We need a new conversation about healthcare in the US. We are the richest country in the world and one of the only industrialized countries to leave citizens uninsured. Here are examples of what un- and underinsurance create:
I think I am having a stroke. My arm is weak and I have slurred speech. Do I go to the emergency department (ED) and spend a $500 co-pay or wait a few hours to see if it gets better (remember- time is brain)? If I go, do I get the CT/MRI recommended when it could cost me thousands of dollars? Can I afford therapy to recover afterwards or medications to prevent a second stroke? (This is not hypothetical- an ED physician from another hospital recently told me of a patient who they thought had a stroke. She could not pay for a MRI out of pocket and went home undiagnosed)
Or for chronic disease- do I pay for food, clothes, school, or my asthma medication? Do I skip my diabetes medicine for a few weeks so I can afford my rent? Should I go without insurance for a few months and hope for the best?
I work as a physician assistant at a safety-net hospital and regularly see uninsured patients in similar lose-lose situations. We know the US system underperforms and costs much more than other industrialized countries. One reason why is un- and underinsurance. Putting off care increases the risk of devastating events (heart attack, stroke) and premature death (the exact mortality numbers are controversial but there is likely a connection) It also leads to disability, chronic illness, and their associated costs. Healthier people have increased capacity to care for others and build stronger communities. Millions are still not covered by the Affordable Care Act (“Obamacare”) so how do we reduce the number of uninsured Americans to zero?
Universal health coverage would cover every US citizen, automatically, and thousands of Americans are working to make this happen. Bernie Sanders (I-VT) recently held a national panel discussion on single-payer and 57 members of congress have co-sponsored H.R. 676- Expanded & Improved Medicare For All Act. Here in Minnesota, the local chapter of Physicians for a National Health Program (PNHP- a national organization with ~19,000 members) is pursuing Senate File 18/House File 76- The Minnesota Health Plan to cover all Minnesotans. Vermont actually passed single-payer in 2011 and plans to start a single, statewide health insurance in 2017 (Green Mountain Care).
A one-minute video from MN-PNHP does a great job summarizing what a national health program could look like.
This is payment reform, not socialist medicine. Hospitals and health systems remain privately owned, and we as patients can go to whichever one we choose. Everyone accepts national health insurance so we decide on quality. There is still competition to provide excellent care amongst health systems, perhaps even more now that patients are free from networks. For example, our veterans are free to seek care outside the VA. Cost savings are projected through reduced administrative overhead and increased negotiating power with pharmaceutical companies. Others object to cost savings but leaving Americans uninsured is not acceptable, and there will always be people left out of an employer-based, patchwork collection of healthcare plans. Government financed health insurance is not new as the US already provides coverage for the elderly (Medicare), poor (Medicaid- although not enough), children, public employees, and veterans. A single-payer plan allows everyone to get the healthcare that they need.
What questions and comments do you have? I would love to hear from you. I would also encourage you to check out the PNHP website if you want to learn more (especially FAQ section) or get involved (you do not have to be a physician to join). If you like this post please recommend it to spread the message. We all deserve healthcare when we need it.
“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” — Dr. Martin Luther King, Jr.