We just played a headline earlier of Joe Biden
talking about why Medicare for All would not
have been a solution to the current problem.
If there was a single-payer system with some
rationale or planning to a process of responding
to an epidemic like this, would the situation
have been easier to deal with?
Absolutely, there’s no doubt.
And I just want to explain a couple reasons
why.
Number one, the idea that 10% of your population
doesn’t have healthcare at all, or another
50% on top of that have a deductible that’s
so high that they’ve learned to ignore symptoms
like a fever and a dry cough — which, by
the way, are the symptoms of COVID-19 — because
they know that if they do go and seek medical
care for those symptoms, that they’ll be
hit with a bill on the back end, that’s
a really dangerous state of affairs when you’ve
got an incoming global pandemic.
But even beyond that, I just want you to think
about the structure of our health system.
Hospitals make money in this system on elective
surgeries.
That’s how they get reimbursed from insurance
companies.
But if you’ve got a global endemic that’s
about to hit your hospital,
what’s the first thing you cancel?
Elective surgeries.
And so, now you’ve got hospitals that not
only are trying to staff up and be ready for
one of the most serious public health crises
of our time, but they’re also battling bankruptcy
on the back end because they’ve lost their
main source of pay.
All of that is because the system is run for
profit.
Here’s the other part.
We keep hearing about doctors going without
PPE, personal protective equipment.
And part of the reason why is because they’ve
talked to business consultants who told them
that the best way to supply your hospital
is what we call “just-in-time” supplying,
meaning you don’t want to have a bunch of
stuff laying around,
because you don’t know when you’re going to use it.
That’s all overhead you can strip away.
But here’s the problem.
Well, when you’re hit with a pandemic, just
in time doesn’t work, because all of a sudden
everybody is trying to get the resources that
they need.
Just in time is a classic page out of a business
consulting manual.
When you run hospitals like a business,
you forget the fact that they’re actually supposed to be there to save lives.
And the third point is this.
There is no incentive for prevention in our
system.
Why?
Because our system makes money on people getting
sick, right?
You can’t actually bill something if somebody
does not get sick,
so that you can bill them for the care.
And so, if you look at just the way the system
is set up, there’s very little incentive
to talk about prevention.
And that’s why we keep seeing budgets get
cut for institutions like the CDC or local
health departments or state health departments,
because it just doesn’t fit within
the incentive structure of our health system.
Imagine we had a system that actually rewarded
keeping people healthy rather than taking
care of them after they get sick.
That’s what Medicare for All would have
done.
We have a responsibility to learn from this
moment and realize that we’ve got to guarantee
everybody in this country healthcare.
And if we don’t, we will continue to be
vulnerable
to these kinds of massive public health crises.
