Ann Katzenbach’s article in the January PRT about Marshal Patterson’s laudable support of the injured Canadian motorcyclist was just the vehicle I needed to prompt me to write about a topic that has become almost an obsession with me of late: the badly broken US health care system.
Marshal Patterson is to be commended for his actions in support of our Canadian visitor, and I have little doubt that the medical care the patient received was of high quality. The focus of my concern is the cost of the services delivered and how those costs are paid. Had this biker been fortunate enough to have had his accident in his home country, the cost of his care probably would have been fully covered by the Canadian health care system. Since his initial care was rendered in the US, I suspect he may be presented with bills in the tens of thousands of dollars, which he will have to pay out of his own pocket unless he has some type of supplemental policy that covers costs outside Canada. I have no knowledge of this patient’s resources for payment, and I truly hope his physical injuries are not compounded by crushing medical bills, but his situation serves to dramatize how much more sensible the Canadian system is in comparison to ours.
The electronic, print, and broadcast media have, in recent years, made it abundantly clear that the cost of health care in the US is, on a per capita basis, the most expensive in the world by far, and also that the costs for similar services vary wildly from provider to provider and patient to patient. Yet our health and wellness outcomes are unimpressive relative to virtually every other developed nation. Furthermore, in spite of Obamacare’s advances in providing coverage for millions of formerly uninsured Americans, some 30 million of our citizens are still without coverage of any kind, and millions more have such poor coverage that their out-of-pocket expenses cause them to avoid getting services they need or, even worse, to declare bankruptcy. According to the New York Times, 35 percent of Americans reported having trouble paying medical bills last year. This appalling situation simply does not arise in most developed nations.
While American health care workers provide some of the highest quality services in the world, access to those services, their cost, and the manner in which we pay for them are factors that convince me that a single-payer system, such as those employed in nearly every other developed country, is our only reasonable alternative.
A national, tax-supported single-payer system makes sense on so many levels. It would provide universal coverage—everybody in, nobody out. Properly designed, it would include virtually every provider in its network and would allow individuals to choose their providers. It would greatly reduce the administrative costs of providing care because providers would not have to deal with dozens of insurers, each with their own rules, forms, and networks. It would eliminate our present class-based system, in which you go on Medicaid if you’re poor and you get private insurance if you’re middle class or wealthy.
A major reason that our present system is so expensive is that the private insurance companies’ administrative costs are extremely high. They not only pay very high salaries and bonuses to their executives, but they also spend billions of dollars annually on advertising and lobbying Congress while famously denying coverage. We subscribers, of course, support this craziness with our premiums, deductibles, and co-pays.
Quite a few Americans object to a national health care system on the basis that it’s socialized medicine. To me, this is a red herring. Isn’t insurance of any kind a form of socialized benefit? We buy insurance for all kinds of purposes—auto, home, life—to protect ourselves from financial ruin. In the case of health care (which I believe is a human right), it makes economic sense to include everyone in the pool; to have everyone pay premiums (i.e., taxes); to have all providers participate; and to eliminate the costs of advertising, lobbying, and high executive pay, which substantially burden the current system. Medicare has been shown to achieve all these objectives for our citizens aged 65 and over. The time to extend these benefits to all Americans is long overdue.
Each year, for many years now, national health insurance bills in the form of Medicare for All have been introduced in both houses of Congress. To date, they have all failed to pass, largely because the private insurance lobby is so powerful. Seeking to bring some thoughtful resolution to the health care crisis, citizen activists in many states have been organizing to devise single-payer systems as demonstration programs that may be permissible under Obamacare starting in 2017. I have been active in such an effort in Pennsylvania and hope to help get such a group organized here in Arizona. I know there are many other Arizonans sympathetic to this cause. If you are one, I’d be pleased to hear of your interest. Who knows, maybe we could start a revolution. Call me at (520) 394-0173. Buena salud!