Submitted by Paige Organick
As exemplified with Drew Calver1, the Texas high school teacher rushed to the hospital for life saving treatment after a heart attack in 2017, our current healthcare system is neither careful nor kind. From the hospital bed, he worried about affording his care, but was reassured his insurance would cover all expenses. Nonetheless, his initial bill totaled $108,951 after insurance, partly because his hospital was not in his employer’s insurance network.
Calver’s case demonstrates part of the high treatment workload patients undergo to afford their care. If they’re lucky enough to be insured, they must do a lot of cognitive work to figure out if their provider is in-network or not. After treatment, patients wage small and numerous battles with insurance to prevent bankruptcy by a bill magnitudes higher than those in similarly developed countries.
Due in part to a complicated patchwork of fragmented insurance and healthcare providers, administrative complexity has made the US the top spender on healthcare in the world with some of the lowest health outcomes. Americans, compared to similarly wealthy and developed countries, have a shorter life expectancy, higher rates of disease, the highest rate of infant mortality, and the lowest chance of making it beyond middle age2.
Image from Peterson-Kaiser Health System Tracker
Some of these health outcomes could be improved through Senator Sanders’ proposed Medicare for All act, which would better prioritize preventative care measures. 49% of Americans have employer-insurance4, and as they move jobs their insurance changes, then once they hit 65 they move to Medicare. Insurance companies provide treatments rather than continual maintenance of overall health, passing the buck on to the next payer for incentivizing healthy living and preventative care programs. However, under a single-payer system, the government would be greatly incentivized to fund public health and preventative care measures, keeping the population healthier and in less need of healthcare, similar to other Western countries.
Medicare for All would decrease patient’s treatment workloads Under a single-payer system, Calver would not have needed to worry about being in the right hospital, or having the right doctor in the wrong hospital, in order to afford his care. And although Calver had a crushingly high bill, his bill would have been even higher without insurance, as the 29 million uninsured Americans would have faced. When care is this expensive and this administratively complex, navigating care becomes stressful, causing people to either avoid the doctor’s office altogether or to avoid routine care, only seeking care when they need hospitalization or expensive procedures.
However, Medicare for All won’t be a panacea for our healthcare system. Despite Medicare for All increasing access to care, it may restrict certain services and procedures. If 29 million more Americans suddenly accessed healthcare, there would be a shortage limiting access to certain services such as access to doctors and limited supplies of medications. Additionally, Medicare for All would only cover a contested list of “medically necessary” procedures. This list ranges from the obviously important, like breast cancer screenings, to colonoscopies. What it may not include is prescription drugs for fertility, weight loss, or potentially abortions, as they are so hotly contested right now. Calver’s procedure may have been unavailable due to medical shortages, or some aspects may not have been covered.
America is at a crossroads, and how we move forward reveals what we value in healthcare and the treatment of fellow citizens. Our current industrialized healthcare system benefits those with good insurance and who can afford care. These lucky patients enjoy some of the best diagnostic treatment and advanced procedures in the world. While Medicare for All would potentially limit access to some treatments, it overall would bring other benefits that emphasized overall population health, an arguably more careful and kind approach. The passage of Medicare for All would mark a massive shift in America’s values, evolving the rugged individualism America was founded on into making room for a more communal, equality based healthcare system.
1 “Life Threatening Heart Attack Leaves Teacher with $108,951 Bill”. NPR Morning Edition. https://www.npr.org/sections/health-shots/2018/08/27/640891882/life-threatening-heart-attack-leaves-teacher-with-108-951-bill
2 “For Americans Under 50, Stark Findings on Health”. Sabrina Tavernise. The New York Times. https://www.nytimes.com/2013/01/10/health/americans-under-50-fare-poorly-on-health-measures-new-report-says.html
3 “Mortality Rate, Infant (per 1,000 live births)”. The World Bank. https://data.worldbank.org/indicator/SP.DYN.IMRT.IN
4 “Health Insurance Coverage of the Total Population”. Henry J Kaiser Family Foundation. https://www.kff.org/other/state-indicator/total-population/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D