Letters to Editor, Opinion

LETTER: On Obamacare

I voted for Barack Obama in 2008 because he promised to sign a universal health care law. This aligned with my ambitions to become a doctor who treats patients based on their medical need, not their ability to pay. Finally, the time had come for us to fix our inequitable system and offer our citizens the human right to health.

Six years later, most of the provisions of the Patient Protection and Affordable Care Act have been implemented. However, it’s apparent that political pressure from the private insurance industry and the big drug companies has thwarted the goal of the universal health care.

Obamacare is expected to help an additional 20 million Americans obtain health insurance, mostly through Medicaid expansion and subsidized private insurance, but about 30 million Americans will remain uninsured. According to the American Journal of Public Health, this translates to approximately 30,000 preventable deaths a year.

Mandating Americans who don’t qualify for Medicaid and who don’t have employer-based coverage to buy private insurance policies benefits insurance companies, but does little to make health care affordable.

For example, those enrolling in an exchange-based Bronze Plan will have only 60 percent of their actual health care costs covered by insurance. According to a report by the Kaiser Family Foundation, even after paying premiums, a family may have to spend up to $12,700 out of pocket.

When patients have “more skin in the game,” e.g. higher co-pays and deductibles, they often forgo necessary medical care. Medical costs caused 37 percent of Americans to forgo seeing a doctor or skip filling a prescription in 2013, according to findings by The Commonwealth Fund.

The private insurance industry’s profit-making incentive makes health care a commodity that is unaffordable for the poor. However, there are promising solutions currently being proposed at the state level.

Vermont is already in the process of setting up a statewide single-payer health insurance system.

Vermont’s legislature has declared health care a “public good” and assumes the responsibility to, “ensure universal access to and coverage for high-quality, medically necessary health services for all Vermonters.” This is not “socialized medicine;” doctors and hospitals will remain independent. All medical needs are covered for everyone, and patients are free to choose their doctor.

Canada’s single-payer system has resulted in high-quality universal coverage at a cost that is about half of what the United States spends on health care. Risk is shared across the entire population, administrative costs drop and zero profits go to insurance companies.

If Vermont’s approach succeeds, we can expect other states to follow. Massachusetts Gubernatorial candidate Dr. Donald Berwick, intends to establish a single-payer system if elected. Congressional Representative John Conyers, Jr. has sponsored a single-payer bill in the House and Senator Bernie Sanders has as similar bill in the Senate.

Single-payer national health insurance is not impossible. Canadians did not always have a single-payer health care system — they demanded it. Their single-payer movement started with a single province.

How many more “unprofitable” Americans have to die or go bankrupt before we too demand our human right to health?

Sincerely,

Jawad Husain

Jawad Husain is a medical student at the Boston University School of Medicine.

3 Comments

  1. I was in a physical training class today and the woman practicing next to me experienced a muscle spasm so painful, she lowered herself to the floor and started to quietly sob. I could see the awful expression on her face. She had tweaked something really bad, perhaps she even pulled a rib out of place. She laid on the floor, paralyzed while the class finished up. I spoke with her after class about her plans for addressing the injury. I asked, of course, if she had insurance, thinking for a short moment that maybe she was one of the recent people to benefit from coverage under Obamacare. She wasn’t. Even when I urged her to have it checked, she was adamant that even if she could afford one co-pay for the initial office visit, that she would not be able to shoulder multiple co-pays for any kind of physical therapy treatment. It still bothers me how regularly people are sacrificing getting care because of the costs. Even perceived costs. She was crying on the floor in front of about 60 of her peers, but this was still not as terrible, in her mind, than the costs she anticipated she would pay the insurance company in order to address her injury.

  2. If the Canadian healthcare system is so great, why are Canadians having to come here to get their healthcare?

  3. Billy, there have been peer-reviewed studies done on this that have found the number of Canadians who come to the U.S. for health care is so small that it’s barely detectable relative to the number of Canadians who receive health care in Canada.

    A large population health survey found that amongst Canadians “0.5 percent of respondents indicated that they had received health care in the United States in the prior year, but only 0.11 percent (20 of 18,000 respondents) said that they had gone there for the purpose of obtaining any type of health care, whether or not covered by the public plans.” So 99.39% of Canadians never came to the U.S. for health care. Not a surprise when you consider they don’t have to pay a bill when they receive their health care.
    In contrast, 37% of Americans had problems accessing health care due to costs in 2013.

    sources:
    http://content.healthaffairs.org/content/21/3/19.long
    http://www.commonwealthfund.org/Publications/In-the-Literature/2013/Nov/Access-Affordability-and-Insurance.aspx