By Richard Weiskopf, M.D., Kaye Jaeger, R.N., and Joel Potash, M.D.
Syracuse.com, Sept. 28, 2016
A commentary published Sept. 14 (“How many are insured because of Obamacare? Good question”) points out the challenge of assessing the Affordable Care Act’s impact on closing the insurance gap. Focusing strictly on health “insurance” coverage obscures the crisis in healthcare access across the country that millions continue to live without access to needed health care. In New York, since the passage of the Affordable Care Act, there are still 1.5 million individuals without health insurance and countless more who are underinsured — that is they have insurance but can’t access healthcare they need due to high co-pays, deductibles, and rising drug costs.
In a system dominated by private health insurance corporations, those with high incomes can afford adequate health care, while the poor and many middle class cannot. The consequences are tragic. According to a Harvard study, 45,000 Americans die each year for lack of health insurance. Medical bills contribute to more that 60 percent of all bankruptcies, and most people who file for medical debt related bankruptcy had insurance when they got sick.
What is it like to be uninsured or underinsured? Imagine having asthma or chronic pulmonary disease (COPD) and not being able to afford the medication your doctor prescribes. Beyond daily shortness of breath and chronic cough, untreated respiratory diseases make people more susceptible to pneumonia.
Sudden pauses in medication use are not uncommon and can have serious consequences. For example, a patient who pauses use of hypertension medicine faces an increased likelihood of stroke and heart attack. As healthcare providers, it’s heartbreaking to know that a patient won’t be able to relieve his or her suffering due to financial barriers.
We need to shift our public conversation from discussing issues of insurance to the task of guaranteeing universal access to medically necessary care from cradle to grave.
Under our present system of multiple health insurers, a large amount of the money that private insurance companies collect in premiums is spent on administrative costs and CEO compensation rather than care. The national Medicare program which covers the elderly is much more efficient, allowing a greater portion of the money to be spent directly for health care. Administrative costs in the private insurance infrastructure consume 31 percent of U.S. health spending while Medicare maintains an annual administrative cost of 2 to 3 percent.
An economic analysis conducted in 2015 by economist Gerald Friedman found that implementing a universal public healthcare system, like the one proposed by the New York Health Act, would reduce New York’s health care spending by 25 percent, more than $70 billion, by 2016. The savings would come from reducing burdensome billing expenses, administrative waste, the monopolistic pricing of drugs and medical devices, and fraud. According to Friedman’s analysis, 98 percent of New Yorkers would pay less for health care. But most important, New York Health would provide universal access to healthcare to all New Yorkers.
All of us need health care, regardless of age, income or employment status. The New York State Assembly has passed such a plan with huge majority support. We urge Sen. Dave Valesky to be a champion for universal health care by sponsoring the New York Health Act in the next session and passing it through the Senate.
Dr. Richard Weiskopf is a member of Physicians for a National Health Program (PNHP). Kaye Jaeger is a registered nurse. Dr. Joel Potash is a palliative care physician. All live in Syracuse.