Now Facing Potential Major Medical Costs, I’m Glad I Always Supported for Medicare-for-All
I never thought much about my two open-heart surgeries before.
That’s probably because I had them when I was too young to remember and have lived my life forgetting they even happened.
I never had to take any medication, never had any restrictions.
The only vestige of my unique medical past is when I have to swallow four Amoxicillan capsules one hour before dental appointments.
That was until this month.
At my last annual cardiology appointment in June, instead of declaring another clean bill of health as I have come to expect, my cardiologist (we’ll call him Dr. Laters) asked an interesting question: How long is the four- and- a- half-decade-old repair to my pulmonary valve going to last?
For an answer, he sought advice from a pulmonary valve specialist at Columbia Presbyterian Hospital in Manhattan, where I had both my surgeries to correct congenital atrial and ventricular defects in 1975 and 78.
That surgeon recommended I have an MRI.
No big deal, I thought. It’s a reasonable request. I’m sure everything is fine.
A month later I was sitting at my desk prepping the next day’s lesson plans when Dr. Laters’ number lit up my cell phone.
Calmly, professionally, he told me my pulmonary valve was performing so poorly, it was causing my right ventricle to enlarge.
Someone from Dr. St. Orre’s (not his real name) office would call to schedule an appointment for a consultation about two avenues: valve replacement via catheterization — or surgery.
When I hung up, I was trembling.
This is it. This is the moment I never had to think about.
Yet deep inside I knew it was bound to happen.
After all, my last surgery was in 1978 when I was almost four. My pulmonary valve was determined too small despite prior surgery to open the leaflets. In order to avoid an artificial valve that would have to be replaced periodically as I grew, surgeons implanted a Dacron graft in the pulmonary artery through the valve, thereby enlarging the area but rendering my valve incompetent.
Amid the concerns, questions, and anxieties swirling non-stop through my head, I keep coming back to one thing: I have just joined millions of others with expensive health issues.
Even as an American with decent employer-provided private health insurance, I know there is something fundamentally flawed with the ways in which we deliver healthcare in America.
I acknowledge my good fortune.
My wife and children are healthy, and I still am (the current prognosis notwithstanding). Our co-payments are reasonable, and we have never hit the insurance provider’s arbitrary cap.
Yet I also acknowledge millions of our fellow countrymen and women are not as fortunate. They have high deductibles, co-payments, may have lousy coverage, and are one serious illness or injury away from bankruptcy.
We don’t usually plan for disease, accidents, or medical procedures. My wife had a skin cancer scare three years ago, for example, then my son broke his wrist at school. Now I’m going to have a heart valve replaced.
What shenanigans our insurance company is going to try and pull is anybody’s guess. Maybe it will pay for it all without a second thought.
But if it doesn’t, I could be looking at untold amounts of uncovered “surprise” expenses that could literally bankrupt me and my family.
That wouldn’t be the case if we practiced a Medicare-for-All single-payer national healthcare system.
A recent report from The Commonwealth Fund confirms the U.S. ranks dead last compared to 11 other wealthy countries in four out of five areas pertaining to access to care, process, administrative efficiency, equity, and outcomes.
“Okay, maybe,” skeptics reply, “But we can’t afford it. Medicare-for-All will bring us Soviet-style Socialism!”
There is no shortage of counterarguments to knock down every one of these claims.
First, the reductive “We can’t afford it” fallacy.
That claim is seldom if ever proposed when we feel the need to increase the military budget, print money to provide $2 trillion in economic relief to keep corporations afloat, dole out perpetual subsidies to the world’s most profitable corporations, or permanently cut taxes on those same corporations and their overlords to the tune of $1.5 trillion.
Those who cry poverty are often the same who also boast about us being the richest nation in the world.
They can’t have it both ways.
We have always been able to afford to provide every man, woman, and child born in this country healthcare as a human right.
Consider that over the past dozen or so years we have spent in the neighborhood between $20–35 trillion on corporate bailouts.
All that time we could have been providing healthcare.
Right now, combining Medicare, Medicaid, insurance premiums, and out-of-pocket costs, we are expected to spend about $52 trillion on health care during the next decade.
But Medicare-for-All would eliminate premiums and out-of-pocket costs, reducing the price tag to between $20 trillion and $36 trillion over the same period.
That happens to be the same amount the federal government set aside for corporate welfare since 2008.
After the 2008 financial crash, we granted $700 billion to big banks.
The Federal Reserve committed between $16 trillion and $29 trillion to large financial institutions.
Lawmakers handed $4 trillion in pandemic relief to large corporations.
Administrative savings could start by eliminating or significantly reducing the overhead produced in medical billing, on which the United States spends twice as much as Canada.
How much savings?
According to the nonpartisan Congressional Budget Office, Medicare-for-All could save the country up to $650 billion per year.
Another component: salaries and marketing expenses.
Health insurance companies are, fundamentally, just banks on which insurers spend more than 20% of total expenditures on overhead.
Medicare, on the other hand, spends around 2%.
Transitioning everyone away from private for-profit health insurance to a Medicare-for-All system would save around $200 billion in overhead alone.
The “Soviet-style Socialism” canard is just that.
Canada is not some third-world banana republic where people are dying in the streets. It’s a civilized liberal democracy, as are the nine other countries that outrank us: Australia, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom.
And they are proud and fiercely protective of their national healthcare systems.
There are many permutations of national healthcare systems, and we do not need to follow Canada-or any other country’s-model in lock step.
Great Britain, for example, practices socialized medicine, in which the government owns and operates most of the healthcare providers and doctors are government employees. Although technically a single-payer system, it is just one model.
Canada and many other nations, on the other hand, contract with private providers in which doctors still run their own practices.
This is the difference between “socialized medicine” and “single-payer.”
They are not “rationing care,” as opponents often claim.
Arguably, healthcare costs being the primary driver of bankruptcy, a distinction we share with no other country, is a form of rationed care.
If you have every tried getting an appointment with your primary care physician “as soon as possible,” you’ve experienced it.
If you’ve ever tried to schedule a test that doctor ordered and had to wait weeks or even months, that’s rationed care.
It’s even worse when trying to get in to see a specialist-that’s if your for-profit insurance company approves the visit.
There are no waits for urgent or primary care in Canada.
As I enter the healthcare minefield, I am as confident in my unwavering support for a single-payer healthcare system in America as I am in the belief we will have it within the next decade.
Getting there won’t be easy, especially with well-entrenched special interest groups with unlimited funds pumping lies and propaganda into the media and our political arena.
But just as we have seen movement on same-sex marriage, marijuana legalization, police reform, voting, and the minimum wage, we will move the needle on this too — as long as we don’t cede ground to the other side buying into industry talking points.
I hope a year from now I will be able to report good news.
But as long as wealthy insurance CEOs still imprison patients with the power to choose who lives and who dies, there will be no good news, only those who don’t fall through the cracks and those who don’t.
