Senator Kirk's recovery makes the case for single payer

By Philip Verhoef, M.D.
The State Register Journal (Springfield, Ill.), Jan. 17, 2013

U.S. Sen. Mark Kirk’s recovery from a devastating stroke is a testament to his strength and to many months of excellent rehabilitation care. As a concerned physician, I am heartened by his recent statement that he will be “much more focused on Medicaid and what (his) fellow citizens face,” noting that Medicaid patients only qualify for 11 rehab visits after a stroke.

However, his experience highlights some of the flaws in our current fragmented health care system, many of which are exacerbated by Obamacare.

While Kirk is covered by one of the high-level private insurance plans offered to federal employees, many Illinoisans are covered by less comprehensive health plans and do not have access to the type of care that our elected officials enjoy. By extension, there are a number of stroke patients who will not be able to return to the workforce the same way that Kirk will.

Obamacare props up our fragmented system by requiring insurers to offer support to working Illinoisans, with the most affordable plans covering only 60 percent of costs and containing high deductibles, and the most comprehensive plans being unaffordable. Thus, the costs of health care continue to fall on the people who can least bear it, as they choose the only affordable (sub-standard) insurance available.

Even though Kirk still incurred “major” out-of-pocket expenses, his story is still a happy one compared to those told by the poor — including the poor who have coverage.

More than a third of Illinois physicians refuse to see a single Medicaid patient, and those that do often limit the number of Medicaid patients seen. An important component of Obamacare is to actually expand Medicaid eligibility.

Kirk has already pointed out how inadequate the coverage is, coupled with the limited number of providers that accept Medicaid. Thus, the poor will have a vastly inferior insurance program, and they too will be forced to pay out-of-pocket for what should be the standard of care.

Finally, witness how the state of Illinois has cut Medicaid in the last year. Patients (including children) will only be allowed drug coverage for four of their prescriptions. In addition, Medicaid prescription benefits for senior citizens and the disabled have been eliminated. Medicaid will no longer cover most dental services, although it covers the cost of pulling rotted teeth. This is the flawed system that Kirk and Obamacare want to focus on? Medicaid is constantly underfunded, woefully inadequate, and accepted by far too few healthcare providers to meet the needs of Illinois citizens.

Why not create an expanded and improved Medicare system and extend it to everyone? Kirk could advocate for this system to provide coverage for stroke rehabilitation, primary care, mental health care (especially in light of the recent violent killings), and emergency care.

This coverage would be better than what Kirk currently has. He would have full choice of whatever doctor or hospital he would like to visit. And finally, it could be fully paid for by redirecting the money that we already pay for private health insurance, which costs tenfold more to administer than Medicare, while providing CEOs with multimillion-dollar salaries.

By supporting this single-payer system, he can assure that all Illinoisans receive the care that he did; isn’t that the least that we deserve?

Philip A. Verhoef is a physician in the adult and pediatric intensive care units at the University of Chicago and a member of Physicians for a National Health Program and the Illinois Single Payer Coalition.