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Our elected officials must support Medicare for All

This article was published in The Lens. You can read the original article here.

“Our healthcare system is rotten to the core, and half-measures and meager reforms won’t cut it.”

PNHP demoIn late February, Seattle-area U.S. Rep. Pramila Jayapal, introduced a “Medicare for All” bill in Congress that immediately attracted more than 100 Democratic co-sponsors. The legislation, if passed, would provide comprehensive healthcare coverage — medical, dental, prescriptions, long-term care, mental health, and more — to every resident in the United States, with no copays, premiums, or deductibles.

Medicare for All is a wildly popular policy. Recent polls show that 70 percent of Americans support Medicare for All, including 85 percent of Democrats and 52 percent of Republicans.

Why, then, has our Representative Cedric Richmond not  co-sponsored his fellow Democrat’s bill, one that saves working families money and guarantees healthcare security to every single person in America?

Perhaps he fears that Medicare for All is too pie-in-the-sky. Comprehensive, universal coverage? How could we afford something so extravagant? One estimate from Senator Bernie Sanders’ office calculated that through a combination of progressive income taxes, capital gains and dividends taxes, and limits on tax deductions for the wealthy, we could raise $1.8 trillion over 10 years without needing to raise taxes on the middle and working class.

There are also significant savings associated with transitioning to a Medicare for All program, due to decreased administrative costs and the federal government’s ability to negotiate drug prices. Consequently, even a study from a libertarian think tank, the Mercatus Center, showed that Medicare for All would ultimately save trillions of dollars. Meanwhile, the average family of four with employer-sponsored insurance spent $28,166 on health insurance in 2018. Medicare for All would likely save the average working person thousands of dollars per year by eliminating co-pays, deductibles, and premiums.

Or perhaps Richmond doesn’t want to rock the boat? Isn’t the American healthcare system the envy of the world? But the reality is that we are already spending more money than any other industrialized nation — about double what other rich countries spend per capita — and still achieving worse outcomes.

The U.S. spends a fifth of our GDP on healthcare costs, yet our maternal mortality rate continues to rise, even as the global maternal mortality rate falls. Over the last few years, the rate of congenital syphilis — a completely preventable and debilitating illness — has more than doubled. In Louisiana, Black women are four times more likely to die in childbirth than white women.

Although universal healthcare coverage is not a panacea, it would at least ensure that there are no gaps in coverage during a person’s lifetime, greatly increasing the likelihood that new mothers would receive timely prenatal care.

Perhaps Richmond’s worried about longer wait times, or perhaps he fears that transitioning to Medicare for All will lead to rationing of care. But the reality is that we are already rationing care: patients with money or excellent insurance can get seen quickly, while the rest of us have to wait.

Perhaps Richmond thinks we simply don’t need Medicare for All. After all, thanks to the expansion of Medicaid, hundreds of thousands of Louisianans gained coverage. But currently, 11.4 percent of Louisianans live without health insurance. And for those with insurance, instead of comprehensive care that’s free at the point of service, as Medicare for All would be, insurance companies deliver high premiums, deductibles, copays and denials of service.

Health justice activists have been fighting for universal coverage for decades. Now, in part due to a powerful national coalition formed between National Nurses United, the Democratic Socialists of America, and several other organizations, we are closer than ever before to making this a reality.

Our local New Orleans chapter of the DSA — an organization that has almost 60,000 dues-paying members nationally and hundreds locally — has been building a campaign to demand Medicare for All. We’ve been canvassing our neighborhoods, tabling at public events, organizing community health fairs, and pressuring our politicians. Most importantly, we’ve been listening to the community’s healthcare horror stories. We, the people of New Orleans, are in dire need of better healthcare, and Medicare for All is the only policy tool that can make that happen.

We’ve talked to people who waited weeks to see a specialist because there are so few physicians who accept Medicaid insurance. We’ve spoken with neighbors who paid thousands of dollars in medical bills even though they had insurance. We’ve met people who are afraid to go to the doctor at all — they’re afraid of what they might find and what it might cost. The Medicare for All legislation put forward by Jayapal is sorely needed to correct the inadequacies and failures of our nation’s healthcare system.

Other politicians have also proposed solutions, but they all fall short. Presidential candidate Beto O’Rourke, a former congressman, has spoken in support of the Medicare for America Act, but this program wouldn’t provide universal coverage, and it doesn’t eliminate co-pays, premiums, or deductibles. (Note how the name similarity of “Medicare for All” and “Medicare for America” allows politicians to capitalize on Medicare for All’s popularity by using the #M4A hashtag.)

By retaining private insurance alongside public insurance, Medicare for America would simply perpetuate the tiered, hierarchical system we have now. A crucial aspect of the Medicare for All plan is that it brings everyone together under the same health plan, thus moving us towards a future where everyone has access to the same, high-quality care.

Other approaches, such as the “public option,” which allows individuals to buy into the Medicaid or Medicare programs, have been shown to be deeply ineffective. In 2013, the Congressional Budget Office (CBO) reported that this approach would have “minimal impacts” on the number of uninsured Americans.

Our healthcare system is rotten to the core, and half-measures and meager reforms won’t cut it. We need to pursue radical transformation and effect real change. Right now, we have the political opportunity to do so.

Consistently, when we are talking to our fellow constituents in Richmond’s district, we hear the same refrain: of course we want this, of course we need this, how is it possible that our congressman doesn’t support this?

Soon, for the first time in U.S. history, legislation on the implementation of a single-payer healthcare system will be heard before congressional committees. These hearings will be great opportunities to show Louisianans how transformative a Medicare for All program would be.

Richmond has voiced tentative support for the bill, but we need him to turn that talk into action: we need him to co-sponsor this legislation. As the former head of the Congressional Black Caucus, Richmond is a leader on Capitol Hill. We need his leadership on healthcare. Otherwise, his constituents will continue to endure substandard care, to be driven into medical bankruptcy, and to die of preventable illnesses.

If Richmond truly believes that all Louisianans, no matter their income or their age or their medical history, deserve comprehensive healthcare, he will co-sponsor the Medicare for All Act and champion it in the halls of Congress. If he chooses not to do that, we hope he’ll tell us: which of his constituents does he believe should go without healthcare?

FracesGillFrances Gill is a medical student and co-chair of the Health Care Committee in the New Orleans chapter of the Democratic Socialists of America. The DSA is a national organization with chapters in New Orleans and Baton Rouge. Email healthcare@dsaneworleans.org for more information.

ACTION ALERT: Justice for the police shooting of Stephanie Washington!

SNAHP IconOn Tuesday, April 16th 2019, an Officer of the Yale Police Department fired his weapon during a motor vehicle stop, and the unarmed passenger, Stephanie Washington, was shot and injured. Her life is permanently changed by the trauma she experienced this day at the hands of the police.

The members of Students for a National Health Program know that health is more than just access to a doctor. Health is freedom from all forms of oppression and violence. To this end, we condemn acts of police brutality and stand in solidarity with Stephanie Washington, New Haven Black Lives Matter, and all others affected by this issue.

Join us in supporting Yale SNaHP students demanding that the Yale Police Department and the officer involved be held accountable for the shooting of Stephanie Washington.

Please sign this petition demanding reform from the Yale Police Department in light of these events: https://forms.gle/SK846Lj3nGT88f2XA

Private health insurance is harmful to your health

The following commentary was published in the Syracuse Post-Standard by local members of Students for a National Health Program and Physicians for a National Health Program at SUNY Upstate Medical University: Dr. Sunny Aslam, assistant professor of psychiatry; Robertha Barnes, MS/MD student; Sydney Russell Leed, MD/MPH student; Kunfeng Sun, MS3; Mike Vidal, MS/MD student; Azwade Rahman, MD/MPH student; Ella Cappello, MS2.

“The profit motive of corporations does not lend itself to caring for the sickest among us..”

hands-699486_1920At the Martin Luther King Day Health Justice Conference at Upstate Medical University, the keynote speaker stated, “Politics is nothing more than medicine but on a societal level.” Her figurative use of the word “medicine” means that elected officials have the responsibility to diagnose and treat issues that affect their communities. As current and future health care providers, we have the duty to do what is best for each patient, and more broadly, to speak up for legislation that can improve the health of all our patients. Because governmental policies have the power to affect the medical outcomes of our patients, it makes sense for us to speak up in support of the New York Health Act (NYHA) and Medicare for All.

Today, every candidate for the 2020 presidential election (including the current president) is talking about health care, and specifically the role that private insurance should have in American health care. The private health insurance industry has had more than half a century to lower costs and improve outcomes, but it has failed miserably, resulting in tens of thousands of premature deaths each year. The profit motive of corporations does not lend itself to caring for the sickest among us, as insurance companies only profit when people are healthy, or when care is denied. The sickest patients often end up on government plans due to job loss, affordability, medical bankruptcy, poverty and expiration of coverage. Physicians know that the administrative burden of confirming coverage, submitting claims and filling out forms for multiple insurers contributes to delays in care and time away from patients.

With the newly elected New York state Assembly and Senate, patients and doctors see the possibility of change with the New York Health Act (NYHA). However, the powerful private insurance industry is pressuring newly elected state officials, many of whom ran on a pro-NYHA platform, to include some role for private insurers. As we’ve learned over the past 50 years, private insurance won’t work to lower costs and guarantee access. In fact, the more privatized health care is, the higher the cost. We as current and future health care providers support the NYHA because it will get us back to the relationship between a physician and the patient, without insurance bureaucrats in between.

Single-payer opponents most often cite the 2018 RAND study to claim the NYHA will increase taxes and amount to a “government takeover” of health care, but the study also predicts that most New Yorkers would pay less under the NYHA. Families would no longer pay an average of $28,000 per year for a private plan covering a family of four. Instead of workers and employers paying premiums to a private insurance company, all state residents would be covered with no co-pays, deductibles, co-insurance, or premiums. Medical bankruptcy would be a thing of the past. Opponents who scream about increased taxes don’t point out that the NYHA will reduce overall costs for almost every family. Unlike private insurance plans, with their narrow “networks” of approved providers, the NYHA would provide more choice, as all doctors and hospitals would be “in-network”; treatments would be determined by patients and doctors, not an insurance company motivated by profit.

Many say we can’t afford universal health care, but we are already paying for it. The U.S. spends nearly 20 percent of our gross domestic product on health care, roughly double the per capita rate of high-income countries with national health plans. Yet we have the shortest life expectancy and higher infant and maternal mortality rates. With the money saved by drastically reducing administrative costs from private insurers and negotiating down prescription drug prices and other supplies, we can cover all Americans without breaking the bank. Access to primary and preventative care will save even more money and lives over the long run.

One of our members works with homeless men and women at local shelters. Many of these patients require urgent examinations for addiction and psychiatric illness, but insurance companies require “prior authorization” before we can see the patient at all. This treatment is often life-saving as well as money-saving, since otherwise the patient will end up with an expensive trip to the emergency room. More importantly, delays in care for mental health and substance abuse can result in death.

It’s time to end the needless suffering and death, medical bankruptcies and endless paperwork imposed by private insurance. We hope Gov. Andrew Cuomo and our state legislators pass the NYHA. It’s the only way to cover all those who live in New York, save money and save lives.

Medical students advocate for Medicare for All

This article was published in the Berkeley Blog. You can read the original article here.

“We have pledged to ‘do no harm’ in our pursuit of medicine; however, our current for-profit insurance system in the United States routinely harms patients.”

uc-berkeley_snahpAt the UC Berkeley-UCSF Joint Medical Program (JMP), our instructors implore us to examine the social and structural determinants of health. Many of us at the JMP have recently gathered to support the Medicare for All National Week of Action, as we believe that one of the greatest strides our country could make towards health justice and equity would be to guarantee every person in the United States access to high-quality healthcare via a single-payer funding system.

We have pledged to ‘do no harm’ in our pursuit of medicine; however, our current for-profit insurance system in the United States routinely harms patients. It consistently produces far poorer health outcomes than any other industrialized country. Physicians and other providers often deny patients life-saving care because they lack the proper insurance, causing tens of thousands of preventable deaths every year.

Indeed, the United States routinely ranks last among developed nations in terms of health equity – quantified as the percentage of patients who did not get recommended tests, treatments, or follow up care due to cost. Alarmingly, life expectancy increases linearly by income level in the United States and can be mapped to geographic areas. Many Americans skip treatment every day due to unaffordable out-of-pocket costs. An estimated one million individuals experience medical bankruptcy every year.

Even after the passage of the Affordable Care Act, over 25 million Americans remain uninsured. Furthermore, nearly a third of Americans are considered ‘under-insured’; around 80% of medical bankruptcies occur in patients who were already covered. This current system is clearly inadequate – when people resort to crowdfunding their medical bills, something needs to change.

These health and economic injustices exacerbate the inequalities already experienced along racial, ethnic, and immigration status. A single-payer system would not solve these health disparities or eliminate the structural racism embedded in our health system. However, it would ensure that healthcare is considered a universal necessity and not a commodity reserved for the few who can afford it.

A single-payer system promotes equity by replacing all out-of-pocket expenses (premiums, payroll deductions, deductibles, co-pays) with a progressive tax on corporations and the highest income bracket. The waste associated with private insurers has been estimated at $400 billion per year; single-payer would increase efficiency by cutting 80% of administrative costs and diverting these currently squandered resources toward patient care. Having a single payer forces hugely profitable pharmaceutical companies to negotiate and cut prices. These savings and the additional taxes would more than provide for universal coverage. In fact, study after study show that a single-payer system would save the U.S. money, on the order of trillions of dollars over the next decade.

Still, all these economic arguments mean little until we recognize healthcare as a human right. Equity and efficiency in the American health-care system have fallen to unacceptable levels. We do not want to practice medicine in a system that fails to meet the health needs of our population, especially its most vulnerable. This dire situation requires a bold solution: implementing a single-payer system is an essential step towards providing our patients the care they deserve.

Liberty and health care for all: The 2019 SNaHP Summit in NYC

SNaHPSummit2019

Save the date! The 8th annual SNaHP Summit will take place on Saturday, March 2, 2019, from 9:00am to 7:00pm at the Roy and Diana Vagelos Education Center (VEC) at Columbia University Medical Center (CUMC) in New York City.

The SNaHP Summit is a one-day gathering of medical and health professional students from institutions all over the country who support single-payer national health insurance. Our theme for the 2019 Summit is “Liberty and Health Care for All.”

By attending, you can expect to learn what a national health program would look like in the U.S. and develop vital advocacy skills geared toward health professional students. Participants will also contribute directly to the national strategy of SNaHP through networking and breakout sessions.

Click here to register for the Summit.

Additional questions? Email organizer@pnhp.org.

ATSU group makes case for single payer system

This article was originally published in the Kirksville Daily Express. You can read the article here.

By Jessica Karins

“We are all just a layoff away from being among the ranks of the uninsured.”

– Wendell Potter

PNHP demoIn 2007, Wendell Potter was one of about 20 health care executives sitting in a conference room waiting anxiously for a report from a representative they had sent to Cannes Film Festival. A documentary was screening at Cannes which the executives knew might be an all-out attack on their public image.

The documentary was Michael Moore’s “Sicko,” and it would change the way Potter saw his work for the health insurance industry.

“Our worst fears were realized,” Potter said.

Potter came to Truman State University’s campus for an event sponsored by Truman’s economics department and the A.T. Still University organization Students for a National Health Program. SNHP is a student branch of the advocacy group Physicians for a National Health Program, a group of doctors who argue for ending America’s private insurance system and shifting to a single payer, or “Medicare for All” system.

Potter worked for years in corporate communications for health care companies, ultimately heading the department for insurance giant Cigna.

“I was a staunch believer and supporter of the free market,” Potter said.

Potter said his job was to convince the public that private insurance was the most beneficial system for health care. In the early 2000s, he said, that job largely consisted of moving consumers to high-deductible plans which the industry called “consumer-driven care,” meaning people would pay more up front for their health care costs before insurance coverage began.

Potter said his process of changing his mind about the health care industry began when he saw that Michael Moore documentary and realized the film’s portrayal of health care executives as greedy and heartless was not inaccurate to his experiences.

“He took a great deal of pains to make sure that he was portraying the system really very accurately,” Potter said.

As Potter pondered what to do next, a high-profile case hit the media. A 17-year-old girl, Nataline Sarkisyan, had been denied by his company a liver transplant her doctors said was medically necessary. Her parents were interviewed on CNN and staged a protest outside Cigna’s headquarters.

Potter said he convinced the company’s executives to reverse their decision.

“The problem was that days had passed. That liver was no longer available,” Potter said. “Five days before Christmas, Nataline died.”

Potter quit his job in 2008 and is now a writer who travels the country advocating for a single payer health care system. He said the Affordable Care Act has helped the problem slightly, but it is not enough.

“We are all just a layoff away from being among the ranks of the uninsured,” Potter said.

Like Potter, PNHP supports a proposal they call “expanded and improved Medicare for All.” They support a bill first introduced in Congress in 2003, House Resolution 676, which would create a national system of full health insurance including dental, vision and mental health coverage.

The cost of creating such a system in the United States is debated by economists, but PNHP believes it would save money.

“Single payer national health reform would save nearly $500 billion annually on paperwork and administration, enough to cover all of the uninsured and to eliminate deductibles, co-insurance, and co-pays for everyone,” according to the organization’s website.

Dr. James Adams, the faculty sponsor of SNHP at ATSU, said medical students are concerned about the future of health care under America’s current system.

“Once they graduate, it’s their system, and they know the current system is in crisis,” Dr. Adams said.

According to data from Gallup Polling, about 44 million Americans are uninsured and an additional 38 million are under-insured, meaning their insurance cannot cover their actual medical costs.

Most other Western countries have a single payer health care system. A national poll by Kaiser Health in 2008 found that 59 percent of physicians supported a single health care system, and Dr. Adams said that number has likely risen since then. Recent Gallup polling shows that 70 percent of Americans overall now support it, including a majority of Republicans.

Dr. Adams said physicians spend a large amount of time, money and emotional energy negotiating with health care companies that do not want to cover their patients’ costs.

“The insurance companies throw down all these barriers to patients,” Dr. Adams said. “Passing a Medicare for All system would buy our patients freedom from all that.”

Dr. Adams said SNHP tries to focus on the positives of a potential single payer system, rather than the negatives of the current insurance system. He said it would mean the end of paying for costs like pharmaceutical drugs, ambulance rides and nursing home care.

“No more premiums, no more copays, no more coinsurance, no more deductibles,” Dr. Adams said. “People would be out in the street demanding it if they really knew.”

ACTION ALERT: Support immigrant justice by saying NO to the public charge!

Medicine for Migration squareMedicine for Migration Twitter

Immigrants are under attack.

On September 22, 2018, U.S. Department of Homeland Security released a proposed rule that could threaten the health and well-being of millions of children and families.
The proposed regulation seeks to expand the scope of programs that can trigger a public charge determination.  Public charge determinations are provided to immigration officers and can be used as a reason to deny a person’s green-card application. Under the proposed regulation, green-card applications can be denied to immigrants, even parents of US-born children, who receive social services like Medicaid; Medicare Part D, which helps the elderly afford prescription medicines; food assistance programs like SNAP and WIC; and Section 8 housing vouchers.
By expanding public charge determination, millions of children and families are at risk of being deprived of vital nutrition, health, and housing services out of fear that using such programs puts obtaining legal residency in jeopardy. 

But we can fight back. This regulation will been open for public comment until December 10, 2018 and a wave of comments and public demonstrations of support from the medical community will be impactful in preventing passage of the proposed change.

Show your support by:

  • Submitting a public comment here.
    • Only unique comments are counted, so add to the template provided by the Protecting Immigrant Families campaign on their website or check out these instructions for writing a comment.
    • Comments on their website will automatically upload to the federal register.
  • Ask your federal legislators to defend immigrant rights and stand against this regulation by signing on to this letter.
  • Tell your friends, family, and everyone you know to submit a comment. This is how we stop this.
  • Tell everyone on social media. Join our Facebook event. Add a Facebook filter, change your cover photos, and share the public comment page. Instructions are in our social media folder here.
    • Use the national coordinated hashtag #MedicineforMigration in your social media posts.
  • Join schools across the nation and commit your program to spreading the word about this cruel proposal and submitting comments about this cruel regulation during the National Advocacy Week, December 3-10.

SNaHP is proud to support the Medicine for Migration: National Week of Advocacy because immigrant rights are human rights!

A group of students at Weill Cornell and Columbia explain why their CEO is wrong to oppose ‘Medicare for All’

This article was originally published in Business Insider. You can read the article here.

Future of care must include single-payer system

This article was originally published by The International Falls Journal. You can read the original article here.

“As we head into an election cycle and as our healthcare costs become increasingly unaffordable, ask your representatives if they support a single-payer system that will cover you and everyone that you love.”

hands-699486_1920The stories are often shared in passing. As if they’re facts of life that one cannot change. The church secretary that makes $40,000 and spends $25,000 of it on health insurance premiums. The bartender who made too much in tips last month, lost his MNSure coverage, and now hasn’t taken his diabetes, hypertension, or psychiatric meds in weeks. The farm family where one family member must work off the farm to get insurance.

I am only a second-year medical student, but stories of people losing or not being able to afford essential medical care are already a commonplace part of my clinical experience.

In 2015, one third of all Americans put off necessary treatment because of costs. That means that almost everyone reading this knows someone, or they themselves, didn’t get the care they needed because of how much it cost. This summer I spent a rural rotation in International Falls. I was impressed with the quality of care and resilience that this community has shown in its commitment to providing healthcare to the community. I also heard at all levels – from administrators to patients, frustration with the healthcare system, costs, and accessibility of care.

Frustrations with healthcare are not unique to International Falls with an estimated 700,000 Americans going bankrupt every year because of medical debt. Healthcare spending now eats up almost one third of an average family’s income in America. If we were getting the best care in the world, that might be worth it, but the United States ranks 30th in the world for life expectancy, right behind Costa Rica and ahead of Cuba and we rank 26th in infant mortality. Rural communities are especially hard hit with shrinking insurance markets and difficulties retaining providers.

Every American deserves quality care that is affordable and accessible. With a single-payer system that is publicly funded and privately operated, we can get that. A single-payer healthcare system is funded by taxes on employers and individuals based on income. There are no co-pays, premiums, or deductibles. Once you pay into the system, all medically necessary care is free – from primary care, to surgery, dental, and vision care. You can see your hometown doctor that knows you best without having to worry if they are “in network” because every provider is included within the single payer system.

Physicians don’t have to fight insurance companies because single-payer insurance isn’t for-profit and lets patients and their physicians decide what care is medically necessary. And with a publicly accountable system, rural hospitals can incentivize providers to practice in communities like International Falls by increasing the budgets of rural hospitals and clinics to provide more competitive wages.

Non-partisan studies have shown that single-payer insurance would save 95 percent of American families money. Single-payer insurance is good for individuals, it is good for businesses, and it is good for rural communities that are the foundation of our country.

So as we head into an election cycle and as our healthcare costs become increasingly unaffordable, ask your representatives if they support a single-payer system that will cover you and everyone that you love.

beret_fitzgerald
Beret Fitzgerald is a medical student at the University of Minnesota who completed a summer internship with Physicians for a National Health Program Minnesota.

 

ACTION ALERT: Support the National Prison Strike

National Prison Strike StampStarting August 21, 2018, incarcerated peoples in 17+ states will be striking to demand an end to the death penalty, unfair wages, unsafe conditions, and racist policing and sentencing practices. They are also demanding equitable access to therapeutic rehabilitation programs and the right to vote.

Throughout the history of prison strikes, lack of quality medical care is a constant theme. The Attica Prison Rebellion, which this strike commemorates, was in part a response to the poor health conditions and medical experimentation on incarcerated people. At Attica, there were compassionate physicians who demanded access to prisoners to assess their injuries following the violent retaliation by correctional officers. As caregivers and public health advocates, SNaHP seeks to honor this legacy of medical solidarity by supporting those striking almost fifty years later in the 2018 National Prison Strike.

SNaHP is encouraging caregivers and public health advocates to personally support the 2018 National Prison Strike by signing the Letter of Solidarity sponsored by White Coats 4 Black Lives.

Here are a few other ways you can support to the strike:

  1. Educate ourselves and others about the strike demands.
  2. Officially endorse the strike by emailing a statement of endorsement to prisonstrikemedia@gmail.com and millionsforprisonersmarch@gmail.com. (Sample statement here).
  3. Share the Letter of Solidarity with classmates, colleagues, and social media: http://bit.ly/students-for-the-strike.
  4. Amplify incarcerated voices via social media using the #August21 and #prisonstrike hashtags.
  5. Organize a phone tree in preparation for phone zaps and similar requests once the strike is underway.