By Jennifer Perkins, M.D.
Anchorage Daily News, December 8, 2019
Health care is the central issue for the elections of 2020. The strain of high costs and unpredictability to families and business has people demanding for change. But what that change looks like is much less clear and the definitions confusing.
In the recent debates, a Medicare buy-in plan comes out the winner, with a recent FOX News poll showing 68% were in support. Single-payer, or āImproved Medicare for All,ā infused energy and enthusiasm during the last election cycle and persist, with almost half of Americans in favor of a national health program. The sticking point between a single-payer and a public option is the argument that people donāt want to give up their private plans. When asked what they like about their insurance, they often answer that their claim was covered and their copay reasonable, at least once the deductible was met. Does this humble expectation come from experience with plans that declined payment for expensive care, denied coverage, or had unaffordable out-of-pocket costs? Isnāt this why we have insurance, to pay for care when we need it? I wonder if the real question is whether a single-payer system will really provide comparable care. The health of our families feels too important to gamble with. Are we willing to continue to suffer the abuses of a profit-driven system because we fear to lose what we have despite evidence that single-payer systems can provide high quality care at lower cost?
A public option sounds like a reasonable middle ground, but fails to address the deeply entrenched problems with our current system that drive cost and put us one medical catastrophe from bankruptcy. The complexity of the medical industry will remain intact, failing to deliver savings. Insurers are experts at covering only the healthiest of us. The public plan will become a repository for the sickest, and through the crippling cost, will likely become inferior coverage. Health disparities will continue to grow, and we will continue to funnel money into excessive profits and overhead that could be used to provide good care for everyone. And even if such a plan provided some relief nationally, how would it affect Alaskans?
Alaskans are tough, resilient and fiercely independent. We must be in this rugged, vast land. Yet we trust in the systems that support us to survive here. If we roll a snowmachine or break a leg skiing in the backcountry, we expect and receive excellent trauma careābut at what expense, and whoās paying for it? We should not have to worry about this. Of all the states, we have perhaps the most to gain from a single-payer system. Alaskans who rely on Medicare know the difficulty of finding a provider. How will simply adding a buy-in option help if no clinics will see you? Under a single-payer system, everyone would have access to all providers who take insurance because there is no other option. Prices would be negotiated fairly for you without additional cost to you.
We are getting squeezed aggressively by the health care industry through direct health costs, wage stagnation and the large, growing burden on local government that siphons money from schools and infrastructure. We are at a turning point and need to demand change that will truly address the underlying problem of our profit-driven system. A single-payer insurance plan will reduce cost and help focus our collective energy on improving health care for all Alaskans. Join me in demanding from our representatives the plan we deserve.
Dr. Jennifer Perkins is a practicing family practitioner in Anchorage. She graduated from University of Wisconsin School of Medicine & Public Health in 2014 and has been in practice for four years.