“Did you catch Open Forum on April 23 by Mr. David Eddy claiming Medicare For All would spell the demise of life-saving medical care in the United States?” asked Phineas.
“I did and went out and gathered facts regarding Mr. Eddy’s claims,” I replied.
“In no particular order, I hope to shed light on his claims about ‘a decrease in human longevity.’
“First, the Veterans Affairs health-care system was using an electronic health record many years before we private providers were dragged into using an EHR under threat of losing reimbursement. The VA system integrated clinical information with prescription data, which I and many others thought a helpful tool.
“Second, the VA system has been chronically underfunded and understaffed relative to numbers of physicians needed to care for the enormous numbers of veterans. Lack of access to care and long wait times resulted in bad clinical outcomes.
Phineas added, “Mr. Eddy ignores the impact of the huge numbers of uninsured members of our communities. They lack primary, outpatient care providers for their chronic problems, which then progress to acute illness due to lack of money to pay for care.”
“Correct. When people present to our Emergency Departments their illnesses are often advanced, causing additional complications, which are more difficult to correct. Our clinicians and hospitals care for such people without consideration of their financial status. We with insurance all pay for this unreimbursed care with increased premiums and prices for our care.
“Fourth, delay in access to outpatient care is not only due to certain physicians not accepting Medicare or Medicaid, but the sheer lack of physicians.
“That explains the huge number of Physician Assistants and Nurse Practitioners now providing care,” added Phineas.
“Fifth, clinicians, and health-care systems SHOULD be seeking to deliver less expensive care overall, which will require moving care from the acute hospital setting to preventative care at home supervised by primary-care providers.”
“Valley Health already has started programs to provide outpatient care for those with lung problems,” said Phineas.
“Sixth, I do not believe medical research will decline in terms of developing innovations, new medications, or procedures to treat illnesses. The true cost-benefit analysis of pharmaceuticals is already a disgrace. These corporations make huge profits in the United States, but much less in Canada and overseas. I suspect new technologies have similar discrepancies between true cost and profit margin.
“Seventh, standardization of care protocols based on evidence-based medicine data have already resulted in improved outcomes, not increased deaths.
“Eighth, how to pay for basic Medicare For All may be answered by Matt Taibbi’s April 2019 Rolling Stone article “The Pentagon Money Pit” documenting the enormous, unaccountable sums of money in the Pentagon budget.
“I read that article. Matt suggested that two-thirds of the cost of Medicare For All could be paid for if this hidden and misspent money could be recovered and applied to health care.”
“Finally, The Advisory Board, a non-partisan economic think tank published an article documenting that insufficient startup funding was the primary reason Vermont failed to launch a single-payer health system. The money for health care exists but is being diverted into money pits. We are not taking full advantage of preventative-care opportunities. We spend more money, time, and effort to deliver less useful outcomes than we could under a better devised system.”
“Perhaps basic Medicare For All paired with secondary private insurance for those who can afford it would be a compromise.”
“We are already paying for care for all citizens by diverting costs from those without money or insurance to the rest of us with insurance.”
“Institutionalized Robin Hood-ism,” Phineas added with a laugh.
“The U.K. gave us Robin Hood and has in effect a two-tiered health-care system.”
“Who will stand up and be our Robin Hood?”