To the Editor:

How many people do you know who are old enough to be eligible for Medicare insurance but decline to enroll? Likely none. If there are any, they would have to be extremely rich to be able to afford to forego this great program. People simply do not decline to enroll when they become eligible at age 65, because Medicare is, and has been, the best deal available for health insurance coverage in the U.S. since its inception in 1965.  

Wouldn’t it be wonderful if at birth, every U.S. citizen could get a health insurance card, like a Medicare card, giving them access to any doctor or hospital in the country? It turns out this scenario is quite achievable. “The Expanded and Improved Medicare for All Act,” HR 676, was introduced in Congress in January and currently has 111 co-sponsors. It would guarantee high quality coverage for all medically necessary services for every single American. It would cover doctor visits, hospital care, prescriptions, mental health services, nursing home care, rehab, homecare, eye care and dental care. Instead of paying premiums, copays, and deductibles, we would pay a similar or smaller amount in taxes. (Just as we pay taxes so that every American can receive the basic public education that we as Americans believe to be a right and a necessity for a modern civic society.) 

The Medicare for All Americans plan is the only health care reform that will cover everyone and control costs. Under such a system, private health insurance companies could still offer supplemental plans, as they do currently for Medicare beneficiaries, but only for services not covered by the public plan, such as cosmetic surgery. Unlike Medicare, private health insurance companies operate to make a profit and they have huge overhead. Expanding a government plan like Medicare would save billions in administrative costs and profits, and thus drive overall costs down. A single payer system would also drive down prescription drug costs.  

To become more informed, go to the website for Physicians for a National Health Program, www.pnhp.org, an organization of physicians who have been advocating for this type of health care insurance for decades.  

Don’t let anyone tell you that single payer is “government run health care.” That would be like the Health Department or the Veterans Hospitals or the British Health Care system, all of which provide good care but in each of these systems the government directly pays the salaries of doctors and the costs of hospitals. Under single payer, doctors would not be employees of the government and we would all get a health care card that would allow us to go to any doctor or hospital in the U.S. 

Don’t let anyone tell you that you a single payer plan will take away your right to choose your own doctor. Currently private health insurances tell you which doctor you must go to, which are “in network” or “out of network.” Medicare for All Americans would not do this.  

Don’t let anyone tell you that a single payer plan would lead to “rationing like in Canada.” We already have “rationing.” Currently, it is private health care insurance that rations your care, telling you and your doctor what services they will and will not cover. And currently our health care services are rationed even more by income. If you can’t afford insurance, you don’t get care. No one dies or goes bankrupt from lack of access to health care insurance in Canada.  

Unfortunately, the House narrowly passed a very different kind of health care reform bill in May. According to the non-partisan Congressional Budget Office, this bill would increase the number of Americans without health insurance by 23 million within nine years. That would make 51 million Americans under age 65 who would not have health insurance if this law goes into effect, almost double the number who would not have insurance if the current Affordable Care Act would stay in place.  Fourteen million of those additional uninsured people would already be without insurance by next year.   

Republicans in the House are claiming that their bill, HR 1628, protects people with pre-existing health conditions, but the CBO’s report reveals that this is not true. Their bill allows states to waiver two current federal requirements: they could modify the “essential health benefits” that must be covered under approved health insurance policies, and they could set premiums based on a person’s health status if that person has not had continuous coverage. Therefore, the report concludes, “Premiums would vary significantly according to health status and the type of benefits provided, and less healthy people would face extremely high premiums … people who are less healthy, (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all — despite the additional funding that would be available under HR 1628 to help reduce premiums.” 

HR 1628 was opposed by conservative, moderate and liberal health care experts, including the American Medical Association, the American Academy of Pediatrics, the American Hospital Association, the American Nurses Association, The American Cancer Society, The American Diabetes Association, The American Lung Association, The American Heart Association, The March of Dimes, and the AARP.  

A majority of Americans now favor a single-payer system. Join us. If you would like to see Medicare for All put into place as our health care plan, please be in touch with your legislators. Call Rep. Mark Meadows, (202.225.6401 or 828.693.5660) to tell him the time has come for a single payer health insurance system. Tell him if you do not like HR 1628, and ask him to support instead HR 676, the “Medicare for All Americans” bill.   The Senate is currently working on its own plan behind closed doors. If you are a Republican and have voted for Senators Richard Burr and Thom Tillis in the past, but do not like the direction the Republicans are now taking health care insurance, please call Sen. Burr (202.224.3154) and Senator Tillis. (202.224.6342) and tell them so.  

Tell them you will not be able to continue to vote for them if they cut American’s access to health care insurance. Tell them that the time has come for a Medicare for All single payer health insurance system. At the very least, ask your senators to conduct open public hearings about their developing plan, and to get an analysis by the Congregational Budget before they vote on it.  

Thank you.

(Joyce Hooley, MD MPH FAAP, is a former Haywood County pediatrician now practicing in Mars Hill.)