BY KIM BEHRENS RN | As an emergency room nurse, I am confronted daily with patients whose lives are devastated by inadequate health insurance.
In one memorable example, last year I approached a middle-aged woman with advanced ovarian cancer as she sobbed inconsolably on her stretcher.
“Where is your pain?” I asked.
In response she cried, “I can’t stay here anymore. Because I’ve been so sick I haven’t been able to work, and now my health insurance ran out and I can’t pay for the extension, and I don’t want my son to drop out of college.
“Please don’t do anything for me,” she added, “because I won’t be able to pay for it, I have to go back to Hungary,” a country I recognized as having a universal healthcare system.
President Obama has delivered a healthcare plan — the Affordable Care Act, or A.C.A. — that has expanded the distribution of healthcare to many but has failed to limit rising costs.
Thirty million Americans remain uninsured. The requirements that insurance companies can neither refuse coverage to those with pre-existing conditions nor set an upper limit upon reimbursement for any given condition represent progress.
Nothing in the A.C.A., however, restricts the insurance industry from continuously raising premiums to maintain soaring profits. The average deductible on all plans, $1,077 in 2015, discourages many from seeking care. The relentless merger of insurance company conglomerates lessens the possibility that competition will limit future cost escalations.
We need to build the political will to change the current system to one that doesn’t bankrupt us just because we are unlucky enough to get sick; a system that doesn’t discourage us from seeking healthcare just because we don’t have the money to cover the co-pays or the deductibles.
The solution?
In 2015 the New York State Assembly passed with a huge majority the New York Health Act (A.5062), a bill that would provide healthcare for every resident via a single public fund, a.k.a. a single-payer healthcare system. This bill has received no attention from the press. The bill now faces an uphill battle in the state Senate (S.3525), but more and more doctors, nurses, social workers, small business owners and patients realize we need this.
Given our current political climate, passage of a universal healthcare system is daunting as the Republicans vote to repeal the Affordable Care Act nearly every day. However, the A.C.A. stipulates that a state can move to a universal healthcare system as long as it meets certain criteria: It must cover at least as many people, it cannot cost more to the government, and it must offer the minimum benefit package stipulated in the A.C.A.
While guaranteeing access to healthcare for all residents, New York Health provides for a single-payer payment mechanism, similar to those used successfully in all other industrialized countries. People who have needed medical care while visiting either Canada or Western Europe appreciate the timely, proficient and compassionate care they have received in those countries.
The New York Health Act would establish a fund designed solely to facilitate the flow of money needed for healthcare. We all would pay into it according to our ability and there would be enough funds to cover the healthcare bill when it’s our time to use healthcare services. Projections show that 98 percent of New Yorkers would save money under this method of financing.
Hospitals and physicians would continue to operate privately. There would be no “networks” limiting which providers you could see; patients would be free to select their own physicians and hospitals.
Opponents of the plan often say frivolously, “We can’t afford it.” The truth is we cannot afford not to have it. Other countries with economies comparable to ours have universal coverage yet pay half as much per person as we pay for healthcare in the United States. Roughly 30 percent of our healthcare dollars are consumed by administrative costs.
The recent revelation that one pharmaceutical company (Turing) has arbitrarily increased the retail cost of its generic drug (Daraprim) 5,000 percent again demonstrates the abuses of the pharmaceutical and insurance industries that profit exorbitantly from the current healthcare system. This price gouging would be eliminated in a single-payer system because the government would be able to negotiate the cost for bulk purchasing.
New York State has a long legacy of progressive change. After World War I, New York crafted and implemented unique socially progressive legislation strengthening workers’ compensation and child and women’s labor laws. These laws served as a template for the New Deal to follow.
Today, New York Health would immediately benefit New Yorkers and again foreshadow future progressive national legislation as New York would continue to lead the way.
Behrens is an emergency room nurse in New York City and a board member, New York Metro Chapter of Physicians for a National Health Program
