By Paul O’Rourke-Babb
Enterprise-Record, April 7, 2019
New Medicare-for-All legislation (The Medicare for All Act of 2019, HR 1384) was just introduced in the U.S. House of Representatives by Rep. Pramila Jayapal (D-Wash) with 103 cosponsors. I’m for it. Our nation has another, better, chance to fix our broken health insurance system.
As a retired Nurse Practitioner and a long-time Butte County resident, I strongly believe Medicare for All will give our communities the health care security that we desperately need. Here’s why.
Whether you’re a patient, a health care provider or a hospital, I don’t need to tell you the health care challenges we were facing before the fire just got a whole lot worse. You already know.
Fifty thousand people have been displaced. Adventist Hospital, doctors’ and therapists’ offices, and clinics have been damaged or destroyed by fire. If you owned your business and lost it, you also lost your ability to pay for private insurance. If your employer was burned out, you lost your job and if your employer was sponsoring your health insurance, you lost that too.
Getting health care was a problem before the fire, but it’s even worse now. No matter whether you get insurance through work, Covered California or Medicare, the scarcity of primary care doctors was already a problem. If you’re on Medi-Cal, almost no physician would accept you as a patient. At the same time that the number of people who qualify for Medi-Cal will likely rise, the ability of doctors to hire staff and see those people will worsen.
That’s because many patients and their doctors lost their homes and businesses and had to move away to find shelter. The Butte County vacancy rate was already critical at around 2%. Then the fire took out an estimated 6.5% of the county’s housing units.
On top of that, our communities have been traumatized. Month-long waits or long drives to access mental health care were common before the fire. Today it’s worse.
Affording health care remains another big problem. Over 21% of Butte County households were living in poverty before the fire. But even at higher incomes, the costs of health insurance prevented 4 in 10 of us from seeking the care we need.
Now it’s worse. Insurance premiums, deductibles and co-pays don’t magically disappear during disasters. But the money to pay them has to compete with the need to rebuild our lives from scratch.
Area hospitals, greatly impacted by the fire, are also disproportionately burdened by having to deal with multiple insurance companies and this adds a layer of completely unnecessary expense to our health care.
Medicare for All would make health care more affordable. Here’s how:
It would reduce the cost of billing.
Medicare for All would dramatically reduce the average $99,581 that physicians spend each year on billing and insurance-related work just to get paid. It would save hospitals millions of dollars on redundant and often competing billing administration, up to 25% to 30% of their budgets.
Reduced billing costs means savings for you and for a public insurance system.
It would finance health care in a completely different way.
A public Medicare-for-All system will eliminate upfront costs like premiums, deductibles and co-pays. A combination of taxes, based on one’s ability to pay, would ensure that everybody would pay their fair share for the same comprehensive policy. And universal coverage would ensure that the system would remain solvent and financially stable.
It would cost you less.
The savings from a more efficient health care system means that we would pay less in taxes than we are now paying in premiums and out-of-pocket costs.
We would all have the same comprehensive, high-quality health insurance no matter what circumstances change in our lives.
You could see the doctor of your choice, even if your doctor had to set up a new practice in another area or gave up private practice and took a job at a hospital.
When I moved to Butte County many years ago for work, the active arts community and beautiful environment attracted me. Life here should be peaceful and uncomplicated. When it comes to our health care, it’s anything but. It doesn’t have to be this way. Contact your congressional representatives and voice support for Jayapal’s new bill. At the same time, let your state legislators know that you also support California Medicare for All. We need it now, more than ever.
Paul O’Rourke-Babb is a retired Nurse Practitioner and longtime member of Physicians for a National Health Program. He lives in Chico.
By Don McCanne, M.D.
The Butte County fire in which the beautiful town of Paradise was destroyed was a heart-wrenching experience for my wife and me, especially wistful since we had visited our dear friends there frequently in years past. Our friend and health care reform colleague, Paul O’Rourke-Babb, describes in his article what this meant to so many residents of Butte County. It was a terribly tragic event that only those who were there to experience it can truly comprehend.
So why does this belong in a blog on single payer Medicare for All? Paul tells us. Although they lost their hospitals and clinics, the surrounding communities were there to help. But they were restricted by the deficiencies in our highly dysfunctional health care financing system. Imagine if, instead, everyone was covered by a single payer Medicare for All program. All attention would be directed to providing the care needed, with no concerns about insurance coverage, cost sharing, provider networks, prior authorization requirements, or any of the other cruel, parsimonious features of our current system.
When the fire and forest services were battling the blazes destroying the homes, they did not first check to see if the homes were registered to qualify for fire services nor did they have to obtain prior authorization to extinguish the blazes. We have often said that health care should always be there for you just as the fire department is when you need it. We would have that with a well designed, single payer Medicare for All.
Maybe it would not have made much difference during the urgent moments of the fire, but it can make a very big difference now for those who lost their work and the health insurance that went with it and are now facing medical bills that compound the financial hardships that they are facing. We can do only so much to try to console those facing grief, but at least we can take worries about paying for health out of any future tragedy like this – by enacting and implementing single payer Medicare for All.
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