Experience argues for ‘Medicare for All’
By Lara Wright, M.D.
I am a family physician who has firsthand experience about the need for health insurance reform. In 1999, after completing a residency in family practice, I was diagnosed with a brain tumor. Fortunately, I had utilized COBRA to continue my health benefits for 18 months. When my diagnosis was made, I still had health insurance, as well as supportive family, friends and colleagues who worked in health care.
Even with so much help, I experienced much difficulty navigating the health insurance system. As someone with a history of a brain tumor, my options for insurance after my COBRA coverage expired were minimal and expensive. Many of the options would cover all medical problems except those relating to the brain tumor.
The difficulties with health insurance compounded the stress for me and my family in dealing with treatment of and recovery from my brain tumor.
During the next few years, I worked as a patient advocate for a health insurance plan. In that job, I sometimes heard patients referred to as “product lines”, a surprising and disturbing experience.
Now, 10 years later, I again work as a doctor. The prognosis from my rehabilitation physician immediately after my surgery included a lifetime of permanent disability. Thankfully, I have far exceeded the prognosis of my physician. Instead of receiving benefits, I am able to work, treat patients and pay taxes.
I work in a county clinic, where I see patients who are faced with the difficult decision to pay for rent and food for their families, or pay for their health care. Many are unable to afford health insurance and risk running up hospital bills for emergency care that will drive them into debt and possibly into bankruptcy.
A recent study shows that over half of personal bankruptcies are linked to medical bills, and 75 percent of people filing those bankruptcies had health insurance when they got sick.
The insight into my patients’ experiences with illness combined with my own experiences as a patient and patient advocate give me a unique perspective on our medical and insurance systems. My experiences have led me to realize that the best solution is single-payer health care, an improved Medicare for All. This alternative has been largely neglected in the present health reform debate.
The California Senate and Assembly have twice passed a single-payer health insurance plan, but Governor Schwarzenegger vetoed it both times. On the national front, H.R. 676 and S. 703 are two bills in the U.S. House and Senate that include single-payer health insurance plans, funded by the government but delivered through the existing private and public hospital system.
A recent study showed that 59 percent of physicians now support a national health insurance program. Such a system would meet their patients’ needs best, as well as eliminate many of the wasteful administrative costs with the current private health insurance industry. Moving to a single-payer system would enable our nation to save $400 billion annually, enough to provide comprehensive, quality care to all.
Critics say single-payer health insurance is socialized medicine. Not so, single-payer is insurance for everyone. A good example of socialized medicine is the Veterans Administration: hospitals are owned by the government and doctors and nurses are on the federal payroll.
Under single payer, however, doctors and hospitals remain largely private. You go to whichever doctor or hospital you choose. Instead of private insurers, a nonprofit government agency pays all the bills, similar to how traditional Medicare operates today. Private insurance includes wasteful administrative costs, sometimes up to 20-30%, a significant portion of which is spent to deny care that is not covered and decide who will make for a profitable consumer, or “product line”.
The United States is the only developed country without a national health insurance plan. The U.S. ranks number 29 in infant mortality and number 30 in expected life span among countries in the world, while far outspending all other countries.
We desperately need real health insurance reform. The best option is single-payer Medicare for All.
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Is it possible to organize a “Medicare for All” march on Washington DC to occur on Saturday October 24, which happens to be United Nations Day? I believe there would be an immediate, nationwide enthusiastic response to such an event and at least one million people would arrive at the Lincoln Memorial on that day carrying signs “Medicare for All.” This would give President Obama an indisputable and overwhelming demonstration of popular support that he needs to demand that Congress and the Senate give the American people the simplest and most logical health care solution: “Medicare for All.”
With a democratic senate, house and president, if not now, when? How this is paid for seems to be such a huge question, but it's so easy! Health care would be taken out of all paychecks just like Social Security, and would actually cost people LESS than their current insurance. The only thing I can figure the pols are stuck on is that it would pretty much abolish medical insurance. Boohoo. If they, the insurance industry that is, had played fair with consumers all along this wouldn't be happening. I'm sick of the pols being beholden to the insurance industry because of the “campaign” money. Listen up politicians: You make a good living as a politician, stop being so greedy! Stop lining your pockets with money that (essentially) forces you to betray your constituents! WE elected you, if anyone owns you it is US, not the insurance industry!!!
Unfortunately, marches on the Mall are not that simple. It is actually quite expensive. While the government doesn't charge for such events, there are still considerable expenses involved. The organizers need to provide porta-potties, a stage and a public address system. I'm sure there are other things, but that is just off the top of my head. I don't suppose I need to point this out, but just porta-potties for a million people would cost close to $100,000.
I fail to see how letting one entity “a single payer” is a good situation in a democratic society. We don't have one television network, we don't have one national media company, we don't have one automobile manufaturer, we don't have one cell phone company, we don't have one brand of coffee, we don't have one manufacturer of computers, cameras, TV's, dishwashers, furnaces, shingles for a house, or tooth paste or toilet paper. Any time you put one entity in control of one domain in a country, it is a bad idea. I agree we need reform to keep insurance companies from dropping people, but the fact that I hear nobody pointing out is that insurance rates are determined by well calculated mathmatical formulas, basically acturial tables. If you open up the insurance to EVERYBODY, you are going to have to drastically change the acturial calculations to cover everybody, and the costs will go up, or you will ration the delivery of care as happens in every country with a single payor system. Canda's single payor plan only works because, people accept the fact they have to wait, and they can jump south of the border to the USA to jump ahead of the line they have in Canada. Let the insurance companies sell insurance across state lines. Hell, if Germany and France have such good systems of health care insurance, let them sell insurance in the USA. I'm a family doctor and I practiced in Australia for 10 months as a working sabbitcal. I saw the people who waited over a year for elective orthopedic surgery and still did not even have a date set for surgery, and saw the healthy, fit and active 70 year old man who was told he was “too old” to have a knee replacement. If the governement was really really serious about lessening the impact of health care expense for the individual, they would let us deduct 100% of our medical expenses including health insurance costs off of our own personal incomes to lessen our tax. Why should anybody else pay for my health care. Everybody wants everything, and nobody wants to pay. USA infant mortality is not that good, that has more to do with poor health choices by people than lack of medical care. In most states a pregnant woman will qualify for medical prenatal care, but a notable few would rather smoke, drink and do drugs rather than do the right thing. Look at the surival rates for premature infants, many other countries don't count premature babies as live births like the USA. You want a single payor plan? Calculate the acturial premium needed for anybody to buy into medicare and let the people who want to buy into a single payor plan buy the public plan. How nice of the current proposals to say,”If you are happy with your insurance, we'll let you keep it.” Listen the governement has no right to tell me that I can't have my own insurance, any more than they have the right to tell me if I can own 1 car or 8 cars.
I agree with you 100%. Why is healthcare only for the rich or the ones lucky enough to have a job where it's an option? It's just not right. So the rest of us can either choose to pay our mortgage or be homeless so that we can afford insurance, doesn't sound right to me?
If the government pays 100% of your salary, you don't have a 'private practice', you are a government employee.
It is very deceptive to say that under a single payer system that physicians are in 'private practice'. It is private in name only.
One would hope that a doctor would be more honest than that, but I guess that education is no guarantee of honesty.
O. K. Smart gut- yeh let's let the feds run a health care system,Geez- maybe they can do the same good job as they've done with FEMA or the US Postal Sevice.I COULD GO ON AND ON- PROBABLY NOT NECESSARY ! Oh – and what about the unnecessary procedures performed by many physicians so they can bill Medicare,Medicaid or private insurance companies .
Sir, if the government can't efficiantly run Medicare, Medicaid, and the VA, then how in the world do you think they can efficiantly run “Medicare for All”. Medicare cost the government $500 billion last year alone, yet you say that somehow saving $400 billion would allow us to cover the nation? I think not.
What this country needs is TORT (this would help you doc) reform and a real effort to cut the wast and fraud from the existing government entitlement programs we have now. I do agree that Medicare Advantage/Part C should be done away with or reformed. Privitizing Medicare is a good idea in theory although I don't know how they could make it work. Advantage Plans do provide some benefits that original Medicare doesn't cover, but they have too many dis-advantages for my clients. Medicare supplements are the way to go if a senior can afford an insurance premium (around $125). A Plan F or Plan J will pay ALL the gaps in Medicare, while giving you the entire network of Medicare. You can go to any physician or facility that accepts Medicare. To get more information click any of the links above.
Tort reform is a nice, but inconsequential , goal at this point. There are much bigger fish to fry.
Paperwork accounts for a huge % (as much as 20%) of the health care dollar. The industry needs to move immediately to streamline and standardize all forms and systems to save megabucks.
It doesn't take an act of Congress. It can and should be done proactively by insurors now.
One thing that would require legislative action and should be done is to allow individuals to band together (without being an employment based group) to buy group insurance and negotiate favorable rates like big corporations and unions do.
Another needed reform is to end the exemption for 'self insured' plans. If an employer wants to 'play insurance company', he should be regulated like one.