In September, I presented a resolution to the 2021 Maine Medical Association’s General Assembly, urging support for “the establishment of an equitable, sustainable, comprehensive, affordable, high-quality, publicly-funded universal health care system at the national level, as well as for comparable legislation at the state level.” My decision to present this resolution was prompted by the annual meeting’s theme: “Equality, Equity, and Our Evolving Health Care System”. The attendees voted to table the resolution, giving the MMA a chance to survey members about their attitudes toward publicly-funded universal health care at the national and state levels.

Our current healthcare system is rife with inequities of access, cost, coverage and outcomes. About 20 million Americans lack health insurance. Many millions more are underinsured. People who are uninsured and underinsured experience the worst healthcare inequity, with reduced access to lifesaving healthcare due to unaffordability.

Insurance coverage disparities

There are dozens of different healthcare coverage plans in Maine, with inequitable premiums, co-pays and deductibles. These plans provide disparate levels of coverage, variable reimbursements, different provider panels, different formularies, etc. A public plan would make everyone’s benefits the same, and eliminate provider panels, etc.

COVID coverage inequities

In 2020, as the pandemic took hold, U.S. health insurance companies declared they would cover 100 percent of the costs for COVID treatment, waiving co-pays and deductibles for hospital stays that frequently range into the hundreds of thousands of dollars. But this year, most insurers (over 80% of them, all but Maine Community Health Options in Maine) have reinstated co-pays and deductibles for COVID patients. “Now the financial burden of COVID is falling unevenly on patients across the country, varying widely by health-care plan and geography.”  A public plan would eliminate most cost sharing.

The Commonwealth Fund: the US healthcare system ranks LAST on equity

In August, the Commonwealth Fund issued its updated report comparing healthcare in the US to 10 other high income countries. The US healthcare system ranks LAST in health care affordability and health equity, and also has the highest rate of infant mortality and mortality amenable to health care. (Although Maine’s infant mortality rate is slightly lower than the US average, Maine also compares poorly to the other 10 countries.)

Racial inequity

The Kaiser Family Foundation reports that non-elderly Blacks and Hispanics continue to fare worse than Whites across most examined indicators of coverage and access. Blacks are significantly more likely than whites to be uninsured. Early death among black men is a uniquely American problem. Pregnancy is particularly dangerous for black women in America.

 

 

 

 

 

Rural inequity

People in our rural communities lose 3 years of life compared to Americans in urban communities. They pay more for health insurance, are more likely to be uninsured, and are more likely to suffer and die from treatable illness. A public plan would ensure that people of all demographics had good coverage, and that rural hospitals would be supported.

Medicare means healthier Americans

A universal healthcare system would improve outcomes. As one example, let’s take a look at Medicare. Medicare is a popular, sustainable publicly-financed system whose mission is to facilitate access to medical care for its beneficiaries. Above age 65, when nearly everyone is covered by Medicare, the US ranking in mortality rates improves from worst to among the best when compared to other countries.

I encourage all MMA members to become more informed about universal healthcare and to learn more about how universal healthcare would reduce healthcare inequities. For more information about universal healthcare, please visit the websites of Maine AllCare www.maineallcare.org and PNHP www.pnhp.org.

Julie Keller Pease MD

Editors note: Dr. Pease is a founding member of the Maine AllCare Board, and a member of the One Payer States Board of Directors. This article was published in the quarterly newsletter of the Maine Medical Association. View the original article HERE.  View the proposed Maine Medical Association resolution here: MMA Resolution to Support Health Equity