“(Medicare for All) would enable greater focus and funding for vital public health needs, such as syringe-exchange programs and even hand-washing stations in high-risk areas.”
Opinion: Why San Diegans Desperately Need Medicare for All
By Dr. Mikael Langner. Times of San Diego. March 13, 2019
Several years after the implementation of Obamacare, roughly 200,000 residents in San Diego County are still living without health insurance.
Many of them suffer from chronic conditions, including diabetes and heart disease, as well as mental health and substance abuse disorders. Some of them are homeless.
As a local physician, I know that even insured patients are postponing doctor visits, forgoing recommended procedures or halving medication doses due to cost.
We all know someone who is not getting the treatment that he or she needs under our current healthcare system. Some may be dying because of it.
While California may not see an improved Medicare for All bill this year, Rep. Pramila Jayapal, a Washington Democrat, has just introduced a version in the U.S. House of Representatives. This means our nation has another chance to heal our ailing healthcare system.
Medicare for All would guarantee health care to everyone regardless of their health or wealth and help alleviate undiagnosed and untreated illnesses that can impact public health, employee productivity and everyone’s quality of life.
Take the 2017-18 Hepatitis A outbreak here in San Diego County that infected nearly 600 people. It resulted in nearly 400 hospitalizations and left 20 dead. A state audit faulted the county and city for their inadequate initial response to the outbreak.
In 2017, the county also reported more than 3,100 new cases of Hepatitis C, which is spread in part by those who share needles.
A Medicare for All system, which involves a single source of funding for all health expenditures, would result in significant savings to the country — and most residents — because it eliminates the middlemen, which are the insurance companies. This would enable greater focus and funding for vital public health needs, such as syringe-exchange programs and even hand-washing stations in high-risk areas.
Meanwhile, substance use, including the opioid epidemic, has plagued San Diego County, with reportedly more than 250 opiate overdose deaths in 2016.
Ninety percent of people nationwide who have a substance use problem don’t get treatment for it. I believe stigma is partly to blame. After all, if health insurance is tied to a person’s employment, employees may have a legitimate fear they will lose their job if they seek help and their employer finds out.
In a Medicare for All system, health care would no longer be tied to employment. Instead, it would provide insurance to everyone regardless of their employment status, creating an openness that we lack today.
It would also alleviate another worrisome problem: physician burnout. A new report from the Harvard Global Health Institute and others called this a “public health crisis” that threatens to undermine the “very provision of care” in our country.
Recent research suggests that almost half of all doctors experience some kind of burnout, which can lead to mistakes and lapses in judgment. Much of it is related to the vast amounts of paperwork that insurance companies demand. I often spend up to half my day dealing with questions and forms required by multiple companies. This is work that maximizes their profits but diminishes patient care.
Meanwhile, a routine bill in a doctor’s office in Canada — which has a single-payer system similar to what’s being proposed in the U.S. — takes about 13 seconds to process as illustrated in the 2015 documentary “Fix It.” That gives Canadian doctors more time to spend with patients, leading to better care.
Though doctors may have lower reimbursement rates under a Medicare for All system, they would be able to see more patients in a day while enjoying reduced operating costs.
Medicare for All would not be a perfect system but many doctors believe it would be far superior to the highly complex, costly and piecemeal approach in place now.
The United States has an opportunity to offer what every other large, rich country already does— universal health coverage that leaves no man, woman or child behind.
I urge my fellow San Diego residents to educate yourselves, organize and contact your congressional representatives to voice support for Jayapal’s Medicare for All Act of 2019.
At the same time, we must also keep this critical issue alive with California lawmakers as they have the power to introduce and support a state bill in the future.
The stakes are clear. We simply can’t afford to lose any more time, dollars or lives than we already have.
Dr. Mikael Langner is a general practice physician living in San Diego. He founded the San Diego chapter of Physicians for a National Health Program.
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