American Healthcare

 

 

As a medical student at The University of Minnesota I’m learning that patient’s stories are not only a privilege to hear, but probably my best guide for being a good physician. I’m also learning that that these stories have as much to do with our broken healthcare system as the physical ailments themselves. I believe in my country, but I believe we can do better and that we as a nation must ask ourselves if this is the world we want to live in.

This past summer, while volunteering at a free clinic run by medical students from the University of Minnesota, I was walking a young mother through the process of applying for health insurance for her 4 year-old daughter. She is a child and citizen of the richest country in the world, yet she is not automatically enrolled in healthcare. Mother and daughter had to wait in a dank church basement, at night for over two hours, in order to have a first year medical student listen to her cough. This past year I often found myself providing first-line healthcare to men, women, and children without health insurance. This is an opportunity for me to practice clinical skills, and learn about both medicine and healthcare policy. This opportunity for privileged students like me to provide subpar care as a stopgap measure for our nation’s most vulnerable people is not only problematic, but shameful.

The facts regarding healthcare management are unambiguous, it would be cheaper and more effective to have single payer healthcare: a universal healthcare system in which every American would pay into a single government-run plan. Single payer universal healthcare is the American thing to do.

Single payer health care is the American thing to do because it frees employers from being mandated to pay for their employee’s health insurance and allows them to invest that money back into their businesses. It’s American because it insures that every man, woman, and child in the United States doesn’t have to worry about delaying care, being bankrupted by healthcare costs, and losing health insurance if they lose their jobs. The US spends twice as much per capita on healthcare as the average developed nation that provides universal coverage, and we rank dead last out of the top 19 highest income countries in preventing deaths amenable to healthcare (Nolte et al, 2008) (Woolhandler, 2002).

This summer I also interned at a rural hospital in northern Wisconsin where many patients had chronic diseases that couldn’t be fixed by a single procedure or pill, but required long-term health maintenance. One patient was a 67-year-old woman with uncontrolled diabetes. Before becoming eligible for medicare, she hadn’t seen a doctor for her diabetes because she couldn’t afford to buy good, low-deductible low-copay insurance. She is one more American paying the physical costs of our broken system, as our nations economic costs are rising as she begins to receive care to deal with her worsening chronic illness.

Single payer healthcare is American because it reduces unnecessary costs. The overhead of Medicare is around 2%, compared to an average of 13% for private insurance (Sullivan, 2013). The US would save an estimated 380 billion dollars anually if we instituted as single payer system (Woolhandler, 2011) (Lewin Analysis, 2012). Medicare is our grossly overburdened and inefficient government system that doesn’t have the benefit of young, rich, healthy patients, yet it is far more efficient than the private healthcare system. Single payer healthcare removes the middleman from between the consumer (the patients) and the providers (healthcare professionals). The middleman—the insurance industry—produces nothing, skims revenue off of this transaction, and disrupts the flow of the market. Furthermore, this middleman is currently telling the consumer what they can and cannot buy, as well as telling the provider what they can and cannot sell.

While at this hospital in rural Wisconsin, I also shadowed an internal medicine physician at the Bad River Indian Reservation. One of our patients came in with 3rd degree burns covering his hands that were so severe he couldn’t hold a cup of coffee. He had delayed coming into the clinic due to fears of high costs, and refused to seek further treatment at the burn clinic—after the doctor suggested it—due to high copays. He had insurance, but he was underinsured and suffering from it.

Most of all, single payer healthcare is the American solution because we live in a land of opportunity with the rights to Life, Liberty, and the Pursuit of Happiness guaranteed to us in our Declaration of Independence. Neither life, liberty, nor the pursuit of happiness is possible when we don’t have access to healthcare without the fear of being bankrupted and billed into poverty and ruin.

We are a nation that rewards innovators and fighters, those who strive to be the best that they can be. But how many young men and women are stopped from achieving their potential and bettering their country due to barriers to healthcare affecting themselves and their families? America can easily create the best healthcare system in the world because we already have what it takes. We have the top healthcare centers in the world—many of them here in Minnesota—and we already spend the money that would allow us fantastic coverage and care without the wait lines. What we don’t have however, are enough people in power that are courageous enough to fight for those who don’t have a voice and who suffer under our current system. We need to come together as a society to make this kind of change, because it’s the American—and the right—thing to do.

 

 

  1. Nolte E, Ph.D., and McKee CM, M.D., “Measuring the Health of Nations: Updating an Earlier Analysis,” Health Affairs, January/February 2008.
  1. Woolhandler S, M.D., et al. “Paying for National Health Insurance – And Not Getting It,” Health Affairs 21(4); July/August 2002.
  1. Sullivan K, J.D., “How to Think Clearly about Medicare Administrative Costs: Data Sources and Measurement,” Journal of Health Politics, Policy and Law, Feb.15, 2013.
  1. Woolhandler S. “Cutting Health Costs by Reducing the Bureaucracy,” New York Times, Nov. 20, 2011.
  1. Lewin 2012 Analysis: Beyond the Affordable Care Act: An analyis of a Unified System of Health Care for all Minnesota , Growth and Jestice http://www.growthandjustice.org/publications/P10
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5 Responses to American Healthcare

  1. Sonia says:

    Yes, yes, and yes. Even when someone is insured, the jargon and loopholes make it so complicated to navigate. At my old position, I spent far too many hours fighting with Medicaid, and the rather inept folks who work for the Health Insurance Marketplace. And when my clients were denied every safety net that exists in Missouri , I felt so very helpless.

  2. Jan says:

    Collin….I couldn’t have said it better! I am in full agreement! Now how do we get others to come on board???!
    XOX, Jan

  3. J Kachelmacher says:

    Collin … I’m so glad Janice mentioned your blog! Your passion and perspective is certainly shared by all of your health care friends and family and more. As you express your rationale for single-payer, it is so clear and basic why this makes sense for our communities (and all of my schools)…how do we get your article out there for more eyes and bodies to see and act???
    Much love,
    Jennifer
    P.S. Sending to Jamie and Sam

    • ccousins says:

      You and Jan are too sweet. Yeah, it’s frustrating to see that we could be doing so much more for people but that it’s not happening because there are too many people in power that are already making money off our system. Much love,

      Collin

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