Guest column: The solution to healthcare is at hand

Bryan Whiting’s prescription for our failed healthcare system in the Jan. 9 Post Independent merely repeats the simplistic conservative credo that most problems could be solved if more folks would simply exercise a bit more personal responsibility. If only our poor had bootstraps with which to pull themselves up.

He first sets out to discredit the Affordable Care Act, or ACA, which in fact did many great things that benefit even conservatives, like eliminating pre-existing conditions. It’s unfortunate that fierce resistance by Republicans and the insurance and pharmaceutical industries precluded a public option that would have likely resulted in much lower premiums for everyone. The chief architect of the ACA, Senate Finance Committee Chair Max Baucus, declared that a universal plan like Medicare for All was off the table, but after he retired from the Senate he changed his opinion, saying that “we’ve got to start looking at single-payer.” If he can see this obvious light, the rest of us should be able to.

Mr. Whiting proceeds to further disparage the ACA, painting it with the tired old “socialist” brush — meaning a social good, like fire departments, public roads, libraries, schools, et al — before making popular erroneous statements about the Canadian system. He claims that nearly 2 million foreigners came to the U.S. for medical care — I’m not sure when this happened — but doesn’t include that each year about 10 times that many U.S. citizens seek more affordable and often better healthcare in other countries, even risking their lives to save a few bucks in places like Mexico. Some insurance plans even pay U.S. surgeons to accompany patients to other countries to save money by doing their operations there.

Canada has longer life expectancy and lower infant mortality than we do, while spending about half as much. But everyone gets care. Conservatives always talk about choice. Which choice would you prefer – waiting a bit longer to see a doctor or living longer while saving money? 

He repeats the erroneous claim that in the U.S. “the industry” is required to provide health care to everyone regardless of insurance, ability to pay, citizenship or residency. That’s simply wrong, as many sadly discover when they are turned away at ERs, urgent care clinics, and physician offices.

Then he embarks on a math overload to justify his Three-Part Shared System centered on Health Savings Accounts, or HSAs, which conservatives have been pushing for years. This and other ineffective ideas like price transparency are aimed at putting the burden on individuals to lower their healthcare costs while taking big gambles that they won’t get hit by a truck or come down with cancer. 

There are many things wrong with this approach, the principal one being that most people would likely choose the cheapest deductible option or choose to go without coverage. A single illness or accident would likely throw them into bankruptcy. The second is that too many millions of us simply can’t afford even the lowest payment. Whiting says that “Everyone is covered,” but that coverage would be a very threadbare blanket.

Unlike most conservatives and libertarians, Whiting accepts that a mandate is necessary for such a plan to be effective. A similar mandate for the ACA would have made it even more successful, but Republicans quashed it.

He writes that “It’s our personal responsibility to develop an efficient health care system and insist our legislators support it in a bipartisan fashion.” That efficient health care system has been designed, by Harvard healthcare policy experts, and implemented in Taiwan in 1995, putting Taiwan at the top of most rankings of national healthcare systems. If U.S. experts can design the world’s best healthcare system, we can clearly enjoy its benefits here, with comprehensive universal coverage, better outcomes, trillions in savings, and permanent peace of mind. There needn’t even be long waiting times, which seem somewhat unique to Canada, which is still ranked among the Top Ten national systems. Employers, unions, and families will no longer need to worry about healthcare. We can direct our personal responsibility to things that we can actually control.

Dr. George Bohmfalk is a retired neurosurgeon and member of Physicians for a National Health Program, pnhp.org.