By Sunny Aslam, MD; Robertha Barnes, MS/MD student; Sydney Russell Leed, MD/MPH student; Kunfeng Sun, MS3; Mike Vidal, MS/MD student; Azwade Rahman, MD/MPH student; and Ella Capello, MS2
Syracuse Post-Standard, April 2, 2019
At the Martin Luther King Day Health Justice Conference at Upstate Medical University, the keynote speaker stated, āPolitics is nothing more than medicine but on a societal level.ā Her figurative use of the word āmedicineā means that elected officials have the responsibility to diagnose and treat issues that affect their communities. As current and future health care providers, we have the duty to do what is best for each patient, and more broadly, to speak up for legislation that can improve the health of all our patients. Because governmental policies have the power to affect the medical outcomes of our patients, it makes sense for us to speak up in support of the New York Health Act (NYHA) and Medicare for All.
Today, every candidate for the 2020 presidential election (including the current president) is talking about health care, and specifically the role that private insurance should have in American health care. The private health insurance industry has had more than half a century to lower costs and improve outcomes, but it has failed miserably, resulting in tens of thousands of premature deaths each year. The profit motive of corporations does not lend itself to caring for the sickest among us, as insurance companies only profit when people are healthy, or when care is denied. The sickest patients often end up on government plans due to job loss, affordability, medical bankruptcy, poverty and expiration of coverage. Physicians know that the administrative burden of confirming coverage, submitting claims and filling out forms for multiple insurers contributes to delays in care and time away from patients.
With the newly elected New York state Assembly and Senate, patients and doctors see the possibility of change with the New York Health Act (NYHA). However, the powerful private insurance industry is pressuring newly elected state officials, many of whom ran on a pro-NYHA platform, to include some role for private insurers. As weāve learned over the past 50 years, private insurance wonāt work to lower costs and guarantee access. In fact, the more privatized health care is, the higher the cost. We as current and future health care providers support the NYHA because it will get us back to the relationship between a physician and the patient, without insurance bureaucrats in between.
Single-payer opponents most often cite the 2018 RAND study to claim the NYHA will increase taxes and amount to a āgovernment takeoverā of health care, but the study also predicts that most New Yorkers would pay less under the NYHA. Families would no longer pay an average of $28,000 per year for a private plan covering a family of four. Instead of workers and employers paying premiums to a private insurance company, all state residents would be covered with no co-pays, deductibles, co-insurance, or premiums. Medical bankruptcy would be a thing of the past. Opponents who scream about increased taxes donāt point out that the NYHA will reduce overall costs for almost every family. Unlike private insurance plans, with their narrow ānetworksā of approved providers, the NYHA would provide more choice, as all doctors and hospitals would be āin-networkā; treatments would be determined by patients and doctors, not an insurance company motivated by profit.
Many say we canāt afford universal health care, but we are already paying for it. The U.S. spends nearly 20 percent of our gross domestic product on health care, roughly double the per capita rate of high-income countries with national health plans. Yet we have the shortest life expectancy and higher infant and maternal mortality rates. With the money saved by drastically reducing administrative costs from private insurers and negotiating down prescription drug prices and other supplies, we can cover all Americans without breaking the bank. Access to primary and preventative care will save even more money and lives over the long run.
One of our members works with homeless men and women at local shelters. Many of these patients require urgent examinations for addiction and psychiatric illness, but insurance companies require āprior authorizationā before we can see the patient at all. This treatment is often life-saving as well as money-saving, since otherwise the patient will end up with an expensive trip to the emergency room. More importantly, delays in care for mental health and substance abuse can result in death.
Itās time to end the needless suffering and death, medical bankruptcies and endless paperwork imposed by private insurance. We hope Gov. Andrew Cuomo and our state legislators pass the NYHA. Itās the only way to cover all those who live in New York, save money and save lives.
The authors are members of Students for a National Health Program and Physicians for a National Health Program at SUNY Upstate Medical University.