Dr. Mathew's remarks on HCAN

Our chapter of Physicians for a National Health Program is pleased to participate and be a sponsor of this national coalition pushing for our common goal of affordable, quality healthcare for all Americans. The problems are painfully obvious, a dysfunctional, non-system of health care, which, should it continue on it present course, will soon become non-functional. The symptoms are well known: Almost 50 million Americans lacked health insurance for all or a part of last year. 25 million Americans who did have health insurance often found it pitifully inadequate when a medical crisis hit. They were only marginally better off than those who had no coverage at all.

Statistics confirm this major breakdown. Premiums have climbed 87% since 2,000, while workers’ meager pay raises have been far outstripped by major increases in their share of the premiums. While the U.S. ranks No. 37 on a variety of health care quality measure used by the World Health Organization, per capita spending is twice as high as any other nation.

Some 22 million Americans with health insurance still spent a large chunk of their incomes for out-of-pocket medical expenses. As out-of-pocket expenses and deductibles have risen, many families are postponing or foregoing treatment. About half of these underinsured had difficulty paying their bills; many took out loans, mortgages or credit card debt to pay them. The present economic downturn (which the President says is not a recession) greatly adds to the problem.

Notwithstanding Gov Charlie Crist’s recent well intentioned efforts to provide health insurance for Florida’s 3.8 million uninsured, it is becoming increasingly obvious that private, for profit insurance companies cannot be the solution. The industry has appropriately been called “The Health Insurance Mafia”(Kellerman WSJ 14 Apr 08).

The insurance model is unique in that its profits depend on services not being provided. The system operates by progressive rationing, using denials of authorization and steadily rising co-payments by the patients, plus massive paperwork and other bureaucratic hurdles.

This is not only bad for patients, but also for us physicians. Doctors are resenting the increasingly short leash on which they are held by insurers and large hospital chains, the current masters of American medicine.

For decades the American Medical Association successfully opposed national health care reform, scaring the public with dire warnings about “socialized medicine”. Today’s medical political landscape has vastly changed. Only about a third of the country’s physicians are currently members of the AMA, while several major physician organizations, representing internal medicine specialists, psychiatrists and others, have come out in support of a universal, single payer system.

While the U.S. lags behind most of the western world in health care, there is one area where we are clearly number one: we incarcerate more of our citizens than any other country in the world — numbers and rates greater than China, Russia or Cuba. Here in our Sunshine State over 93 thousand are currently in our state prisons, projected to soon pass the 100 thousand mark. Why mention this shameful statistic in our discussion of health care? Because, pursuant to federal court decisions, these prisoners in our prisons and jails have a constitutional right to health care. You don’t have that right; I don’t have it, but we must by law provide it to our prisoners, a very costly proviso. (Personal experience — for nine years, 1989-1998, I was chief health officer for the Florida State Prison system.)

What is the answer for us Americans who would prefer to have their health care assured without having to serve time? There is only one reasonable goal: a single payer, comprehensive plan for all Americans, “Medicare for All” — comprehensive coverage, including medical, mental health and dental. How can we afford it? We are already paying enough to cover everyone. Our current system has 31% administrative costs, vs. 17% in Canada and about 4% for traditional Medicare. As with traditional Medicare, medical decisions would remain between the patient and his or her doctor.

How do we get there? We must elect and persuade a Congress that will respond to the wishes and needs of the American people. The bills have been filed — HR 676 & Sen. bill 703. All of us, united and working together, must apply maximum pressure on our elected public servants to make this long overdue health care reform a reality.

Charles R. Mathews, M.D., for
Capital City Chapter, Physicians for a National Health Program