PERSPECTIVES ON PROPOSITION 186 : ‘Single Payer’ Is a Tonic for Patients : Threats of lost benefits and high costs are an industry smoke screen. Prop. 186 offers full coverage and security.
As I followed the national debate on health care, I could not help but remember the hundreds of tragedies I’ve come across since I have been a physician: lack of access to proper care, financial ruin despite thousands spent on health premiums, insurance companies that want to insure the healthy and desert the sick and who see patients as objects to manipulate to maximize profits, lack of peace of mind regarding our most precious commodity, our health.
We have a chaotic health insurance non-system that dictates everything, guarantees nothing and purposefully sacrifices people’s health, financial security and peace of mind for financial gain. And now the beneficiaries of this chaos are using every means possible to dissuade the public from passing Proposition 186, the California Health Security Act.
I have seen and lived what this proposition entails. I studied medicine at McGill University in Montreal where I experienced the single-payer system firsthand. Like most of my American colleagues who trained in Canada, I enthusiastically support single-payer universal coverage. As a physician, I may have been called a heretic just a few years ago for promoting single-payer health care. But the insurance companies and “mis”managed-care firms have abused us and our patients. They have micromanaged our patient care and violated the sanctity of the doctor-patient relationship. They have forced our large academic centers to compromise their educational and research missions in order to compete with them.
As a result, what was heresy has now gained legitimacy. In addition to the 1,000 physicians of the California Physicians Alliance who crafted the California Health Security Act, the California Medical Assn. admits that more than 10,000 of its members favor a single-payer system. This trend among physicians is being progressively censored and suppressed by many hospital administrators who thrive on the current massive inefficiency.
Proposition 186’s single-payer plan is a publicly financed, privately delivered, competitive health-care system that would provide legal California residents with a card enabling them to see the physician of their choice. The public would elect a health commissioner to administer the system, someone who is accountable to us and not to stockholders. The commissioner would be advised by a board of physicians and medical experts and would answer to consumer councils throughout the state.
The health security act was carefully written and worded by physicians to preclude any micromanagement or intervention in the physician-patient relationship. The excellent benefits package would be available to all from cradle to grave. It could not be taken away because of change in employment, disability, illness, divorce or anything else.
Most of us would be very angry if the government we elected had to authorize our health care before we received it; yet we easily accept profit-motivated insurance companies doing just that. It is time to reduce the 15%-30% insurance overhead (and multimillion dollar CEO salaries) our health premiums finance and replace it with the 2%-4% overhead seen in Medicare and single-payer systems. The money is there. It is just being wasted, most recently on huge campaigns to defeat national health reform and false advertising to defeat Proposition 186.
Many voters are starting to look past the propaganda and cliches, but two major concerns remain. The first is: “If I have good insurance now, what’s in it for me?” My wife and I have excellent insurance. We pay no premiums, have some choice and low deductibles. But we still lack what we most long for: security. If I become disabled and lose my job and my ability to pay premiums, I lose it all. You may be terribly disappointed with even good insurance once you need it for a chronic disease, devastating illness or long-term care. The list of reasons for which people lose their health insurance is endless.
The second concern is cost; we don’t want to pay more taxes. Most of us already pay heavy health-care taxes in the form of constantly rising premiums. In addition, we all pay for our care through deductibles and co-payments that can go into the thousands. The overwhelming majority of middle-income Californians will pay less in taxes than they are now paying for health coverage. The Congressional Budget Office, after reviewing all alternatives, concluded that single-payer is the only plan that would cover all Americans, reduce health expenditures and reduce the deficit.
One of the major strategies of those who want to deny us our rights is to villainize our northern neighbor’s health-care system. But poll after poll has shown the Canadian public and physicians to be very satisfied with their system. Canadians have universal coverage and total health security; 95% of all medical services in Canada are administered within 24 hours of need; Canadian medicine remains at the frontier of medical science, with developments of such innovative therapies as lung and bone marrow transplants, which are performed on a higher per-capita basis in Canada and denied to many Americans with “good” insurance under the pretext that they are “investigational therapy.”
I studied medicine because I wanted to engage in the healing arts, not in business administration. Please vote “yes” on 186 to restore this privilege to me and thousands of my fellow physicians and to give yourself what you so truly deserve: your right to a doctor.
