The slow and uncoordinated response to the coronavirus pandemic should make it clear that the top priority for our nation should be the development of a basic health care plan for all Americans. Our profit-driven, fragmented medical-delivery system is among the highest-cost systems in the world, with quality indicators below most developed nations. This pandemic has vividly exposed the consequences with widespread fear, a stock market crash and panic buying.
The only form of universal access and funding of medical care in America is through the most expensive point of entry — the emergency room. It is against federal law to turn anyone away. A 2019 study by UnitedHealth showed that the average ER visit cost was $2,032 for a condition that could be managed in a primary care doctor’s office for $167. With ever-increasing out-of-pocket costs, 50% of personal bankruptcies are now caused by medical indebtedness. Citizens and small businesses struggle to pay annually increasing health insurance costs.
Out of frustration with insurance hassles and increasing costs of running a practice, private physicians have sold out to large hospital corporations or venture capital investors. Patients have lost their valuable advocate in the medical maze of dysfunction — their private, independent physician.
A basic single-payer health plan would save our nation’s most important resource — its people — and our economy. This plan could return doctors to private practice, where they are most tightly aligned to the patient, not an employer. A plan where the patient chooses and employs his personal physician, not a big hospital system or the government. This plan should be administered by the Center for Medicare and Medicaid Services, which already pays 70% of America’s health care costs. If citizens want different or more coverage than the basic plan, they could pay for it. This taxpayer-funded universal access health plan would provide coverage without a copay for the following services:
• Any medical care related to a public health threat.
• Prenatal, delivery and postpartum care for 1 year.
• Well child care and vaccinations.
• Annual primary care visits for adults for preventive care and specialty care authorization.
• Three quarterly visits a year for a primary care and each specialty care provider of the chronically ill.
• Six sick visits per year to a primary care provider.
• 12 telehealth consultations with a primary care provider and six specialty telehealth consults/year.
• Unlimited telephone care by primary or specialty care.
• All A- or B-rated services recommended by the U.S. Preventive Services Task Force.
• Five years of family support, home health, therapy and nursing services for those aging in place.
• Three years of skilled nursing home care.
• Unlimited home/skilled care for those determined eligible by the Social Security administration.
• Medically necessary urgent or ER care (but triaged to primary care for nonemergent care).
• Physician-authorized medical equipment, home health and therapy.
• Physician-authorized hospital and hospice care.
We need a U.S. Public Health Threat Task Force — a nongovernmental body of experts to speak from consensus and guide health-care providers, institutions and policymakers with a coordinated action plan. In this pandemic vacuum, Congress authorized spending $2.2 trillion while physicians and hospitals are scrambling to find protective equipment made in China.
This health plan would remove the insurance hassle for frustrated patients and burned-out doctors, alleviate the burden of citizens and businesses paying runaway health insurance costs, restore trust in our government, renew our economy and show that caring for others is the highest American ideal. Let’s hope that we now understand that the health of every individual in our society is directly linked to our own.
Dr. Oscar Lovelace, who heads a rural family practice in Prosperity, chaired the governor’s 2003 Health Care Task Force and ran against Gov. Mark Sanford in the 2006 Republican primary. Sam Griswold, M.S., Ph.D., is retired from state government after serving in the Cabinets of two governors and is a former director of the departments of Social Services and Health and Human Services.