Peter Gordon

By Peter Gordon. 12/9/2019

The vibrant color of the autumn foliage blazed in stark contrast to the grey November sky. It was cold outside, and I couldn’t breathe. Speeding down Massachusetts Ave, my coworker drove me to the Boston Medical Center emergency room, where my breathing was stabilized with a nebulizer and regimen of predisone.

This was my first asthma attack, and it wouldn’t be my last. In order to control my asthma, I always need to take a preventive inhaler every morning and I have to have a rescue inhaler with me at all times, in case of an attack. Fortunately, I live in a state that provides me with public health insurance (Masshealth), where I can buy these medications at very affordable $3.50 copay.

Other people are not so lucky. Jesimya David Scherer from Minnesota was working two jobs to support himself and was studying to become an electrician. He had been successfully managing his diabetes since he was ten years old, until one day he found out that he didn’t have enough money to pay the copay on his insulin. So, he started rationing it. He was hospitalized in April with diabetic ketoacidosis. In June, he called in sick to work. He was found dead the following day. Insulin can be produced for just a few dollars, yet manufacturers like Eli Lilly, Sanofi, and Novo Nordisk mark up the price as much as 5,000 percent and there are millions of Americans with diabetes that have no choice but to pay. Uninsured Americans are at risk of premature death. Not ensuring that all American’s have healthcare is reckless and irresponsible. In a sense, we are giving many American’s a death sentence.

In addition to not covering those who need healthcare the most, our current system exists primarily to enrich private insurance companies. Insurers will continue to reap profits by stripping down policies, restricting provider networks, limiting and denying care, and increasing patients’ co-pays, deductibles, and other out of pocket costs.

“Obamacare was deliberately designed to operate via private health insurers” says Ted Bauman, senior research analyst and economist at Banyan Hill Publishing. “That’s why it was good for their stocks — it created a mandatory mass-market for them. By contrast, a true “Medicare for All” framework in the United States would completely upend the healthcare sector and cause massive disruption to healthcare stocks.” Bauman sees the potential for health insurance companies being “reduced to providing high-end boutique top-up policies for households that could afford them.” The result? “They would effectively be shut out of the mass insurance market, since that’s what Medicare is, after all. They would be a shell of their former selves. This would be devastating to their share prices.” (Mourdoukoutas, 2019).

Over half of uninsured Americans reported difficulty paying medical bills, while one out of five Americans with insurance also reported difficulties paying their bills. Those with difficulty paying medical bills cited facing hard choices, including cutting back on food and other basic items or using up most or all their savings.

“The current debate over the future of the Affordable Care Act is obscuring a more pedestrian reality. Just because a person is insured, it doesn’t mean he or she can actually afford their doctor, hospital, pharmaceutical, and other medical bills. The point of insurance is to protect patients’ finances from the costs of everything from hospitalizations to prescription drugs, but out-of-pocket spending for people even with employer-provided health insurance has increased by more than 50 percent since 2010, according to human resources consultant Aon Hewitt. The Kaiser Family Foundation reports that in 2016, half of all insurance policy-holders faced a deductible, the amount people need to pay on their own before their insurance kicks in, of at least $1,000. For people who buy their insurance via one of the Affordable Care Act’s exchanges, that figure will be higher still: Almost 90 percent have deductibles of $1,300 for an individual or $2,600 for a family.” (Olen, 2017).

Opponents of Medicare for all attack it as an expensive system, but, under our current system we are wasting money. Streamlining the payment system would free up substantial physician and nurse time for patient care. Administrative costs consume 25 percent of hospital spending. If we could reduce administrative waste as other countries have, we could save more than $150 billion a year. Switching to a single-payer system could save nearly $600 billion per year by slashing overhead and negotiating lower drug costs. Savings are enough to cover everyone and eliminate cost-sharing in health care. Medical bills contribute to more than 60 percent of all bankruptcies. Three-fourths of those bankrupted had health insurance at the time they got sick.

While the Affordable Care Act reduced the accumulation of medical debt, it has not ended medical bankruptcy. It is clear that our current system is unsustainable; so, what can be done? We are approaching an election that may very well prove to be pivotal in our nation’s history. Democratic candidates Bernie Sanders and Elizabeth Warren have made Medicare For All a part of their platforms. “It is unacceptable that the monthly cost of cancer drugs has more than doubled over the last ten years to $9,990. In the United States of America, you should not be forced into bankruptcy for being diagnosed with cancer.” Bernie Sanders said. If single payer system is something you desire, then you might consider voting for one of these candidates. Given what is a stake for our own lives as well as the lives of our children, it may be the most important vote that you ever cast.