Posted on June 19, 2009

Testimony of Margaret Flowers, M.D., to the Senate HELP Committee


[The following testimony is the prepared text of the remarks given by Dr. Margaret Flowers at a hearing on “Health Care Reform” conducted by the Senate Health, Employment, Labor and Pensions Committee on June 11 in Washington.]

By Margaret Flowers, M.D.

Dear Chairman Kennedy and Senators,

Thank you for inviting me to speak to you today from the perspective of a physician and activist. I am a pediatrician with experience both as the director of a hospitalist program and chair of pediatrics at a rural hospital and in community-based private practice. I am currently co-chair of the Maryland chapter of Physicians for a National Health Program. PNHP has over 16,000 members nationwide. I also sit on the steering committee of the Leadership Conference for Guaranteed Health Care/National Single Payer Alliance which represents over 20 million people nationwide. I know that today I am speaking on behalf of the majority of people living in America who desire a national health program.

For several decades now we have seen the health care situation in this country deteriorate. Health care providers have struggled to provide care in this increasingly difficult environment and it has taken a toll. We are seeing doctors, like myself, leaving practice, doctors who are refusing to accept health insurance, and a new category of doctors, disruptive physicians. These disruptive physicians are expressing the dysfunction of a health care situation that places obstacles between them and the treatment of their patients.

The greatest obstacle is the private health insurance industry. This industry detracts from the health of our nation rather than adding value.

We have reached a unique point in American history and we have an opportunity for real health care reform. The economic downturn, the millions of Americans who can’t get needed care and the election of a President who understands that health care is a human right place us in the position to finish what President Franklin Delano Roosevelt hoped to accomplish almost 75 years ago in the Social Security Act: a national health system. The lack of a coordinated and comprehensive national health system sets us apart from the other industrialized nations and we see the results in markedly increased costs and poor health outcomes.

Current expectations are high. People are craving change. For decades, reliance on the market and efforts to patch together a system using a public and private mix have failed to guarantee quality health care to every person in America. The reliance on the market dates back to the 1960s when there was a strong belief that America was so different from the other nations that our uniquely American market would solve our health care problems. We were wrong then and it is disappointing to see us continue to cling to this idea. This is not the time for more tinkering, yet that is what we are seeing. This is the time to step back and look at the big picture.

The health care market has produced a situation in which private health insurers rake in obscene profits while millions of Americans suffer from a lack of needed care. We are ranked the worst of 19 industrialized nations in terms of preventable deaths, over 101,000 each year. We have the highest infant and maternal mortalities. Health care is rationed based upon ability to pay. Patients have to wait months to get in to see a doctor and many patients never even make it through the door. We are the country that provides little in terms of employment security and support compared to other nations, yet we tie health insurance to employment. As a result, when people become ill and cannot work or when people lose their jobs because of the economic downturn, they lose their health insurance. There are an estimated 14,000 people losing their jobs every day at present. This means that when our people are most vulnerable, they are the least protected. We are the only nation in which people hold bake sales in order to pay for lifesaving treatment. We are the only nation that allows millions of people to go into bankruptcy because of medical debt.

In 1809, 200 years ago, Thomas Jefferson said, “The care of human life and happiness, not their destruction, is the legitimate responsibility of good government.” It is time to end the destruction of human life in this nation. We have a moral imperative to create a health system that provides health care to all people. Senator Kennedy, I know that you and others who are seated here today understand this and hold this same belief.

The briefing paper put forth by this committee contains reform ideas that would improve health outcomes if they were part of a national system. However, the current reforms will not reach the goals of providing affordable high quality care for all people in America. These reforms will not be universal and will increase health care costs. I have outlined the reasons for this in my submitted testimony.

The plan being put forth at present may be considered to be politically feasible, although I question even that. It will not be practically feasible in that it will not address the fundamental problems in America today. In order to create a national health system that improves health, we need to have a full, open and honest discussion about it. I am thankful that we will start this discussion today. However, there is much to be considered and many people who can provide you with the data that you need in order to have a full deliberation about a national health program based on single payer financing. The LCGHC respectfully requests that your committee and the Senate Finance Committee hold a joint hearing on the merits of a national single-payer health system in order to accomplish this.

The market has been very successful in providing enormous income to the few who administer and invest in the health industry. The price we pay for this is the squandering of our economic, mental and physical health as a nation. The market has failed to improve health and control costs because it is the wrong model. Health care is not a commodity, it is a human right. The United States signed the Universal Declaration of Human Rights in 1948. The other industrialized nations who have followed this human rights approach spend less and have better outcomes.

We must ask ourselves, as we go through this process of reviewing health legislation today, what are the results that we want to see? Will we continue down this path that has failed us for decades? Will we continue to fear the power of the medical-industrial complex? Or will we grasp this opportunity for real change? Will we create a health system based upon these few principles: that everybody has access to the same standard of care, that there are no financial barriers to care or financial consequences as a result of getting needed care and that medical decisions are made by patients in consultation with their medical providers based upon what is best for the patient rather than what they can afford? Will we provide health security, as embodied in the American Health Security Act of 2009, S. 703, so that every person will wake up in the morning knowing that if they need health care, they can get it, plain and simple, because it is their right and not a privilege?