Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why it is essential to prioritize universal coverage

Payman Sattar, MD
Policy
June 8, 2021
Share
Tweet
Share

A patient of mine (who was also a friend) reached out recently to say the cost of one of his essential medications had increased to a $300 monthly out-of-pocket expense.

As an independent musician, he did not get his health care through an employer. The COVID pandemic eliminated his gigs. His money reserves dwindled, and he stopped this essential medication — something he did not share with me. Not long after, I heard that he suffered a stroke and died.

No doctor should have to know the feeling of losing a patient — especially a friend — because they cannot afford routine, standard-of-care medications, the price of which is governed by the whims of an insurance company. It doesn’t have to be this way.

The goal of all-inclusive health care is again a possibility.

But it has been this close before. In 2013, just prior to the rollout of the Affordable Care Act (ACA), there were 42 million Americans uninsured. This dropped to a low of 27.4 million in 2016. Over the next four years, the prior administration chipped away at provisions of the ACA, and the uninsured rate increased to 31.5 million by 2020.

In a recently launched open enrollment period that lasts until August 15, President Joe Biden announced that to date 1 million Americans have already signed up for health care coverage.

This is part of Biden’s ambitious health care plan. In his recent speech to Congress, Biden said, “Let’s give Medicare the power to save hundreds of billions of dollars by negotiating lower drug prescription prices. And by the way, it won’t just — it won’t just help people on Medicare. It’ll lower prescription drug costs for everyone. And the money we save, which is billions of dollars, can go to strengthening the Affordable Care Act and expand Medicare benefits without costing taxpayers an additional penny. It is within our power to do it.”

Yes, the ACA wasn’t perfect. It raised costs for some more so than others, and overall costs increased over time. It didn’t insure everyone. Now, whichever health care plan we adopt — Medicare for All (which has recently been proposed to Congress), Biden’s beefed-up ACA or one of the myriad other proposals — complete inclusion should be a priority.

Critics claim this would be too expensive. But they don’t see the many hidden costs that can be avoided with all-inclusive health care coverage.

The fact is that there is already a form of universal coverage, but it is the most expensive and least effective way to deliver care: sporadically through emergency rooms, where care costs, on average, 12 times more than it does in a physician’s office.

This accounts for an excess cost of $32 billion annually. This is because of a law passed during the Ronald Reagan administration that requires emergency departments of hospitals that accept Medicare payments to provide care for anyone seeking treatment regardless of ability to pay.

While well-intentioned, it had the unintended consequence of driving uninsured patients to the emergency department for routine and non-emergent care.

Our refusal to cover everyone is, paradoxically, one of the reasons that America’s health care costs 30 percent more than the next highest-spending country. It is about twice as much as the average amount spent by countries that provide universal coverage.

ADVERTISEMENT

There are some costs that are harder to quantify. About two-thirds of all bankruptcies were tied to medical issues. This affects roughly 530,000 families each year.

About one-third of all crowdsourcing donations go to funding health care, a uniquely American phenomenon. This highlights how our current health care system is failing and is in need of repair.

A recent study by the Lancet found that a “Medicare for all” model would save approximately 68,000 lives and $631 billion per year. This plan is the most studied, but it may not be the best; other proposals should also be scrutinized.

Looking to other countries that provide universal coverage to see what works and what would fit well for the U.S. is an option. Countries like France, Australia, and England provide universal coverage and rank their health care systems very highly, and are culturally and socioeconomically similar to the U.S.

Whatever health care direction the country moves toward, it is essential to prioritize universal coverage. Otherwise, Americans will eventually end up paying for inefficient, expensive services in the form of higher premiums and taxes, while millions of Americans will remain uninsured, without access to health care or life-saving medications. Many, like my friend and patient, will die.

That is too high a cost to pay.

Payman Sattar is a cardiologist.

Image credit: Shutterstock.com

Prev

How AI technologies improve the patient experience

June 7, 2021 Kevin 2
…
Next

We already know how to save physicians from burnout

June 8, 2021 Kevin 0
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
How AI technologies improve the patient experience
Next Post >
We already know how to save physicians from burnout

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

Related Posts

  • Exploring 2 roads to universal health coverage

    Cody Mullens
  • A path to universal health coverage in America

    Cedric Dark, MD, MPH
  • Don’t call it universal without including abortion coverage

    Vidya Visvabharathy
  • Why the health care industry must prioritize health equity

    George T. Mathew, MD, MBA
  • Having health coverage isn’t the same as being covered

    Peter Ubel, MD
  • 4 significant misconceptions about universal health care systems

    Niran S. Al-Agba, MD

More in Policy

  • The silent toll of ICE raids on U.S. patient care

    Carlin Lockwood
  • What Adam Smith would say about America’s for-profit health care

    M. Bennet Broner, PhD
  • The lab behind the lens: Equity begins with diagnosis

    Michael Misialek, MD
  • Conflicts of interest are eroding trust in U.S. health agencies

    Martha Rosenberg
  • When America sneezes, the world catches a cold: Trump’s freeze on HIV/AIDS funding

    Koketso Masenya
  • A surgeon’s late-night crisis reveals the cost confusion in health care

    Christine Ward, MD
  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • How conflicts of interest are eroding trust in U.S. health agencies [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why young doctors in South Korea feel broken before they even begin

      Anonymous | Education
    • Measles is back: Why vaccination is more vital than ever

      American College of Physicians | Conditions
    • When errors of nature are treated as medical negligence

      Howard Smith, MD | Physician
    • Physician job change: Navigating your 457 plan and avoiding tax traps [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden chains holding doctors back

      Neil Baum, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • How conflicts of interest are eroding trust in U.S. health agencies [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why young doctors in South Korea feel broken before they even begin

      Anonymous | Education
    • Measles is back: Why vaccination is more vital than ever

      American College of Physicians | Conditions
    • When errors of nature are treated as medical negligence

      Howard Smith, MD | Physician
    • Physician job change: Navigating your 457 plan and avoiding tax traps [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden chains holding doctors back

      Neil Baum, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Why it is essential to prioritize universal coverage
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...