Maine campus hears support for single-payer health care

By Dina Mendros, Staff Writer
Biddeford (Maine) Journal Tribune, May 11, 2012

BIDDEFORD, Maine — The Affordable Care Act passed Congress in 2010. Now the country is awaiting a decision from the U.S. Supreme Court to see if part or all of the act will be struck down. And even if moves forward unscathed, some say the so-called Obamacare doesn't go far enough.

"The United States is abnormal in not having a health care system that's about health," said Dr. Margaret Flowers, who works with the national organization Physicians for a National Health Program. Instead, she said in her address to medical students and others at the University of New England Biddeford campus Thursday, health care in this country "is about profit."

To change the focus from profit to making people healthier, Physicians for a National Health Program, known as PNHP, supports a universal, single-payer health care system.

Prior to working for PNHP to reform health care in the U.S., Flowers practiced medicine in a hospital setting and in private practice. She said she joined the organization because she became frustrated with insurance companies dictating how she should treat her patients.

Historically, she said, many industrialized countries began instituting universal health care after World War II, as part of social and economic reform. However, the U.S. took a different route. Private companies began offering health insurance to entice workers.

Now the U.S. has the most expensive medical system, but has poorer outcomes than many other industrialized nations, said Flower. Also, the country pays the most per person for health care, approximately $8,000 - more than twice the amount of some industrialized countries with universal health care.

Yet, the U.S. has the highest preventable death rate in the industrialized world, she said.

In addition, said Flowers, currently, there are about 50 million Americans who are uninsured, plus many who are underinsured. Under the Affordable Care Act, about half the uninsured will remain uninsured, and the underinsured rate will rise, she said.

As proposed by the PNHP, with universal, single-payer health care, everyone would be covered throughout their lifetime, for all medically necessary care.

The system would be funded through taxes.

That's not much different than today, said Flowers. Already public money pays for about 60 percent of the costs associated with the U.S. health care system, through federal and state taxes, property taxes and tax subsidies.

The remaining 40 percent of costs are equally divided between employers and employees, she said.

A universal, single-payer health care system would cost less than the current system, said Flowers.

Part of the reduction of costs would result because this simpler system would spend much less than the 30 percent of U.S. health spending that now goes to cover administrative costs, she said.

While some view this pro-posed system as socialized medicine, it's different, according to the PNHP website. Doctors won't work for and draw salaries from the government. They'll be in private practice and paid on a fee-for-service basis.

"I'm totally for what you're proposing," said Patty Morris from Cape Elizabeth, in attendance at Flowers' speech Thursday.

However, being a mother of a daughter with cystic fibrosis, she asked how would such a system affect the outcome of those with her daughter's condition. She said she feared out-comes for those with chronic diseases might be worse and research for drugs and treatments for small groups might disappear.

There was no reason to think those with chronic diseases would have worse outcomes under universal health care, said Flowers. There would be increased access to care for those with such conditions who cannot currently pay for treatment.

Also, she said, public funds for medical research would continue.

First-year medical student Robert Zonderuan asked Flowers about comments she made regarding primary care physicians. There aren't enough, said Flowers, in part because when students are faced with debt from medical school, averaging more than $100,000 for graduates, they turn to specialties where they can earn more money to pay for their schooling.

Under the system she pro-poses, there wouldn't be such a large earning gap between doctors in private practice and those who specialize in a particular field. Thus there would be fewer incentives to specialize, she said.

Before concluding her talk, Flowers put out a call to action to students and others in the audience to help with the fight to create a universal, single-payer health care system in the U.S.