Can you hear the sound of our health care system collapsing? It is not just the threat of TrumpCare, which throws 24 million Americans off health insurance while cutting taxes for the wealthy (of the $900 million in tax cuts over the next 10 years, 57 percent of those cuts will go to the top 10 percent of income earners and 33 percent will go to the top 0.1 percent).
Health insurers are failing. Blue Cross & Blue Shield of Rhode Island reported a $35 million loss in 2016, a year in which the outgoing Blue Cross CEO and CFO were given severance packages in excess of $1 million apiece. They blamed the losses on the high number of older people needing orthopedic procedures. Blue Cross has now lost money in 3 of the last 5 years, even with the ACA subsidies to the private insurance market. TrumpCare would create a “stability fund” that also subsidizes private health insurance companies, recognizing that they wouldn’t survive without corporate welfare—but it remains to be seen if that will be enough to keep them afloat.
Hospitals are failing. In recent years, Rhode Island’s hospitals have been purchased or begun negotiations to be purchased by out-of-state corporations because it is impossible for them to stay solvent. No matter how well hospitals are managed, 1/3 of every “health care” dollar is spent on the administrative costs associated with our current system of multiple health insurance companies. For example, Mass General Hospital employs 350 people to process their billing. In Canada, where the government runs a Medicare-for-All, single payer system, Toronto General, which is about the same size as Mass General, needs just 3 people to process billing.
Medicare is failing. Congress has relentlessly reduced Medicare funding or diverted it into the private insurance market. For example, in 2003, when the federal government could have simply expanded Medicare, it paid private health insurance companies to fill Medicare “gaps,” such as prescription coverage, with the “Medicare Advantage” program. To entice private health insurers to offer gap coverage, Congress guaranteed them profits or “overpayments,” which were $34 billion in 2012, alone. The result is that older Americans receive some health care through Medicare but many cut their pills in half.
People are dying. Even if the ACA is fully implemented, approximately 4 percent of Rhode Islanders would not be insured and many more would remain under-insured. Studies estimate this would cause approximately 100 Rhode Islanders to die each year from lack of proper health insurance. I have personally witnessed patients delay or not seek treatment because they feared their insurance would not cover it. Unfortunately, since the death certificate will read, “heart attack,” not “avoided treatment because of high deductible,” the actual number of deaths may be even greater. Contrary to what Republican Congressman Raul Labrador of Idaho recently told his constituents at a town hall meeting, people do die when they do not have access to health care.
The answer is a single-payer system, such as the one in Canada, which has been working well for over 40 years at less than half the cost per capita that the U.S. pays. It is time we adopt a system that works, is affordable and saves lives. There are bills in the Rhode Island legislature, H5069 and S154, that would create such a system here in Rhode Island. I urge every Rhode Islander to contact your state senator and representative as well as our Congressional delegation and urge them to support this legislation.