly funded, privately delivered actual health care system, as is proposed in the current House Bill 1976. Because health care is a human right.