What’s the Future of Our Health Care?

PAST THE SPRING FLOWERS in Stuyvesant Square is the temporary shelter where emergency patients are initially evaluated at Beth Israel. Photo by Penny Mintz.

By Penny Mintz

In this country people are responsible for the cost of their health care. Generally, if you have a catastrophic medical condition you get the treatment you need first and worry about paying for it later. Unfortunately, private health insurance is extremely expensive. In addition, with the exception of Medicare, health plans are infamous for denying payment. Consequently, in this great nation of ours, medical costs are the number one cause of bankruptcy.

Right now, the hospitals in New York City are in the same position as a person with a catastrophic medical condition. The NYC Department of Health reported that as of midday, April 19th, nearly 35,000 people in New York City had been hospitalized with COVID-19. The city had only 20,000 hospital beds before the pandemic struck, reduced from 40,000 over the last two decades. We all know how the lack of beds, staff, and equipment has impacted the hospitals and the health of people with medical problems other than the coronavirus.

So far, no one with the virus is being turned away for lack of insurance. They cannot be turned away because, unlike those with diabetes or bum knees, untreated COVID-19 patients infect the rest of us.

So far, the hospitals have incurred enormous costs. Right now, Governor Cuomo has effectively merged all of the hospitals in the state so that resources can go where they are needed and hospitals are not pitted against each other in competing for equipment and staff. The provision of care has effectively been socialized.

But who will eventually pay? Will hospitals and doctors go under when large numbers of uninsured patients are bankrupt? Will our medical system collapse? Or will tax money be raised to permit hospitals and doctors to stay in business and allow patients to physically recover without being economically devastated?

No doubt, Medicare will eventually pay for the elderly patients insured under that system. And a percentage of the bills of some of the other patients will be paid by private insurers. But in our system, private insurance is most commonly a job benefit provided by employers. At the moment, the unemployment rate is approximately 20 percent, the highest it has been since the depths of the Great Depression. The unemployed have no medical insurance, and uninsured people cannot afford to pay medical costs even if they are employed.

Medical costs would be much lower if the system were not based on private insurance plans. In 2019, we spent $3.5 trillion on medical care. More than $1 trillion of that money was reserved for the profits of the seven largest insurance companies. Another $812 billion was spent on the administrative costs of filling out insurance forms. So, a staggering 50 percent of the total $3.5 billion that you and I, in the United States, paid for medical care in 2019 did not provide actual care.

If we had Medicare For All, the cost of care would have to be paid for with tax dollars. But the savings of money previously coming out of our pockets—premiums, copays, deductibles, administrative costs, and the reduction of wages paid to cover our employers’ insurance costs—would be staggering.

The medical costs of the COVID-19 pandemic will most certainly be incurred by city, state, and federal governments—as they should be. We pool our resources to accomplish these kinds of goals. That’s the benefit that government provides. Where will that money come from? We absolutely have to roll back federal tax cuts enacted by Bush and Trump, and the state cuts enacted by Cuomo. These tax cuts have only benefited people of extreme wealth. It is in everyone’s interest to reverse them. If our healthcare system goes belly up, there won’t be any hospitals to train the doctors that even the very richest people inevitably need. They will have to go to Australia, Canada, Finland, France, Germany, Hungary, Iceland, Ireland, Israel, the Netherlands, New Zealand, Norway, Portugal, the Slovak Republic, Slovenia, Sweden, Switzerland, or the United Kingdom—all countries with successful socialized medicine systems.

Don’t even get me started on how even the richest will suffer in an austerity budget. There will be no money to educate their workforces, or to maintain roads and airports for their transportation needs, or to pay police to protect their property and personal security, or . . . .

I could go on, but I’m having heart palpitations. I have to stop.

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