Carrie Seidman: Time for a health care overhaul

Feb. 10--The reason I sold a house I'd owned less than a year, left behind family and friends and moved from the arid high desert of New Mexico to the steamy Gulf coast of Florida (a place I'd sworn I would never live) was to make sure I had health insurance.

If that seems ridiculous, well, you wouldn't get much argument from me. It's not that I have regrets about the choice. But I do regret that it was forced by not having other options.

When the paper I worked for in Albuquerque shut down and I lost my job (and with it my health benefits), private insurance for someone who'd just finished chemo for breast cancer was either unobtainable or unaffordable. (Obamacare didn't exist yet.) The best offer I got was 2,000 miles away in Sarasota and, obviously, I needed coverage. So I uprooted from a place where I'd lived nearly 20 years.

That's just one of thousands of life choices Americans make daily based on their ability to get, keep or afford their health care and medications. When the decision involves going without insurance entirely, the consequences can be far more dire.

"Every day I see people who are underinsured, or not insured, come in with conditions that should or could have been totally prevented if they were managing their care regularly," said Rosanne O'Malley, a nurse in a Trinity, Florida, emergency room. "But they aren't covered, so they let it get out of hand and then it's an emergency."

O'Malley spoke in Sarasota recently as a member of National Nurses United, the largest union and professional association of registered nurses in the country. The organization is on a cross-country campaign to advocate for a single-payer, government-run health care system, commonly referred to as "Medicare for All."

It's not just the patients she sees nor the daily examples of "hospitals putting profits before people" that pushed O'Malley into public advocacy. There's another reason -- or, more accurately, two.

When her brother decided to leave a lifetime of factory work at age 58, "his health insurance went away with his job," O'Malley told an audience at the Fogartyville Community Media and Arts Center. But after more than a year of declining health, he took a new job, just to get coverage.

That was in October. When O'Malley visited him in December, he hadn't yet seen a doctor; he was still waiting out the three months it took for him to become vested in his new employer's plan. The day after O'Malley returned home, she got a call. Her brother had died, at 60, of a massive heart attack.

"He had no insurance and he knew it would be astronomically expensive to see someone without it," she said. "It cost my brother his life."

A year later, she lost her other brother, also to heart disease. Self-employed, he'd gone for years without insurance and, at 65, had just received his first Medicare card. He never had a chance to use it.

"I hope none of your families are ever faced with the uninsured catastrophe my family faced," she said.

With the imminent introduction of bills in both the House (HR 676) and Senate (SB 1804), a grassroots support is mounting in support of a single-payer plan. A Harvard/Politico poll showed just under 70 percent of Americans felt Medicare for All -- or something like it -- should be an "extremely important" priority for Congress.

Advocates say the advantages are obvious: Everybody's in, nobody's out. Benefits are uniform, rather than based on what you can afford. It's financed equitably, through progressive taxation geared to income level. You can take it with you from one job to the next. You have freedom to choose your providers and procedures can't be denied. And administrative overhead -- currently about a quarter of all hospital spending in this country -- would plummet.

Opponents -- including hospitals, many physicians and the pharmaceutical industry -- cry "socialism" and insist such a system can't possibly work. They predict soaring costs, untenable reimbursement rates that would force closures, long waits for appointments and the stifling of drug research and innovation.

No matter where you line up in the debate, it's hard to ignore evidence that our current system needs a major overhaul.

The U.S. pays almost twice as much (more than $10,000 per person annually) as any other wealthy country in the world, yet our outcomes are worse. (From birth to the mid-60s anyway; interestingly, at 65, when Medicare kicks in, the statistics reverse.) Medical bills are a major reason for filing for bankruptcy and one-third of all Go Fund Me campaigns are for medical expenses. Employers spent $900 billion on health care (the equivalent of $2,700 for every person in the country) last year alone. And Florida holds the distinction of having the highest hospital charge-to-cost ratio in the country, an average 800 percent.

"Everyone, no matter what their political affiliation, thinks our current system is a problem," said Bradley Van Wauss, southern regional director of the National Nurses Organizing Committee, who also spoke at the event. "The U.S. ranks last among wealthy countries in health care quality, efficiency and access. The design of our system is a function of the current capitalist climate and, all along the way, someone's siphoning off profits."

What people fear in transitioning to a single-payer system is what people always seem to fear -- cost, and change. Yet estimates show 95 percent would end up paying less in taxes to cover their care than they currently fork over in premiums, deductibles and co-pays (all of which would go away). As for change, isn't a more uniformly healthy population and a longer and better quality of life the change we want to see?

But Van Wauss might have had the best argument when he asked everyone in the audience who was satisfied with their current insurance to raise a hand.

To a person, every hand that went up was attached to someone currently receiving Medicare.

Contact columnist Carrie Seidman at 941-361-4834 or [email protected]. Follow her on Twitter @CarrieSeidman and Facebook at facebook.com/cseidman.

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