At a recent gathering, I was pushing the “Medicare for All” (MFA) button and someone asked me if I thought this button would pass. I feel that the problem of “non-institutional” health care is so severe that fundamental changes in reimbursement such as MFA are inevitable, but I doubt I will live to see that change. I answered no. This made me think about why I thought this way.
Our society responds fairly well to crises, but not to ongoing problems, regardless of their severity. It’s similar to how alcoholics and drug addicts need to reach “rock bottom” before accepting necessary but extremely painful treatment and the changes that come with it. What is “rock bottom” in our health care? We see women dying because they don’t get the obstetric care they need. We are seeing primary care fail due to inadequate reimbursement and excessive red tape. We are seeing hospitals close as profits are siphoned off by private equity and other for-profit companies (see recent and ongoing Steward Hospital Crisis). Even as we face the worst pandemic in a century, our neglect of public health leaves us unprepared for the next one. We as a society, and our leaders, shake our heads, complain, and move on. Why don’t we consider this “rock bottom”? What more do we need?
As a society, we often think about health care when it directly affects us and our families. (Of course, it’s already too late to demand change, so we just deal with the flawed system as best we can and move on with our lives.) Those in power need to take responsibility for this situation, even if it affects them. You will be protected from the worst. Our legislators have great health insurance and have the power to guarantee it forever. Pharmaceutical companies, health insurance companies, commercial enterprises, and even large teaching hospital chains are happy to retain and expand their pieces of the ever-growing financial pie. State medical association leaders also benefit from big insurance companies. Without a plan, these powers can remain under control. Do we need to wait until the moneyed interests experience some kind of crisis and share the pain?
When will we decide once and for all that health care is not only a right, but must be prioritized over profits? For All creates a trust fund to plan for the future and streamline redemptions while saving money. Our members, especially the Speaker of the Massachusetts House of Representatives, have been working on this bill in committee for more than 25 years. We need to put pressure on our legislators to support the MFA bill. Change is scary and uncomfortable, but without change, the future of healthcare is bleak.
Dr. Christopher Frawley lives in Williamsburg.
