By Dr. Emilee Bargoma and Greg Akili —
There have been several attempts over the past 80 years to provide healthcare coverage in the US, because while it spends more on healthcare than any industrialized country, 44 million are under-insured and 30 million are uninsured. These populations cannot afford the high deductibles and out-of-pocket costs in their plans. The closest Americans have come to universal healthcare has been the Affordable Care Act. Unfortunately, it was not well received, is cumbersome, and has left the insurance industry in charge, which has resulted in the continued rise of healthcare costs.
With this as the backdrop to this country’s compounding healthcare inadequacies, many healthcare professionals fear a potentially crippling impending health crisis: The novel human coronavirus COVID-19. If it becomes epidemic, its widespread effects will exacerbate the existing vulnerabilities in resource-poor populations. These populations have disproportionately higher rates of diseases and illnesses, making them immune-compromised and particularly vulnerable to viruses, including COVID-19.
Further compounding this issue is that most of the at-risk populations live in dense apartment (or multi-family) dwellings, and predominantly use public transportation. Because they often live far from the nearest hospital, and cannot afford the medical expense, they are less likely to seek medical attention. This puts them at increased risk of transmission. Therefore, it is a matter of public health that insurance coverage covers everyone.
“Medicare for All” is the current health provision being proposed to cover all Americans. This proposed system is modeled after the currently existing provision of Medicare for seniors. Since it has been very effective for the Senior community, Medicare for All will be just as effective for all residents. This is not a reinvention of the wheel, rather it is the expansion of it. With a very low 3-4% administrative processing rate, Medicare is a lot more cost-effective and significantly cheaper than the 27-30% administrative rate currently being charged by the private-insurance-based systems that most people in the US are forced to rely on. Medicare for All will eliminate these “middle-men” insurance companies whose only function is to provide the paper process that pay healthcare providers.
Fast globalization has made the Coronavirus a real concern in the US. Questions are arising, such as, “Can I afford to go to the doctor?” and “Can I afford treatment?” These should not be the kinds of questions that people in the richest country in the world should be asking. People will more willingly seek immediate medical attention if they are assured that when they do, they will not be presented with a potentially ruinous medical bill. These regular (non-emergency) visits to the doctor or hospital will ultimately help reduce the current burden on the country’s health expenses.
The coronavirus scare is a cautionary tale on why our healthcare system cannot afford to leave anyone out. Unfortunately, even in the face of a pandemic health crisis, major efforts are being undertaken in the United States to ensure that people do not have healthcare. For example, the current administration has cut funding for the “Navigator” program — under which trained individuals or organizations help people sign up for insurance through Obamacare from $62.5m to $10m, together with a 90% reduction in funding for Obamacare advertising. This is because the United States insists on seeing healthcare as a privilege, and not a basic Human Right.
For 55 years Medicare has been successful for seniors 65 and older. Extending it to all ages only makes sense. Medicare for All will finally usher in the necessary universal access to healthcare this country needs, a necessity that is disproportionately missing for many communities, especially the Black community.
The Black population in America continues to suffer the highest rates of maternal mortality (3 times more than white counterparts); Inadequate access to care for Sickle Cell Anemia — which often results in expensive medical procedures that cost the State even more money; High rates of asthma (4-5 times more than white counterparts); Diabetes; Hypertension; Anemia; and Obesity. These are all diseases and health conditions that puts this group at a particularly higher risk of infection and transmission in the event of epidemic outbreaks. There is enough readily available data about Black health inequities to support a call for health justice.
The current world health crisis highlights how truly deficient the American healthcare system is. The lack of Medicare for All means that millions of Americans cannot afford a visit to the doctor if they become ill with COVID-19. Our system has led us to believe that only a few deserve medical attention. Unfortunately, it is with this frame of mind that the individuals most at risk will decide whether or not to seek medical attention. This is a grave disservice to our overall health, because we ALL have a shared risk when it comes to health coverage. Anyone who needs medical care should be able to seek it immediately. We cannot run the risk of having potentially infected persons go untested and untreated.
One only has to look at other industrialized countries that have universal coverage to see why they consistently outperform the United States on measures of healthcare access and outcomes, and affordability and overall costs. If unable to restrain it and COVID-19 becomes pandemic, its potential to become a viral epidemic in the United States is a real risk shared by us all. Because the virus is indiscriminate with whom it infects, rich or poor, insured or uninsured. Therefore, it presents a great public health crisis for everyone, one that requires we operate in the interest of the community and not the individual.
The most effective and efficient way to do this is with a health care system in place that protects and serves All in the U.S. Interestingly, it will be much easier to enact Medicare for All than the current effort to create a vaccine for COVID-19. Which, when available, will only be for some. Because of white supremacy, institutional racism, individual bigotry and mass denial, the most disenfranchised groups will remain marginalized. Most especially, the Black community. Therefore, Black vision and Black voices must be included at all levels to ensure that Black concerns and interests are a central part of any universal plan. Otherwise, Medicare for All will quickly become Medicare for Some.
Dr. Emilee Bargoma, member Black Lives Matters-LA and Greg Akili, Director of the Fannie Lou Hamer Institute, Board member Institute of the Black World 21st Century and Organizer with Black Lives Matters-LA.
