opinion

Democrats can't afford to spurn Medicare for all: A doctor’s plea for single payer

In 2019, post-Obamacare America, there are more than 60 million Americans who are living without or with inadequate health insurance. Each year, 45,000 of them die preventable deaths. Two-thirds of all bankruptcies (or half-a-million a year) are the result of out-of-control health care costs. This is despite us spending nearly $4 trillion a year on healthcare, a figure that is projected to rise to nearly $6 trillion by then end of the 2020s. We spend 17 percent of our GDP on healthcare, more than double that of any other industrialized nation. Despite this, our health outcomes rank consistently near the bottom.

This is not because our hospitals are inferior or our doctors are less competent, it is because our healthcare industry puts profits over patients. The insurance industry is killing our loved ones, devastating our households, and bankrupting our economy.

The case for a single-payer system is simple: it takes the profit out of healthcare. Our current system functions on a single premise: the industry charges as much as the market will bear. A single payer can negotiate rates that benefit patients rather than corporate CEOs, drug pricing that begins to reflect a medication’s actual worth rather than how much it can line the pockets of pharmaceutical board members, and healthcare utilization that puts health and safety over profiteering. A single payer system not only guarantees universal coverage, but it decreases overall spending on health care. A Medicare-For-All system would save an estimated $500 billion in year one and $6 trillion over the next decade. This is trillions of dollars that the government can reallocate to fight climate change, feed the hungry, and provide universal education.

Opponents of single payer, including several candidates who support a public option or strengthening the ACA, will state incorrectly that their proposals offer more choice. The truth is, no one really wants choice in their health insurance; they just want to be told that their healthcare will be covered. Inevitably, a public option will come to cover the sickest among us. This gives license to private insurers to cover only the wealthiest and most healthful, resulting in a greater percent of premiums, deductibles and copays that go directly into the pockets of the CEOs. A public option is designed to fail, because a publicly funded program that covers the sickest Americans will never be able to compete with a private industry that handpicks from the lowest risk pool. And a failed public option predestines a future in which single payer can never come to fruition.

Whether or not you support Senators Warren or Sanders in other regards, the choice healthcare is simple. If we do not, as a party, vote to embrace single payer, we will be condemning our nation to substandard healthcare and uncontrollable spending for decades to come.

Penfield resident Toby Terwilliger, MD is currently in his 3rd year of Internal Medicine-Pediatrics residency at the Rutgers New Jersey Medical School in Newark, NJ. He is a proud and active member of Physicians for a National Health Program (PNHP).