Medical Student Prescribes Remedy Our Sick System Needs

I am a fourth-year medical student. I've dreamed about being a physician since I was in sixth grade. For a long time, my deepest hopes were to get into college, be accepted by a medical school, and maintain the grades and test scores needed to keep me there. My clinical rotations have taken me to hospitals across Pennsylvania, from Pittsburgh's North Side to North Philadelphia, with stops in rural and suburban communities in between. I'm less than a year away from obtaining my medical degree.

Despite many hours of study and months in the hospital wards, I don't feel any closer to practicing the kind of medicine I've always dreamed about than when I watched my first episode of "ER."

That's because I now understand that I won't be able to care for patients as they—or I—would like.

"[A single-payer system] is not a government take-over; this is the people reclaiming control over their healthcare. This is the only way to keep everyone healthy and to do it efficiently."

How so? Although we have more ways than ever before to treat illness, our healthcare system is broken. The current system is set up to make profits for corporate shareholders, not to keep people healthy.

Right now, we are paying exorbitantly - the highest per capita expenditure in the world - for a healthcare system that leaves too many people out. According to the Congressional Budget Office, 28 million people will still be uninsured in 2026, even after the Affordable Care Act is fully implemented.

Further, the specter of under-insurance, where insured individuals' out-of-pocket medical costs are more than 10 percent of their income, is rising. Premiums, deductibles, and co-pays are increasing, deterring people from seeking needed care and exposing them to medical bankruptcy.

This very expensive system is also ineffective. I met a patient who first lost her energy, then her appetite, then her hair, and then her insurance in the middle of cancer treatment. She finally lost her oncologist because the latter did not accept Medicaid.

I've met parents who guiltily admit they can't afford their own medicine and use their children's inhalers when they can't breathe. I'm trained to ask if patients are taking their medicines and then to follow up: "Do you ever have trouble affording your medications?"

I've watched the extent of insurance coverage determine treatment decisions for patients injured in car accidents. Or whether a patient with mental health problems gets treated at all.

So today, I'm pouring my energy into a new dream: to practice medicine in a healthcare system where everyone gets covered for all medically necessary care. I want to help bring about a single-payer, national health insurance program.

This is not pie in the sky. Last month, the nonprofit Physicians for a National Health Program released "Beyond the Affordable Care Act: A Physicians' Proposal for Single-Payer Health Care Reform" in the American Journal of Public Health pages. The proposal is endorsed by more than 2,200 physicians in all specialties.

Under the proposal, everyone will be covered by a publicly financed, nonprofit national health program, or NHP, for both outpatient and inpatient care, as well as rehabilitation, mental health services, long-term care, dental care, and prescriptions.

And it's affordable. By replacing our redundant, complex private insurance bureaucracy with a single, nonprofit, streamlined program, we'll reap savings of roughly $500 billion a year. That's enough to improve and expand coverage to all—i.e., to eliminate the problems of uninsurance and underinsurance and eliminate all co-pays and deductibles—without any increase in total healthcare spending.

The new system will be able to rein in costs. Much like we fund fire departments, the NHP will pay global, lump-sum budgets to hospitals, clinics, and nursing homes rather than charging each aspirin tablet.

Physicians will be paid based on a fee-for-service schedule covering all patients or by salary. The NHP, as a single buyer, will negotiate prices with drug companies, just like other countries already do, reaping additional savings.

We can finance this program by combining all current sources of government health spending, which already accounts for 64.3 percent of the country's health bill, with modest new taxes based on ability to pay. According to one study, 95 percent of all households would save money.

This is not a government takeover; this is the people reclaiming control over their healthcare. This is the only way to keep everyone healthy and to do it efficiently.

This is the plan I want for my patients, family, and myself. Based on recent polls showing solid majority support for "Medicare for All," I'm not alone. We should implement this remedy without delay.