We haven't heard a lot about our overly expensive and convoluted health care system over the past couple of years.
It seems the rallying cry for "Medicare for All" that was near the top of the agenda during the 2020 presidential campaign has been lost in the drum beat of today's bitter politics.
Yet the push for a single-payer health care system that covers all Americans from birth to death and removes the proverbial and overly expensive middleman from health care is more important than ever.
Perhaps the success of the once much-maligned Affordable Care Act — Obamacare to Republicans — has served to ease the pressure from the likes of Vermont Sen. Bernie Sanders, who single-handedly thrust the idea into the mainstream a few years ago. The ACA, after all, has made it possible for more than 16 million Americans to obtain affordable health care coverage.
But it's done little to reduce the unconscionable costs of American health care, costs that have Americans paying twice as much for care than any other advanced country, almost all of which have single-payer systems that consider health care a right, not a privilege.
Despite our continued allegiance to privately run health care, the Pew Research Center's polling still shows that a majority of Americans believe the federal government has a responsibility to make sure all Americans have health care coverage.
Pew reported just two years ago that among the public overall, 63% of U.S. adults say the government has the responsibility to provide health care coverage for all, up slightly from the year before.
As usual there's a big difference between Democrats and Republicans. Roughly two-thirds of Democrats favor so-called Medicare for All while two-thirds of Republicans believe that while there should be major changes, the current system centered on decision-making by the private insurance industry is best.
That the private, for-profit system continues to be a problem was underscored recently in a New York Times guest essay from a Northwestern University physician who proclaimed, "doctors aren't burned out, we're demoralized."
"Doctors have long diagnosed many of our sickest patients with 'demoralization syndrome,' a condition commonly associated with terminal illness that’s characterized by a sense of helplessness and loss of purpose," wrote Dr. Eric Reinhart. "American physicians are now increasingly suffering from a similar condition, except our demoralization is not a reaction to a medical condition, but rather to the diseased systems for which we work."
He added: "The United States is the only large high-income nation that doesn’t provide universal health care to its citizens. Instead, it maintains a lucrative system of for-profit medicine. For decades, at least tens of thousands of preventable deaths have occurred each year because health care here is so expensive."
Reinhard pointed out that one study estimates at least 338,000 COVID deaths in the U.S. could have been prevented by universal health care.
And the system is taking its toll as many health care workers are leaving their jobs, contributing to understaffing at hospitals and clinics across the country, including here in Wisconsin.
"One report estimated that in 2021 alone, about 117,000 physicians left the work force, while fewer than 40,000 joined it," Reinhart wrote. "This has worsened a chronic physician shortage, leaving many hospitals and clinics struggling. And the situation is set to get worse. One in five doctors says he or she plans to leave practice in the coming years."
He insists that this isn't being caused by so-called burnout as some dismissively claim. COVID, for example, exposed the American system's long-ignored inequalities in the standard of care available to rich and poor Americans.
"What has been identified as occupational burnout is a symptom of a deeper collapse," Reinhart wrote. "We are witnessing the slow death of American medical ideology."
Reinhart cited recent newspaper investigations that showed how hospitals are deliberately understaffing themselves and undercutting patient care while sitting on billions of dollars in cash reserves.
"Little of this is new, but doctors’ sense of our complicity in putting profits over people has grown more difficult to ignore," he noted.
He called for doctors to organize and take action against the unjustified inequalities that the quest for profits over quality care is foisting on the American health care system.
"To be able to build the systems we need, we must face an unpleasant truth: Our health care institutions as they exist today are part of the problem rather than the solution," Reinhart concluded.
In other words, we need to rekindle the push for a nonprofit, single-paying system, just as we do for those covered by Medicare. The problems with our system can't be allowed to get any worse.
