The French Way or the Broken US Way of Healthcare?

Advocates for Single Payer Healthcare Rallying in 2009 in Harrisburg, PA

Advocates for Single Payer Healthcare Rallying in 2009 in Harrisburg, PA

Anya Schriffrin has just written a wonderful piece on universal health care from the French perspective called “The French Way of Cancer Treatment.”  She discusses the differences in the treatment her father received at Sloan Kettering Memorial Hospital v. his treatment at Cochin Hospital, a public hospital in Paris.

The differences she saw in her father’s cancer treatment in both countries included:

Issue

At Sloan Kettering (United States)

At Cochin (France)

 

Average length of treatment day

7.5 hours

90 minutes

How specialists see patients

Patient traveled to each specialist’s office

All specialists came to see patient either in home or in the hospital room.

Treatment received

Chemo selected based on insurance company’s formulary

Chemo selected based on doctor’s determination of best treatment

Who paid for meals while in hospital

Patient

Hospital: Included in treatment

Who paid for transportation to and from hospital

Patient and/or Insurance Company

Hospital: Included in treatment

Type of medical care

Insurance based, for-profit

Universal Health Care

Average cost/person for medical care in each country (2011)

$8,608

$4,086

% of Country’s Gross Domestic Product for Health Care

17.9%

11.6%

 

The one statement that stood out for me on the French system was this:

“There were other nice surprises. When my dad needed to see specialists, for example, instead of trekking around the city for appointments, he would stay in one room at Cochin Hospital, a public hospital in the 14th arrondissement where he received his weekly chemo. The specialists would all come to him. The team approach meant the nutritionist, oncologist, general practitioner and pharmacist spoke to each other and coordinated his care. As my dad said, ‘It turns out there are solutions for the all the things we put up with in New York and accept as normal [emphasis added].’

As a cancer survivor, I can attest to similar experiences in the United States just about a quarter century ago.  Nothing has changed.  Like Ms. Schriffrin’s father, my visits to the hospital often took 7-8 hours after getting up way before the break of dawn to travel 3 hours to the hospital to be one of the first people to wait in line to see the doctors and other specialists.  I too had one doctor who wandered in to the clinic for my chemo 7-8 hours AFTER he was scheduled for treating patients. In that particular case, he kept patients and nursing staff waiting until about an hour after the clinic should have closed for the day.  And I had to fight for my life with two insurance companies in order to get the bone-marrow transplant I needed.

My story is similar to many others here in the states.  That’s why I support national universal, single-payer healthcare via Congressman John Conyers’ (D-MI) HR 676 in the United States.  It’s why I support federal legislation to expand the Affordable Healthcare Act to all states to create a state-level single-payer plan like what Vermont has already passed and signed into law. It’s why I support the plan that Senator Bernie Sanders (I-VT) has crafted; it’s called the American Health Security Act of 2013 bill and it creates state-level single-payer healthcare programs with Federal support.   It’s why I am a board member of Health Care for All PA Education Fund.  And it’s why I support the Pennsylvania Health Care Plan proposed by Pennsylvania State Senator Jim Ferlo.

We can do better here in the US.  Better than what Ms. Schriffrin’s father and I have both experienced.

Let’s fix this broken US healthcare system.  Let’s create access to quality healthcare for all via a universal, single-payer healthcare program in the United States.  Check it out.  Let’s do healthcare the French Way in the American style as suggested by Congressman John Conyers Jr. (D-MI), Senator Bernie Sanders (I-VT),  PA Senator Jim Ferlo, the state of Vermont, and Health Care for All PA.

Why I Support Universal Health Care: A Right, Not a Privilege

Congressman John Conyers Jr. (D-MI) has reintroduced his National Health Care plan bill HR 676, “The Expanded and Improved Medicare for All Act.” I strongly support a universal national health care program such as HR 676. I also support any effort by any state to implement a state-based single-payer health care plan. Why?  For many reasons.

My life was threatened by the multi-company, private health insurance system we currently have.

I received a bone marrow transplant in 1989 from my identical twin sister. Although I had no problem finding a match, I had to jump through many hoops and barriers put up by the two health insurance companies covering my sister and myself. In the case of my insurance provider, I was refused coverage of the donor portion of the transplant because my twin sister wasn’t on my health insurance plan. In the case of my twin sister’s insurance provider, they refused to cover her portion of the transplant because she “wasn’t sick.” Then the hospital administration said that they would not perform the transplant until this conflict between the two insurance agencies was resolved with a guarantee of payment by either or both companies. And my doctors said that if the resolution did not occur rapidly, I would be dead within the year due to the seriousness of the form of leukemia that I had.

According to Health Care for America, health insurance companies profit by denying–not by providing–healthcare. Health insurance CEOs of the top 10 health insurance companies today typically enjoy an average of $10,000,000 in annual compensation–salary, bonuses, stock options, etc.

Back to my story. I went into battle mode against the insurance companies when I was told that they would let me die because of their bottom line and attempts to deny coverage. Because of the support and advocacy I had through the organization where I self-purchased my health insurance (the National Organization for Women), we were finally able to get me the life-saving transplant that I needed. And I am here today.

This experience is why I became an advocate for a single-payer health care system rather than the current system that allows private companies the ability to deny critical health care to “save” their bottom line for profit only.

Other Reasons why I support a Universal Health Care Plan at Either the National or State Level.

It is the ethical and moral to treat all people, regardless of economics or status when they are sick.

A 2009 article in the Journal of Public Health reports that approximately 45,000 people on average die each year due to lack of health insurance. One of the goals of The Affordable Care Act (ACA) is to reduce the number of people without health insurance, so that premature deaths from lack of coverage would also be reduced.

People will continue to struggle to receive health care coverage and treatment with both passage of the ACA and the Supreme Court’s decision declaring the ACA as constitutional while allowing states to opt out of the expanded Medicaid program for low-income people.

The Centers for Disease Control acknowledges that access to coverage will improve under the ACA. But that acknowledgement holds a caveat; they state, “Even after ACA is implemented fully, some persons eligible for coverage might go uninsured.” The ACA will not fully resolve this ethical and moral threat to peoples’ lives. 

Some states are threatening people’s health care and lives based on decisions either by their legislature and/or their governors.

These states place people who could have been covered under the Expanded Medicaid program in continued jeopardy since they will neither be able to sign up for Medicaid nor be able to afford private health insurance through the ACA’s health care exchanges. The 13 states that have already threatened the healthcare of their citizens are Alabama, Georgia, Idaho, Louisiana, Maine, Mississippi, North Carolina, South Carolina, South Dakota, Oklahoma, Pennsylvania, Texas, and Wisconsin. Five states – Iowa, Nebraska, New Jersey, Virginia, and Wyoming—are leaning towards opting out of coverage. Kentucky, New York and Oregon haven’t yet made their decision, but do appear to be leaning towards opting into full ACA with the expanded Medicaid coverage. All remaining 22 states plus the District of Columbia have opted into full ACA with the expanded Medicaid coverage.


Where the States Stand

Via: The Advisory Board Company

For the low-income people living in the 18 states that have either opted out of or are considering opting out of the expanded Medicaid coverage, nothing changes for them since most of these individuals will not be able to afford private health insurance in the new health care exchanges under the ACA.

A Single Payer, Universal Healthcare program would cover everyone.

According to predictions by the Congressional Budget Office and the Joint Commission on Taxation, we will we still have 30 million uninsured in 2023 under Obamacare. At the same time, health care costs for our nation, states, and families will continue to increase. A single-payer, universal healthcare program could cover everyone at lower cost. Everyone in and no one out regardless of income or health status.

The BETTER Alternatives: National and State-Based Single-Payer Plans

The plan introduced by Representative Conyers is basically an expansion of the efficient and cost-effective Medicare system currently used by the elderly and people with disabilities. Its overhead (all costs other than for healthcare) is much lower–and patient satisfaction is much higher–than under for-profit healthcare. And it would cover everyone regardless of their economic or health status without fear of an insurance company denying coverage to save their bottom line.

Similarly, legislation is being considered in about half of the states to create state-based single-payer healthcare programs. Some of these states’  legislatures have held hearings and/or had votes on universal healthcare. Vermont has already passed a law that sets in place the possibility of a single-payer healthcare program by 2017. 2017 is the year that the ACA—aka “Obamacare”—allows states to try other healthcare plans IF they cover at least the same number of people with at least the minimum coverage under the ACA.

Obamacare is now the law of the land. It is an improvement over what we had before 2009. It is also the basis from which we can work towards a comprehensive healthcare program. We could do it nationally, such as with HR 676. Or, like Canada, we can start at the state level.

So check out HR 676. See if your Representative is one of the 40 current co-sponsors. If not, meet with him/her, tell your personal story about why you support an expanded and improved Medicare for All, and ask them to co-sponsor the bill. If he/she is already a co-sponsor, ask your Representative to take the next step. They can hold a town-hall meeting on universal healthcare to hear from their constituents. They can also call on the chairs of the three committees reviewing HR 676 to hold Congressional hearings on HR 676. These three committees are the House Energy and Commerce Committee, the House Ways and Means Committee, and the House Natural Resources Committee.

Also get active with your state-based single-payer organization. These local and state-based single-payer health care groups will let you know how can help with your state-based legislation. Healthcare NOW has a full listing of state- and local-based organizations. If your state does not have a single-payer chapter yet, contact Healthcare NOW at their national office in Philadelphia, PA; they can help you to organize a plan for your state.

All other “advanced” nations have already adopted comprehensive healthcare systems. All deliver better health outcomes at a lower per capita cost than the USA. Let’s get cracking. Let’s do it here in the US of A as well.