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Expert OpinionExpert Opinion

Deppe, Silverman & Catapano-Friedman: All-payer plan is risky and counterproductive, October 24, 2016

Editor’s note: This commentary is by Susan Leigh Deppe, MD, of Colchester, Alice Hershey Silverman, MD, of Montpelier, and Lisa Catapano-Friedman, MD, of Bennington, who are psychiatrists with many years’ experience in private practice and other settings in Vermont.

Resilience and leadership for the challenges ahead

By George McNeil, MD
The Pharos, Spring 2016

In the Autumn issue of The Pharos (pp. 2–4), Darrell G. Kirch, MD, writes movingly about physician burnout, depression, and suicide. In the same issue (pp. 66–7), Paul D. Miller, MD, laments the rise in authority of insurance companies and hospital administrators whom he sees as muscling doctors and patients aside in making medical decisions.

Medicare for all is what U.S. needs

By Jack Bernard
The Citizen (Fayetteville, Ga.), Feb. 16, 2016

I enjoyed reading Dr. Scherz’s (opinion column, 1-10-16), which was well written. As a retired senior level healthcare exec and former GOP elected official, I understand his frustration with the downside of Obamacare (the ACA). I hear much the same from my two sons, who are practicing physicians.

How High Is America’s Health Care Cost Burden? Findings from the Commonwealth Fund Health Care Affordability Tracking Survey

July–August 2015, The Commonwealth Fund

One-quarter of privately insured working-age adults have high health care cost burdens relative to their incomes in 2015, according to the Commonwealth Fund Health Care Affordability Index, a comprehensive measure of consumer health care costs. This figure, which is based on a nationally representative sample of people with private insurance who are mainly covered by employer plans, is statistically unchanged from 2014.

"America's Bitter Pill" Makes Case For Why Health Care Law "Won't Work"

January 5, 2015

Editor's note: A 36-minute interview of author Stephen Brill by NPR Fresh Air host Terry Gross on January 5, 2015. Brill makes an eloquent, first person case for universal care – he had $190,000 bill for surgery and paid $12,000 out of pocket; his insurance paid the rest, but the story does not end there.

Single payer: a powerful tool for better care, better health and reduced costs

By Donald M. Berwick, M.D
November 15, 2014

An unofficial transcript of the remarks delivered by Dr. Donald Berwick to the Annual Meeting of Physicians for a National Health Program on Nov. 15, 2014, in New Orleans. Dr. Berwick spoke to the assembly via live video.

10 things your health insurance won’t tell you

By Elizabeth O'Brien
MarketWatch, October 11, 2014

This practical and concern-making list of potential financial surprises thrust upon patients by health insurance companies highlights the continued, across-the-board rise of health care costs. It makes a powerful case, indirectly, for real health care reform: a universal, single-payer publicly funded system, such as Medicare for All.

Time to end co-pays

By David Cay Johnston
September 8, 2014

They are one of many reasons US health care has the world’s highest overhead costs

High Inequality Results in More US Deaths than Tobacco, Car Crashes and Guns Combined

By Joshua Holland
Moyers & Company, April 19, 2014

In 2009, the British Medical Journal (BMJ) published a study that revealed what seems to be a shocking truth: those who live in societies with a higher level of income inequality are at a greater risk for premature death.

Universal coverage remains a big deal | Medicare for All: An Economist's Case

By Philip Verhoef, MD, PhD and Stephen Kemble, MD, March 16, 2014

Recently JAMA published a special theme issue on critical issues in U.S. health care. Among the contributors was Dr. Ezekiel Emanuel, the oncologist, bioethicist and former White House adviser on health policy.

Solving Domestic Problems

By Laurence Seidman
Challenge/January-February 2013

This article makes an economist's case for extending Medicare to cover all Americans. First, Medicare for All would achieve universal coverage and portability. Second, Medicare for All would eliminate health insurance distraction for business managers, entrepreneurs, and job seekers, thereby improving the productivity of the U.S. economy. Third, Medicare for All would use an internationally proven method to reduce the huge gap between medical-care costs in the United States and those in other economically advanced countries: payer bargaining power. Fourth, Medicare for All is easy to explain and may therefore prove politically feasible.

The Myth of Health Care's Free Market

By David Cay Johnston

Ever wonder why an appendectomy costs $8,000 in one place and $29,000 elsewhere? Has it ever occurred to you to negotiate with the pilot of the plane you just boarded about her pay?

Even reformers don’t like Obamacare: a conversation with Dr. Quentin Young

By Phil Kadner

The Republicans are right. The Affordable Care Act, aka Obamacare, is a mess.

The Democrats are right. The nation desperately needed health care reform, and millions of Americans had no insurance.

I Am A Republican… Can We Talk About A Single Payer System?

By David May

I am a Republican. For those who know me that is not a surprise. I live in a red state. I have never voted for a Democratic presidential candidate. I can field strip, clean and reassemble a Remington 12-gauge pump blindfolded. And on top of it, I think we should talk about having a single payer national health care plan. The reason is quite simple. In my view, we already have one; we just don’t take advantage of it.

How Doctors Die

By Ken Murray, MD

Many of us who advocate for universal health care are also aware that the last years of life tend to be costly. Why is that? Does it have to be that way? In the following article Dr. Ken Murray, a Clinical Assistant Professor of Family Medicine at USC, explores the issues and the alternatives to what he describes as "futile care" from a very personal perspective.

MECEP: Failure to Override Health Care Funding Veto "Economic Folly and Human Tragedy"

Augusta, Maine (Wednesday, June 19, 2013) Garrett Martin, executive director of the Maine Center for Economic Policy (MECEP), issued the following statement today on the initial vote in the Maine House to override Governor Paul LePage's veto of LD 1066, An Act to Increase Access to Health Coverage and Qualify Maine for Federal Funding.

Universal Health Care: Can We Afford Anything Less?

By Gerald Friedman

America’s broken health-care system suffers from what appear to be two separate problems. From the right, a chorus warns of the dangers of rising costs; those on the left focus on the growing number of people going without health care because they lack adequate insurance.

A Conservative Case for the Welfare State

By Bruce Bartlett

At the root of much of the dispute between Democrats and Republicans over the so-called fiscal cliff is a deep disagreement over the welfare state. Republicans continue to fight a long-running war against Social Security, Medicare, Medicaid and many other social-welfare programs that most Americans support overwhelmingly and oppose cutting.

Social Responsibility of Physicians

By Bernard Lown, MD

Reflecting back on early days, the first overtreatment I encountered was not related to technology. It involved keeping patients with acute MI’s at strict bed rest for 4 to 6 weeks. This was a form of medieval torture. It promoted depression, bed sores, intractable constipation, phlebitis, lethal pulmonary embolism and much else. Worse it augmented cardiac ischemia and predisposed to malignant arrhythmias.

A Conservative Call For Universal Access To Health Care

By Donald W. Light

Synopsis: Conservatives in every other industrialized country support universal access to needed medical services. An emphasis on individual freedom and responsibility strongly supports this position, and only in the United States do conservatives believe this is not the case.

Editor’s note: The American Health Care Act, the Republican replacement for the ACA, commonly referred to as Obamacare, has been scored by CBO the Congressional Budget Office as nothing short of catastrophic. If passed by Congress, 14 million Americans would lose their health insurance coverage in 2018. And 24 million would lose coverage by 2024.

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

By Dr. Timothy Burns
Special to the Bangor Daily News, March 22, 2017

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.