WASHINGTON—When a baby in California named Evan became very ill 10 years ago, his single mother lacked the money to take him to the doctor and foot the bill for the needed co-pay. So she called her mother, Evan’s grandmother, a registered nurse, for advice.
The grandmother listened to the symptoms and told her daughter to get Evan to the emergency room immediately. “I’ll pay for the co-pay,” the grandmother said.
“I was right: My grandson was suffering from encephalitis, swelling in the brain. Encephalitis can cause permanent brain damage and even death,” her grandmother, Jean Ross, told Congress on Dec. 10.
“I am so grateful I had the economic resources in that moment to help my daughter, because if I had not, like so many other patients who do not have the means, Evan would have been in severe trouble if he didn’t get that care immediately.”
Millions of other U.S. families don’t have a grandmother, or parents, ready, willing and able to step in and pay a child’s high medical bill – and that’s why the U.S. needs a system, Medicare For All, that takes such fraught choices out of the hands and off the minds of suffering families, Ross, an RN, the grandmother, and the co-president of National Nurses United, testified.
“Your health will no longer depend on your ability to pay,” she declared.
Ross brought her grandson’s tale, along with those of patients she’s treated over the years – or in many cases, was unable to treat due to insurers’ denial of payments – to the influential House Energy and Commerce Committee, at its hearing on how to improve the U.S. medical care system.
Whether the panel will really act on any of the proposals before it, ranging from fixing holes in the Affordable Care Act to Medicare For All, is up in the air.
Committee Chairman Frank Pallone, D-N.J., was handed the task of holding the hearing and then burying Medicare For All, which is pushed by NNU, at least a dozen other unions and progressive health care groups and lawmakers. Republicans, including committee members, still chant their party’s “repeal and replace” mantra for the ACA, though they have nothing to replace it with. Meanwhile, GOP President Donald Trump dismantles the ACA by executive action.
And Pallone and other committee members from both parties receive millions of dollars in campaign contributions and benefit from “dark money” political spending by corporate interests – primarily Big Pharma – who profit from taking people’s dollars and then not paying for people’s care, a point Ross and other witnesses repeatedly stressed.
That uphill battle didn’t stop Ross from strongly advocating the benefits of Medicare For All, including universal coverage and lower overall costs. And nurses wouldn’t face agonizing situations where patients refuse treatment, stint on their medicines – and then wind up sicker – or even die because insurers refuse to pay.
“As a registered nurse for 40 years, I know these stories are not unique to me, these particular patients, or my family,” Ross said. “They happen every single day in hospitals, clinics, and communities across the country. The system we have now is ineffective at providing quality, therapeutic care to our patients because it is beholden to the for-profit interests that determine who gets treatment, and what treatment they get.”
“Ineffective care leads to inefficiencies in the system, because it prioritizes short-term cost savings, rather than long-term investments in our health. This all culminates in a system that is entirely unaffordable for our patients and our country – patients cannot afford the costs of their care individually, the country can’t afford the financial burdens of a system that makes poor decisions, and our society cannot afford the consequences to our public health.”
Ross brought attachments and studies from independent experts showing how Medicare For All would both increase the quality of care while lowering the overall share of U.S. goods and services – now 17.6% of gross domestic product and rising – spent on health care.
Her testimony did not detail how Medicare For All would be paid for, which is now a key issue on the presidential primary campaign trail, pitting its advocates, its author, Sen. Bernie Sanders, Ind-Vt., and Sen. Elizabeth Warren, D-Mass., against former Vice President Joseph Biden and South Bend., Ind., Mayor Pete Buttigieg. But an accompanying fact sheet Ross gave the lawmakers did so, in some detail.
“Current U.S. expenditures provide sufficient funding for the program, but they must be captured in a new way,” the fact sheet explains. It envisions putting everyone under Medicare For All, including current Medicare, Medicaid, state children’s health insurance program beneficiaries and users of the ACA marketplaces. Money now used for those programs would go to Medicare For All instead, along with cost savings.
“Although the bill does not specify how the balance of the national expenditures would be financed, there are many options,” the fact sheet says. “These could include a corporate gross receipts tax, progressive personal income tax, financial transaction tax, and repealing the corporate tax cuts passed in 2017.”
Most important, Ross added, families would save thousands of dollars each yearly on co-pays, deductibles, and out-of-pocket costs for treatments the insurers deny or shortchange.
Other witnesses brought stories of how the 10-year-old ACA saves money and lives. Except for GOP witnesses, they reminded lawmakers that even with the ACA now law, the current system still leaves 27 million people uninsured and another 44 million underinsured, i.e., one high medical bill, with insurers’ payment denied, away from bankruptcy.
But Ross said all other solutions, even the so-called “public option,” still fall short of Medicare For All, because all the others still leave the insurers in place, with their high co-pays, deductibles, and denial of care. Instead, comparison charts show those measures would give greater federal medical subsidies to individuals without curbing rising health care costs.
By contrast, Medicare For All would give the federal government, as the prime purchaser of U.S. health care, enormous leverage to force down costs and set reasonable prices, Ross said. And the government, not the patients – or their relatives – would pay.
“As a grandmother, I want to leave my grandchildren with a country where health care is a right. I want my grandchildren to know that when they or their own children get sick, they will only have to focus on their health, and not worry about their bank accounts,” Ross said.
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