By Momoko Hirose: Herald Staff Writer
Dr. Steffie Woolhandler advocated a centralized, government-regulated system of national health insurance, urging members of the academic medical community to lend their support at a lecture Monday night at the BioMed Center.
Woolhandler is a co-founder of Physicians for a National Health Program and is also a member of the advisory board to Mass-CARE, the grassroots initiative for single-payer healthcare in Massachusetts.
Under the current U.S. health care system, numerous for-profit insurance companies operate with few regulations and little regard for patients, Woolhandler said. Regulating and centralizing the system would help cut costs and provide adequate care for most citizens, she added.
“The key conundrum in American health care and American health policy is allegedly the conflict between access and cost,” said Woolhandler. “It’s really elusory and, in fact, a single-payer health care system provides a mechanism through which we can improve access. We can improve quality and simultaneously control costs.”
Woolhandler presented over 20 slides, comparing the United States to other developed nations such as Germany, France and Italy. The United States lagged in life expectancy by two to three years, and its infant mortality rate was comparatively large with 12.2 deaths per 1,000 live births.
Almost every other developed country has 100 percent government-assured insurance, in contrast to the United States, which has only 45 percent, Woolhandler said. All developed nations except for the United States provide universal drug coverage.
“It’s true that we have wonderful hospitals, wonderful nurses, wonderful doctors, wonderful equipment,” Woolhandler said. “But the system as a whole is broken and functions very poorly.”
Across the nation, about 41 million people are uninsured, Woolhandler said. She said that the majority of uninsured citizens are the employed or the children of the employed. One out of every 12 Rhode Islanders is uninsured, according to the lecture pamphlet.
Woolhandler said that the overhead costs of insurance were the issue, pointing out that the CEO of AETNA insurance company makes $12.1 million annually.
“Tax-funded spending in the United States is higher than total spending in any other nation with the exception of Switzerland,” Woolhandler said. “Americans already through our taxes are paying the full cost of a national health insurance program in this country. And then they’re turning around and taking another $1,400 out of their pockets and paying privately.”
Woolhander added that 45.6 percent of all bankruptcies involve a medical reason or a large medical debt.
“It turned out that persons who said that their illness was a major financial problem to their family were much more likely than other patients to want to hasten their death in order to remove the burden from their families,” she said. “Think of what kind of adjective best defines that kind of health care financing system. I think ‘obscene’ is the most polite word that I can come up with.”
Woolhandler also used Canada as an example for the United States, saying that the implementation of a national health program would lower health costs.
“Through a universal system, you get leverage to do cost control that’s simply not available with a pluralistic — what I call ‘fragmented’ — health insurance system,” she said.
Outlining the basic goals of a national health program for the United States, Woolhandler listed the following stipulations: full payment for all needed care; free choice of doctor and hospital; independent, non-profit doctors and hospitals; local planning boards allocating expensive technology; progressive tax for funding; and a public agency to process all bills.
“National health insurance is affordable,” Woolhandler said. “It’s not a technical problem, it’s a political problem.”
This appeared in The Brown Daily Herald on Tuesday, November 5, 2002.