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Three reasons doctors should support ‘Medicare For All’

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Over the past two years, the Medicare For All movement has been gaining historic momentum. In 2018 we learned 70 percent of Americans support Medicare for All (including 85 percent of Democrats and 52 percent of Republicans). During the midterm elections, Medicare for All was supported by Democratic candidates in 52 percent of congressional races.

Health care providers are increasingly enthusiastic: in a New England Journal of Medicine survey, 55 percent of clinicians supported moving American health care to a single-payer system.

{mosads}To my physician colleagues who are still unsure about Medicare For All, I offer the following reasons why now is the time to join the movement for health justice:

  1. Taking Care of Patients, Not Paperwork:

In the current American health care “system,” the insurance industry has endlessly frustrating labyrinths: prior authorizations, repeal processes for denied care, formularies in a constant state of revision, and on and on. In addition to numbing minds and crushing souls, the insurance industry’s obstacle courses cost time and money. The average physician spends about three weeks per year on administrative chores that do not make our patients healthier. In terms of dollars, that equates to an average physician practice spending $83,000 every year on claims and billing rather than patient care.

With Medicare For All, we end the tangled web of insurance companies and work with a single payer: the federal government. Under this system, administrative costs in time and money are greatly reduced, saving our country up to $500 billion per year. I urge my colleagues to imagine what we can do with those three weeks of time that won’t be spent haggling with insurance companies. We can spend more time with our patients, do a little more education and training to keep our skills sharp, or — dare I say it — spend time in rest or recreation so we don’t burn out.

 

  1. Ending Minority Health Disparities

The Affordable Care Act is the greatest extension of health justice to minority communities since the passage of Medicare and Medicaid. Nonetheless, shocking injustices and disparities persist for Americans and their basic human right to health care. Because the Supreme Court ruled the ACA’s Medicaid expansion is not mandatory for states, many governors and state legislatures continue to deny health care to millions and make eligibility and enrollment in Medicaid onerous. Republicans in Congress and members of the Trump administration repeatedly attack the ACA and undermine Medicaid. The cumulative impact of these policy decisions is racist and widens inequities in health. People of color make up over half (59 percent) of America’s uninsured.

Medicare For All establishes health care as a basic human right, regardless of where you live, what you earn, or what you look like. As our minority communities become the majority of the U.S. population, inequities in access to health care are dangerously unsustainable. Now is the time to pass Medicare For All.

 

  1. Reproductive Health Care is Health Care

For the past 40 years, the Hyde Amendment has prohibited federal funds to be used for abortion except in cases of rape, incest or when the mother’s life is in danger. Due to this legislation, women relying on Medicaid, Indian Health Services, and the VA, as well as women serving in the military and Peace Corps, must find $400 to $500 to privately pay for an abortion. Given that 40 percent of Americans do not have $400 for an emergency, and that minority women disproportionately suffer financial hardships, the Hyde Amendment has made safe, legal abortion inaccessible to millions.

Medicare For All effectively repeals the Hyde Amendment and recognizes what the American College of Obstetricians and Gynecologists has said for decades: abortion is health care. The comprehensive benefits funded under Medicare For All include the full range of reproductive health services. Furthermore, Medicare for All includes protections so that states can’t block qualified health care providers from delivering those services. Medicare For All finally integrates abortion and contraception into health care, rather than sectioning them off for ideological agendas.

There are many more reasons for physicians and their colleagues in health care to be excited about Medicare For All. Over the next few weeks and months, we will learn about how the legislation directs hospitals to protect patient-to-nurse ratios and redirect physician workloads to protect patients and strengthen health outcomes. Hospital executives will think twice before making capital expenditures like new buildings for unnecessary expensive technology with minimal benefit to patients. Medicare For All will prioritize patients over profits and makes health justice a core value of our health care system.

Dr. Sanjeev Sriram is senior adviser to Social Security Works.

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