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The only way to end inequality in American health care is universal coverage

Posted March 22, 2017, at 11:22 a.m.

I know numbers. I am a radiation oncology physicist, so I use math and science to help physicians and the rest of our team treat cancer patients with X-rays. I’m used to large numbers and complex systems, but hearing the nonpartisan Congressional Budget Office’s estimates about the Republican replacement for the Affordable Care Act left me numb.

There are a lot of numbers we can discuss in respect to this bill: $880 billion, the cut to Medicaid; $600 billion, the tax cut; 43 percent, the percent of births in Maine to mothers on Medicaid; $7,260, the estimated increase in out-of-pocket costs to a 60-year-old making $20,000 per year in Penobscot County.

As bad as those numbers are, the more important number is 24 million, which is really all you need to know about House Speaker Paul Ryan and President Donald Trump’s health care plan. That’s how many Americans the Congressional Budget Office predicts will lose their insurance by 2026 if this plan becomes law. That is a big number. If you remember it, great, but you can leave those numbers to the policy experts for a minute. There is a much smaller number I want to talk about: one.

We are privileged to live in America. Our industries, ingenuity and ideals serve as inspiration to the world. While we excel on so many levels, we fall woefully short when it comes to health care. The American medical community should be the envy of our peers, but there is one glaring hole. If we get sick, we expect the exams, blood tests, diagnostic imaging, genetic testing, consultations, surgery, chemotherapy, long-term care or whatever medical intervention is called for, but we can get it only if we have the right insurance or the means to pay.

In America, arbitrary personal factors often determine if you can get health care at a cost you can afford. You may be eligible for Medicare, VA coverage or Medicaid. Your employer may offer you coverage. This system leaves massive gaps, and that is what puts us in a category of one globally. One neighbor can feel a dreaded lump and get the best care money can buy. Another could feel the same lump and know she can’t afford to pay the doctor’s bill and the grocery bill. She puts off the doctor so her kids can eat. The lump grows, and the cancer spreads. Instead of seeing her children graduate, get married and have kids of their own as her neighbor does, without insurance she dies needlessly and much too young.

This, some would argue, is the American dream. Both neighbors have access to the same insurance and care. They had the freedom to choose their care. That’s personal liberty, they say.

This is nothing new. As Dr. Martin Luther King Jr. said, “Of all the forms of inequality, injustice in health is the most shocking and inhumane.”

The evidence is overwhelming and clear: People are more likely to die prematurely when they lack insurance, and the Republican plan will drastically decrease the number of people with insurance. We need our political leaders to know it’s not acceptable in the richest country on Earth to pass laws that could result in thousands of preventable deaths each year. No law is perfect, especially in health care. But the American Health Care Act is not even a good faith effort to insure more people. So, let’s revisit our lonely number, one.

We can improve our health care system by allowing everyone to enroll in a plan with a single payer. Another bill, HR 676, is before Congress that would expand Medicare to provide health coverage for all Americans. If you are that one who loses insurance or are priced out of the market before you feel the lump, your lawmakers have failed you. What tax cuts are worth that?

One is easier to remember than 24 million. Take it from a physicist.

Timothy Burns is the chief radiation physicist at the Lafayette Family Cancer Center in Brewer, where he ensures patients get safe and effective radiation treatments. He is also active in the newly formed Bangor chapter of Maine AllCare.

 

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