Bridget Peterson is a student at Jefferson Medical College in Philadelphia and a founding member of FUNCTIONAL, an interdisciplinary advocacy group committed to creating universal healthcare in the US. Bridget is pursuing a career in primary care with the goal of keeping patients healthy through preventative, responsible care. Even if it means living in a van down by the river.
As artists, we often fall into the category of “uninsured.” If we’re lucky enough to be working, union actors we have healthcare coverage; likewise, we can gain coverage if we’re slaving our souls away at a corporate restaurant. In fact, a major factor of working at “day jobs” is the opportunity for insurance. Even so, the need for an effective healthcare system spans gender, generations, and jobs. In the thick of the healthcare battles/reform/debate/what-have-you. In this posting, The Only Thing I Have To Declare presents you with some hard healthcare facts and some food for thought in the discussion for alternatives to the current system.
Healthy Profits vs. Healthy Americans:
The obstacles to and benefits of covering everyone
By Bridget Peterson
What’s the problem?
We all know by now, and can hopefully agree, that the US healthcare system is a in a downward spiral of unsustainable failure. And most of us can definitely agree that we’re beyond sick of hearing about it and trying to sift through the extremist propaganda to find out what’s actually happening. This article is intended to take some of the hostility and confusion out of the debate. You might think that, as a medical student, I have a serious agenda, but the only thing I have to declare is my honest commitment to patient care.
There are numerous ways to frame the healthcare crisis: politically, financially, medically, internationally…irrationally (town hall meeting-style). I’ll spare you most of that and just mention a few of my favorite highlights:
- The US has reached record-breaking levels of healthcare spending (one sixth of the GDP) while simultaneously managing to provide care to a new low proportion of the population.1
- Sixty-two percent of bankruptcies in the US in 2007 were due to medical expenses. Seventy-eight percent of those filing for bankruptcy had private health insurance.2
- 22,000 people are dying every year in the US due to lack of health insurance according to the Institute of Medicine. (Skeptical about the accuracy of this estimate? http://www.urban.org/UploadedPDF/411588_uninsured_dying.pdf) Other estimates put the number of deaths at 100,000 annually.
For a neat summary of more appalling facts, visit http://www.nchc.org/facts/cost.shtml.
The problem is that we have spent decades pouring billions of dollars into a profit-driven private health insurance industry that has done incredibly well for itself, but has failed to deliver and administer healthcare in a way that effectively benefits our population. The US is the only industrialized nation in the world that does not provide healthcare to all its citizens. For this and other reasons (so many other reasons…), we are currently ranking 37th in the world in healthcare, right between the great world powers of Slovenia and Costa Rica (World Health Organization). Isn’t it time that Americans, paying twice per capita than what countries with universal coverage are paying, see some results?
What’s the hold up?
The biggest issue in healthcare right now is simple: both the current system and the reform efforts are a hot disaster. Obama, as we know, is pushing the public option, a government-run insurance plan. This plan, like Medicare, has no third party, mad expensive private insurers, and is basically a good idea (I think). So let’s get after that public option, right? The problems with the public option are two: first, people are horribly misinformed and are going apeshit about lies people have made up. You may have heard that people are saying that Obama wants to encourage seniors to engage in euthanasia, etc. etc., but all these crazy rumors have, in fact, no basis. A decent website to see some of the common myths about the public option, paired conveniently with the truth in video format, is the government website www.whitehouse.gov/realitycheck. The site is actually kind of funny, because it’s basically the White House being like, EVERYONE GET A GRIP! And stop making up lies!
The other problem with the public option is that it is unlikely to solve the problems of the healthcare system because it will be too expensive to sustain when implemented in conjunction with private insurance. Bear with me on this explanation. Single payer, a government-administered health system, controls costs effectively and can cover everyone because it eliminates billions of dollars red tape that is designed to prevent people from using healthcare resources. It does this by running a much more efficient system than private insurers. The government runs Medicare and Medicaid with a 2-3% overhead, meaning about 97 cents of every dollar can go to providing care. Private insurance companies spend almost 31 cents of every dollar just running their company; that is, paying their executives millions of dollars a year, advertising their false promises to the American public, and figuring out ways to avoid reimbursing their “beneficiaries” and deny the sickest people coverage. If there was one system, there would be no advertising or preposterous waste. Do we want to keep paying people to tell us what not to do? Why do we continue to put up with this? Unfortunately, private insurance and big pharma are two of the most powerful lobbyist groups, and they have a political stranglehold on our representatives.
How will this thing really work?
Single payer works for a couple reasons. First, it gives the government the ability to consolidate massively overly-complicated payment systems. Medical offices spend over $31 billion a year in staff time on insurance paperwork alone.3 Second, single payer allows the use of collective bargaining power to get the best prices on services, and more significantly on DRUGS. Big pharma is a whole ‘nother mess, but basically, drug companies are charging the US far more money for drugs than any other country, but we’re too fragmented to do anything about it.
Two other important ways single payer controls costs is by covering everyone and taking care of people. Weird idea, right? Having 47 million uninsured, and far more underinsured, people in our country creates enormous expense for people who are insured, whether they have private or government insurance. When an uninsured patient goes to the ER, the hospital needs to cover their costs somehow, and those costs are covered by insured patients in the form of pro-rated fees that account for non-payment by millions of patients. It is truly in the best interest of insured Americans, not to mention uninsured Americans, for everyone to have coverage. Second, when those uninsured patients do come in to the ER, it’s more likely to be for a heart attack or diabetic crisis than for the low-cost and proven-effective blood pressure medications or glucose checks that keep patients healthy and prevent massively expensive and dangerous complications. Unfortunately, these preventative measures only keep patients who have the option of receiving regular medical care at an affordable price healthy. People who have no coverage avoid the doctor until it is an emergency because they have to; they pay for it with their quality of life and projected outcomes, and everyone else pays for it with their inflated insurance premiums.
In short, we can control costs by providing quality care for everyone, or continue
to pour billions into private insurance, but we cannot do both. The system is so unsustainable that private insurance premiums are set to outstrip the average household income in the next 15 years. As I heard the founder of Physicians for a National Healthcare Plan say, we will not have our hospital beds empty while our people die in the streets. But let’s not wait that long. Healthcare reform is absolutely critical for an economically and physically healthy future in this country, and the time for it is now.
I feel I would be doing a disservice to my cause without clearing up a few of the usual objections, so here we go:
1. Isn’t this socialized medicine? That’s un-American!
No. Single payer is publicly-funded, privately-delivered care. Doctors and hospitals will still be independent entities, and they will still compete for to provide the best care, because they still need to have patients. The government will never tell you what doctor to go to or make any medical decisions for you.
2. I don’t want to pay 60% income tax like Denmark.
Actually, Denmark is the happiest country in the world. I know, I was there, it’s awesome. Anyway, single payer will not require a 60% income tax. There will be a slight tax increase (<2%), but the amount that your taxes would increase will be significantly less than the amount of money you pay annually for a private insurance plan. Bonus on that: you can’t be denied coverage and people will stop losing their homes trying to pay for life-saving care. Win!
3. Don’t all doctors hate this?
NO. A 2008 Annals of Internal Medicine study found 59% of physicians are in support of single payer. Some of us actually went into medicine to help people, not to do paperwork. Plus, having private insurance decide what your patients can and cannot get really puts a damper on how much you can help them. Many people think doctors hate single payer because the American Medical Association, the largest group of physicians in the US, officially opposed single payer. Briefly: the AMA is a conservative organization officially represented almost exclusively by specialists earning top salaries. There is some anxiety among this demographic that single payer may reduce their salaries. There is not a lot of evidence to suggest that this would even happen.
4. Won’t single payer force us to ration healthcare like the Canadians?
Those damn Canadians. Basically, yes. But get this: right now a private industry in which we have no representation rations care (yes, really!) based on what is the most profitable for them, and who can pay for it. A single payer system rations care based on what is in the best interest of health. I strongly encourage the readers of this blog to check out this article by the philosopher Peter Singer. http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html?pagewanted=1&_r=3&em
5. What are the best resources to find out more?
A great resource for single payer facts, and reform in general, is http://www.pnhp.org/facts/single_payer_resources.php
Good sources of truly independent information are The Commonwealth Foundation, http://www.commonwealthfund.org/ (the whole site is good, and puts US healthcare in a global context) and also Fact Check from the Annenberg Public Policy Center, http://www.factcheck.org/2009/08/seven-falsehoods-about-health-care/
Ready to get active? Check out http://www.singlepayeraction.org/
And just in case you need this made super easy, check this out!
References:
1. . Siska, A, et al, Health Spending Projections Through 2018: Recession Effects Add Uncertainty to The Outlook Health Affairs, March/April 2009; 28(2): w346-w357.
2. Himmelstein, D, E., et al, “Medical Bankruptcy in the United States, 2007: Results of a National Study, American Journal of Medicine, May 2009.
3. http://www.entrepreneur.com/tradejournals/article/204206670.html
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Tags: Acting, Actors, america, artists, congress, Day Job, health, Healthcare, insurance, obama, Politics, Relevance, Review, single payer, So Help Me God, Theater, town hall meetings, uninsured, world health organization
awesome article! I agree with all of the points above
I hope people do realize single payer health care is supported by a majority of physicians as well as a majority of students- not to mention the general public. Patients before profits indeed.