By Heather Gray
March 13, 2017
Justice Initiative International
Universal health care? In the 1970s I lived in Singapore and can certainly attest to its excellent healthcare system. I also lived in Australia in the 1960s and 1970s and was so impressed with its national healthcare program as well. My Canadian relatives will not stay long out of Canada because of Canada’s universal healthcare system. While organized differently, Singapore, Australia and Canada all have national health care programs. Friends of mine who were former American citizens and who had moved to Australia in the 1960s visited the United States in the 1990s. While in the states one of them got sick, was in the hospital briefly and was handed a bill for $50,000. They immediately high-tailed it hack to Australia and it’s universal health care system where you don’t go bankrupt if you get sick.
It is thought that the reason American health care has exceptionally low ratings overall is because it is privatized. Human beings become commodified in a privatized health system like prisoners become commodified in a privatized prison system. This, rather than human beings simply and profoundly seeking medical care. In a privatized system human beings are essentially a “product” for someone else’s gain. This is a qualitative difference.
In the 1970s, I was engaged in research for Emory University in Atlanta and interviewed all the freshman medical students at Emory as well as a sampling of the freshman medical students at the University of Georgia.
At the time I did this research there were significant debates in Congress and around the country about possibly implementing a “Universal Health Care System” in the United States. Senator Ted Kennedy was a huge supporter of the program. Kennedy wanted “Medicare” for all. Unfortunately, this did not become a reality. Nevertheless, virtually all the students I talked with thought that by the time they finished medical school they would be working under a universal health care system. Here is some compelling information about Kennedy’s Bill – the official summary:
Medicare for All Act – Amends the Social Security Act to add a new title XXII (Medicare for All) under which: (1) each eligible individual is entitled to benefits which include the full range and scope of benefits available under the original fee-for-service program under parts A (Hospital Insurance) and B (Supplementary Medical Insurance) of title XVIII (Medicare), with parity in coverage of mental health benefits, subject to appropriate cost sharing; (2) each enrollee is free to choose his or her own doctor and private health plan; and (3) benefits are not less than the benefits offered to Members of Congress and Federal employees under FEHBP (Federal Employees Health Benefits Program).
Establishes the Medicare for All Trust Fund.
Amends the Internal Revenue Code to impose: (1) on the income of every individual a tax equal to 1.7% of wages received; (2) on every employer an excise tax equal to 7% of the wages paid to each employee; and (3) on the self-employment income of every individual, a tax equal to the applicable percentage of the self-employment income for such taxable year. (Daily Kos)
I also found, when studying the subject of universal health care, that in Britain, for example, under its universal health care system, the British physicians were largely considered superior to those we have in the United States. The reason, I was told, is because British physicians go into medicine not for financial gain but because they are interested in assisting and caring for people. Their motivations were, then, significantly different.
I did find in my own research that many of the young medical students I interviewed seemed more interested in the money they could make from medicine than in a sentiment of compassion or concern for the other. I naively thought when starting this research that their sentiments would not be so crass. In fact, many of them had parents who were in medicine, who made a lot of money in medical practice, and these students obviously wanted the same.
All that being said, physicians virtually anywhere in the world make, compared to others, a significant amount of money. Below is a chart about incomes from 2008, with US physicians making the most compared to all other countries and with American orthopedic surgeons making the most. In a privatized system, the physicians have others financial concerns (insurance, etc.) as well that would not be as predominant in a publicly run and controlled health care system.
Further, in a privatized health care system, American corporations and their CEO’s are making huge profits. As Consumer Affairs notes: “Health insurance industry rakes in billions while blaming Obamacare for losses: Major insurance companies are enjoying record profits but claim they are losing money under the Affordable Care Act.”
UnitedHealth is but one example:
Consider UnitedHealth, the nation’s largest health insurer that is leaving the marketplace next year. UnitedHealth claims that Obamacare has reduced its 2016 earnings by $850 million. While they might have $850 million less than they wanted, UntedHealth’s profits are still soaring.
In fact, UnitedHealth announced record-breaking profits in 2015, followed by an even better year this year. In July 2016, UnitedHealth celebrated revenues that quarter totalling $46.5 billion, an increase of $10 billion since the same time last year. And company filings show that UnitedHealth’s CEO Stephen J. Hemsley made over $20 million in 2015. To be fair, that is a pay cut. The previous year, in 2014, Hemsley took home $66 million in compensation. (Consumer Affairs)
The “sweaty little hand of corporate greed?” It should have no role in controlling our health care.
Regardless of what Trump and his buddies come up with, which will essentially be an on-going privatized system, it appears that we should all go back to the drawing board and develop a health care plan that would be good for all of us regardless of income.
Let’s have, as Ted Kennedy and others recommended, a Medicare System for all of us.
Regarding a “National Health Care” system I want to also share below the March 9, 2017 open letter to Donald Trump from the Physicians for a National Health Program (PNHP).
PNHP’s open letter to President Trump
An Open Letter To Trump:
The GOP Health Plan Won’t Work,
Replace ACA With Single Payer
Dear Mr. President,
You vowed to replace the Patient Protection and Affordable Care Act (ACA) with something great that would provide Americans with universal coverage and lower deductibles and copayments. As leaders of Physicians for a National Health Program (PNHP), a nonpartisan organization of 20,000 physicians and medical students, and as a business leader who desires fundamental health reform, we request an opportunity to meet with you to explain why single-payer, Medicare for all, is a great solution that will meet your stated goals.
Health care reform is urgently needed. Seven years after the passage of the ACA, 26 million Americans remain uninsured, tens of millions more are underinsured, and health care costs – already twice as high as the average of other wealthy nations – continue to rise. In a recent survey, Americans were more likely to report financial barriers to health care than citizens of any of the 11 other nations surveyed. One-third of Americans, including 43 percent of low-income persons, went without health care due to cost last year.
Unfortunately, “The American Health Care Act” (AHCA) would be a big step in the wrong direction. The bill would shrink Medicaid benefits for millions of poor and low-income families. It would sharply reduce the value of government subsidies, leaving millions of near poor and middle income Americans unable to afford coverage, and shifting millions of others to the kind of bare bones plans that you have decried.
Meanwhile, it would give hundreds of billions of dollars of tax breaks to the wealthiest 2 percent of Americans, and reward insurance firms that pay outrageously high executive salaries.
In sum, this legislation will degrade already inadequate coverage, increasing financial barriers to care and endangering tens of thousands of lives, merely to reduce taxes on rich individuals and corporations.
The working people of America are looking to you for something better.
In contrast, a single-payer system, essentially an expanded and upgraded version of traditional Medicare, could meet your stated goals of more coverage, better benefits and lower costs. Such reform would drastically cut insurance overhead and the paperwork insurers inflict on doctors and hospitals, saving more than $500 billion annually. Those savings would cover the cost of universal, first-dollar coverage – including dental services and long-term care – upgrading coverage for the vast majority of Americans.
And a single-payer reform would allow the U.S. to use proven-effective tools to control costs. Instead of disrupting the delivery of care by shoehorning every doctor and hospital into a gigantic corporation, it would support practices and hospitals of all sizes with negotiated fees and global budgets. Negotiating prices with drug firms as other countries do would save another $150 billion annually. Controlling costs is the only way to make our health care system sustainable for future generations.
Single payer would lift the burden of health benefit costs from employers, making U.S. business more competitive. Richard Master, a business owner in Pennsylvania, produced the film “Fix It” to explain the benefits of single payer to business. Adopting a single-payer system would help keep jobs in the U.S.
Legislation for “improved Medicare for all,” H.R. 676, was introduced in the Congress last month by Rep. John Conyers. Polls have shown that 58 percent of Americans favor replacing the ACA with a single-payer system, as do 59 percent of physicians, 81 percent of Democrats, and a rapidly growing share of Republicans.
Single payer has proven effective in countries around the world, as evidenced by experience in Canada and Scotland, which spend far less than we do, cover everyone, and provide care free at the point of delivery. Tommy Douglas, the founder of Canada’s system, is ranked the most popular figure in that nation’s history, and Sen. Bernie Sanders attracted a huge following with his support for single payer, Medicare for all in his run for the Democratic primary.PNHP has, from the outset, been strongly critical of the ACA’s failure to solve our nation’s health care crisis. The AHCA would divert us even further from the goal of solving that crisis and tarnish your legacy. Single-payer reform is the only solution. Sincerely,
Steffie Woolhandler, M.D., M.P.H., Co-founder PNH