"I've seen people die because of co-payments and deductibles"
This is not idle chatter. This is real. This is a stunning and profound indictment of the U.S. healthcare system. These are the words of Dr. Steffie Woolhandler, a doctor who treats patients every day.
Some of us less diplomatic than Dr. Woolhandler, call what she's describing, pay or die.
In June, Dr. Woolhandler, a Harvard Medical School physician and one of the great heroes of the single-payer movement in the United States, was invited to appear before The President's Council on Bioethics.
The Council was created in 2001 to "advise" the President "on bioethical issues that may emerge as a consequence of advances in biomedical science and technology".
We can hope that President Obama will listen to those like Dr. Woolhandler--the people on the front lines of the tattered remains of our healthcare system.
The hearing was divided into two parts and I urge you to read both transcripts. After you do, I believe you will have no doubt, none whatsoever, that
single-payer (HR 676), is the only way to dig our way out of this national catastrophe.
Then take the next logical step and ask yourself who is responsible for blocking authentic healthcare reform in the United States?
The hearing was divided into two parts. The first involved a presentation by he panelists of the competing reform plans. In the second, the panelists responded to questions.
As you read, also keep in mind that tomorrow is the 40th anniversary of Medicare. Many who support single-payer healthcare refer to it as "Medicare for all". This is really what single-payer amounts to, opening Medicare to all comers. Simple. Beautiful. And who wants to block this? Of course, the private for-profit insurance industry.
But as Republicans move heaven and earth to privatize and destroy the greatest heathcare triumph our nation has ever enacted our generation is waiting for another LBJ. Will Barack Obama meet this immense challenge?
Returning for a moment to Dr Woolhandler's testimony. It is as clear and forceful an argument for single-payer as I have ever seen.
Single-payer is the only solution:
And I'm going to argue today that many of the current proposals are, in fact, placebo reforms and that they're unethical to endorse because, actually, effective reform exists.
The problem: We've got 47,000,000 uninsured Americans generating about 18,000 excess deaths among adults each year. So that's a problem. As we sit here over the next two days, 100 people will die in the United States for lack of health insurance. That's the core ethical problem we're trying to face here.
But there's also the issue about Americans being impoverished by paying for illness. That is, they do get the care, but they're impoverished.
http://www.bioethics.gov/...
Healthcare and bankruptcy:
Now, it turns out that medical bankruptcy is, as I said, half of all personal bankruptcies. Millions of people each year are affected by medical bankruptcy, but 76 percent of people who were in medical bankruptcy in our study had health insurance at the onset of the illness that bankrupted them.
So insured people have an issue, too, if they have a prolonged, serious illness. They can't work. They have lots of co-payments, lots of deductibles. They can end up in bankruptcy, as well.
This is because families simply don't have assets to pay deductibles. This is extremely important as we hear about so-called consumer-directed high-deductible plans, which are a very prominent piece of many of the new policy proposals, including those of John McCain, including that of the new Massachusetts law, high-deductible plans; President Bush, high-deductible plans, $5,000 deductible, typically.
But 40 percent of the US population does not have total financial assets of $5,000. Total financial assets, less than $5,000, so that families simply can't pay the deductibles. They end up not getting care or getting the care and going into bankruptcy.
http://www.bioethics.gov/...
The U.S. spends more than any nation and we get so much less:
And the US is already spending -- these are figures from a couple of years ago -- by far the most of any nation on earth on healthcare. The US is on the bottom. On the top I've listed total health expenditures in other developed nations. For the US at the bottom I've listed total per capita health expenditures divided into the publicly funded and the privately funded share.
. . .That is, we are already through our taxes paying the full price of national health insurance in this country, and then we take an additional $2,500 out of our pockets and pay privately, and we still have the circumstance of 47,000,000 uninsured people, millions more forced into medical bankruptcy.
. . .When you look at medical journal articles on a per-capita basis (and you get the same results if you look at total scientific output on a per-capita basis_, the United States is not a world leader. So our extra spending is not generating more in the way of science when we look at it on a per-capita basis. That is a myth.
Even for certain high-technology treatments such as bone-marrow transplants, the United States is just in the middle of the pack. Where we do lead the world is in our insurance overhead and our administrative costs. And this is expressed on a per-capita basis for every man, woman, and child in the United States .
We lead the world in insurance overhead. We lead the world in difficulties getting care. This is people are asked, percent, finding it extremely, very, or somewhat difficult to get needed care. We lead the world. This is just the English-speaking world.
http://www.bioethics.gov/...
Who's blocking single-payer?
Single-payer national health insurance has a track record in other countries of covering people, of improving health, of getting the job done. It has a track record of allowing patients and actually providers considerable clinical freedom. That's the track record.
And the reason all these other mandate things are on the table has got nothing to do with their effectiveness because we have no evidence they're effective. It's the power of the insurance industry.
And I would add here, yes indeed, the power of the insurance industry and the money they dispense to politicians from both political parties. And the truth remains, until and unless we have publically financed elections, meaningful reform will be hard to achieve.
And finally returning to Medicare and its 40th anniversary tomorrow. Dr. Woolhandler's words are a poignant reminder of the grandeur and brilliance of Medicare.
DR. WOOLHANDLER: I just want to point again to the Medicare program. You cannot opt out of Medicare in this country. I mean, when Ted Kennedy got his brain surgery at Duke, Medicare was the first payer. No matter how much money he may want to pay out of pocket, want to use to buy his way out of the system, that hospital was primarily paid by Medicare. Now, he can have wraparound insurance, but he cannot purchase a private health insurance policy that substitutes for Medicare. That's why Medicare has historically maintained adequate funding over the years, that actually, you know, as a doc I was happy to see a patient had Medicare. It meant I was going to get reimbursed well.
And that's because rich people and poor people had to rely on it. Ted Kennedy legally had to rely on Medicare. Now, if he wanted to go to Riyadh , Saudi Arabia , or something and get his care he could pay out of pocket. But if he wanted to get care in the United States it had to be paid for by Medicare. I think that's politically completely realistic.
Everyone in, no one out. Rich and poor. Senators and janitors, movie stars and waitresses. All Americans.