Op-Ed: Medical Care, American Dream or Nightmare – Redux

By Catherine DeLorey, Women’s Health Institute Director

In the last issue of the Mission Hill Gazette, Dr. Glenn Mollette discussed some issues with the United States health care system, focusing on the costs of services and insurance.

He concludes by stating we must have access to good and affordable medical care and we must make medical insurance a priority. But, he neglects to discuss how we can accomplish this. Medical insurance, as now organized in the United States, is a major element that supports our for-profit health care system, the most expensive health care system in the world.

But, there is one beacon on the horizon that can address this. Single Payer health care, also known as Medicare for All, is the way to make health care affordable and equitable for everyone. Even though more than 70% of US residents support a single payer system, the fact that we do not yet have it suggests this is a political issue more than a scientific issue. The United States is the only developed country in the world that does not offer its residents universal health care.

 In a single payer system, the dysfunctional factors, of lack of access, and high costs of the current system will be eliminated. With a single payer health care system many of the these current dysfunctions would be resolved. “Everybody In, Nobody Out,” a popular chant, highlights a primary characteristic of a single payer system, that everyone has access to health care services. Health care is not based on income, or what the insurance company presumes appropriate. It is a medical decision between the care providers and the patient. In addition to everyone being eligible, single payer health care is portable, that is, it is not dependant on place of employment, marriage, or residence.

In a reformed system there are uniform benefits for everyone. Which health services are offered does not depend on how much money a person has or how expensive an insurance plan they have. Benefits are determined by need. The interferences of the health insurance company determining services would be eliminated. Prevention and health education would be an integral function of an individual health care plan. Health insurers do not pay for prevention because, although it may save money in the long run, it does not always save money in the short term. Since people often change insurance companies, an individual health insurer would not reap the benefits of preventive care.

Another advantage of a single payer system, is that each person selects their own physician. One does not need to be concerned if the provider or specialist is in the plan or not, there are no hidden costs from seeing a physician who is “out of plan”, since there is no “out of plan”. The United States has the most expensive health care system in the world. We pay more than twice the cost of health care of other developed countries, costing more than $11,000 for every person in the country. By not needing to pay premiums, copays or deductibles, single payer will save money for individuals and the entire health care system. More than 95% of individuals would save money.

Although a single payer system is necessary, it is not sufficient. Once we have health care access for everyone, we can begin to address the structural problems with the system Knowing that 70% of the population supports single payer, shows us how much single payer is political. As a political issue, constituents have a responsibility to inform their elected representatives that a single payer system is an idea whose time has come and we should join the rest of the developed world in having a system that is universal, affordable and equitable. Mission Hill is becoming an epicenter for health care reform, being home to two major health activist organizations. Health Care Now (www.healthcare-now.org ) is fighting to win a national single-payer healthcare system because access to healthcare is basic to human dignity, and Mass-Care (www.masscare.org) is the pre-eminent Massachusetts organization working to establish a single payer health care system in Massachusetts.

The following is federal and state legislation supporting single payer / Medicare for All:

• Medicare for All Act of 2021 HR 1976 (https://www.govtrack.us/congress/bills/117/hr1976# ) filed by Representative Pramila Jayapal; 117 co-sponsors.

      • An Act establishing Medicare for all in Massachusetts. H 1267 (https://malegislature.gov/Bills/192/H1267 ) filed by Denise C. Garlick and Lindsay N. Sabadosa; supported by more than 60 legislators,

      • An Act establishing Medicare for all in Massachusetts. S 766 (https://malegislature.gov/Bills/192/S766) filed by Sen. James Eldridge supported by 25 state senators.

 If we are not satisfied with the current dysfunctional health care system it is up to us to support the organizations and legislation that will change it.

Catherine DeLorey is a long time Mission Hill resident. She is president of Women’s Health Institute, a women’s health education organization located in Mission Hill.

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