Do No Harm: A Doctor’s Case For Single Payer

In 2013, Drs. Ubel, Abernethy, and Zafar published “Full Disclosure — Out-of-Pocket Costs as Side Effects” in the New England Journal of Medicine. In this essay, the authors grapple with the ethical responsibilities of physicians when it comes to the enormous cost of modern medicine. If a surgery or a course of chemotherapy is likely to bankrupt a patient, what is our duty to warn them, to ensure that they have considered both benefits and harms? A larger question, however, was left unasked: “How do we as physicians ethically operate within a medical system that forces people on a regular basis to choose between health and financial stability”

To grasp the extent of the issue, consider that even after the passage and defense of the Affordable Care Act, 27 million American remain uninsured. An additional 41 million Americans are underinsured which is to say that their out-of-pocket expenses (such as deductibles and copays) are enough to cause financial duress, despite having health insurance. And as health insurance deductibles increases faster than wages, the proportion of Americans who are underinsured continues to grow.

The consequences of this are grave. Three out of ten American adults report forgoing needed medical care due to cost concerns. One in four were unable to pay for basic necessities like food, heat, or rent because of medical bills. One third spent down all of their savingsContinue reading “Do No Harm: A Doctor’s Case For Single Payer”

Subsidizing U.S. healthcare

In this month’s issue of the American Journal of Public Health, Drs. Steffie Woolhandler and David Himmelstein of Harvard Medical School describe the extent to which our healthcare costs are already largely subsidized by the government.

In fact, between the tax subsidies for employer-sponsored insurance, Medicare, Medicaid, and insurance for public employees, the government already pays for 65% of all U.S. health expenditures, amounting to $6,560 per person in 2015. For less than this countries like Canada are able to offer universal coverage without the extremely expensive premiums and deductibles we are saddled with in the United States.

Woolhandler and Himmelstein argue that the excess we pay is essentially a handout to healthcare industries. When so many Americans are struggling with stagnant wages, is it wise for us to be doling out cash to these companies?

Read their op-ed here: “Single-payer health plan wouldn’t cost U.S. more”