GUEST COMMENTARY: We need a better system to pay for health care

The fatal shooting of a health insurance company executive has exposed the deep dissatisfaction many Americans experience with their health insurance. Social media is abuzz with stories of anger and frustration with a system that prioritizes profit over people.

As a retired physician, I saw the shortcomings of our system regularly fail my patients and am well aware of the need for change. In fact, in 2021, I established The Asclepius Initiative (TAI), a nonprofit that works to communicate the need for a fairer and more just health care financing system.

We believe that you and your family should have access to care when you need it, and your care should be affordable, regardless of where you live or work.

Getting sick isn't a choice, and receiving the necessary care shouldn't be a luxury. Your medical care should be decided by you and your doctor, not a claims processor.

Instead, our current system punishes those who are ill, frequently denying coverage and imposing billing nightmares. In 2021, 1.5 out of every 10 households held medical debt. Today, medical costs remain a leading cause of bankruptcy.

Among the Organisation for Economic Co-operation and Development (OECD) countries, the U.S. has the highest per-person health care spending, costs that might be justified if they produced better outcomes. The U.S., however, actually has the lowest life expectancy, the greatest burden of chronic disease, and the highest maternal and infant mortality rates of its peers.

We are the only high-income country that does not guarantee health care coverage, ranking last, by far, among peer nations in health system performance.

Although not perfect, some version of universal health care coverage would bring the U.S. in line with other countries. It would ensure that everyone could access necessary health services without requiring people to battle with insurance companies or producing financial hardship.

The argument for comprehensive health care coverage isn't just moral; it's practical. A 2020 report estimated that an all-inclusive system could save the U.S. $450 billion annually while preventing nearly 69,000 deaths.

Critics of a universal system often argue that it will lead to rationing or excessive wait times. In actuality, we already have rationing and scheduling logjams; they're simply disguised as exclusions based on type of coverage, affordability of copays, deductibles and coinsurance, or availability of primary care doctors, specialists and hospitals.

Today's national conversation should compel us to consider the kind of health care financing system we want. Do we continue to allow private insurers, wealth status and connections to dictate who gets care and who doesn't, or should we pivot to embrace a model that enshrines health care as a fundamental right?

At TAI, we believe that a health care system that covers everyone benefits everyone. Imagine not having to check that your doctor is "in-network" or fighting to ensure your procedure will be approved.

It's time to move beyond outrage and demand real change. Universal coverage is not a hope — it's a necessity. Our health and economic future depend on it.

Susan G. Bornstein, MD, MPH, is an OB-GYN by training and went back to school for a master's degree in public health. In 2021, she founded The Asclepius Initiative, a 501©(3) nonprofit organization based in Louisville.