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The Journal Gazette

Tuesday, April 16, 2019 1:00 am

'Medicare for All' the moral choice

Dr. Tom Hayhurst

Dr. Tom Hayhurst is a physician and former member of Fort Wayne City Council.

I note that a federal judge recently made a decision potentially invalidating the Affordable Care Act. President Donald Trump subsequently stated he fully supported repeal of the ACA. He went on to tout what he described as a much better health care plan but offered no details.

Repealing the ACA would leave more than 20 million of our currently insured fellow citizens without adequate health insurance. Having reviewed his website, I am not aware of the position of Rep. Jim Banks regarding this matter, which is important to many citizens of northeast Indiana.

Independent studies indicate that thousands of our fellow citizens die each year because they do not have health insurance. As a doctor, I am the volunteer director of the Multi-County Medical Outreach Clinic in Columbia City. With vigorous support from Parkview Health and many agencies and individuals throughout the region, we provide free health care for the working poor (from any county) who are either uninsured or underinsured.

In that setting I have seen many who have been driven into bankruptcy by large medical bills after hospitalization for serious illness. I am also aware of others who have died because of a lack of health insurance. For example, I cared for a 41-year-old man who presented to a local emergency department at 3 a.m. gasping for air with a temperature of 104 and almost no detectable blood pressure. He had extensive pneumonia, did not respond to vigorous treatment and died a few hours later in the intensive care unit. He had delayed seeking medical care because he had lost his job and his health insurance.

Many of our current 30 million (50 million if the ACA is repealed) uninsured fellow citizens face this choice every day. Some are lucky enough to avoid serious consequences of their decision. Many others suffer death or disability or bankruptcy. I have seen it firsthand.

So where do we go from here? At the least, we need to make sure that every citizen has affordable health insurance. The most efficient way to do this would be to gradually expand Medicare to include every citizen.

Medicare has been around since the 1960s and has many advantages over other forms of health insurance. Cost controls have gradually been put into place which help verify that costs are necessary and sensible and appropriate. Pharmaceutical costs will decrease significantly when the government allows competitive bidding for medications under Medicare Part D – which it has blocked for more than a decade. Medicare overhead is much less than that of private sector health insurance companies – 4% to 5% as opposed to 20% to 25% for the private health insurance industry.

The high overhead typical of private health insurance results in billions of wasted dollars. How else would the private health insurance industry afford $100 million+ bonuses for their executives?

There are many who make gloom-and-doom predictions for government health care programs, including U.S. and Canadian Medicare. They complain continually about rationing of health care in Canada. Recently I spoke with a Canadian visitor who had presented to a Canadian hospital with chest discomfort and a possible heart attack. That gentleman was seen by a cardiologist within minutes after arrival.

There is already extensive health care rationing in the USA. The patient I described earlier suffered from health care rationing as a result of poverty. I should add that essentially all Medicare services in the USA are provided by the private sector; the government acts only as an efficient insurance agent.

The Feb. 26 issue of the Journal of the American Medical Association contains an excellent article: “Rationing of Health Care in the United States.” The article concludes: “It has been said many times that in the richest country in the world, in which many of the greatest scientific and medical advances are developed, it is a blight on the U.S. soul that each of its residents does not fully benefit from available health care.”

That quote touches on the aspect of the health care debate that concerns me greatly – the immorality of needless death, disability and financial ruin in our country, which declares it is a God-fearing, “religious” country. Some faith leaders speak out on this moral issue.

But why aren't we hearing an outcry from more religious leaders to solve this moral and economic “blight on the soul of America”?

Our goal should be eventual “Medicare for All”; it surpasses all other options for making affordable quality health care available to every U.S. citizen.