Why not good health care for all?

By Philip A. Verhoef, M.D.
Chicago Sun-Times, Letters, Jan. 7, 2013

I am glad that Sen. Mark Kirk has made such a successful recovery from the devastating stroke he suffered a year ago, and even more thrilled that he will be “much more focused on Medicaid and what [his] fellow citizens face.” However, his experience highlights some of the flaws in our current health-care system, many of which are exacerbated by ObamaCare. First, there are multiple tiers of care in our health-care system, which may partly explain the observation that impoverished males have a life expectancy 14 years less than those of the upper socioeconomic strata; clearly, it’s hard to rise out of the lower class when one is constantly having to choose between putting food on the table or paying for health care. The ObamaCare solution is to require insurers to offer various levels of insurance that may only cover 60 percent of health care costs and carry ever-higher deductibles, thus shifting the costs of health care to the people who can least afford it and perpetuating our multitiered system.

Second, as noted by the Sun-Times on Jan. 2, Sen. Kirk “incurred major out-of-pocket expenses” even though he has, arguably, the best health care insurance in the country. This means that his Cadillac insurance still provides insufficient coverage. As he alludes to, Medicaid provides vastly inadequate support for stroke rehabilitation. Further, very few medical providers accept Medicaid patients for outpatient care. Part of the ObamaCare solution is to expand Medicaid eligibility to more people, while allowing states to opt out of administration of the Medicaid expansion. The end result is that more people will have Medicaid, and they will have to shoulder more out-of-pocket expenses, like Kirk.

Why not expand and improve the Medicare system and extend it to everyone? It could be paid for by redirecting the money that we already pay for private health insurance (which costs 10-fold more to administer than Medicare).

I hope that Sen. Kirk will consider this common-sense approach to health-care reform. I know that my patients and I would really appreciate it.

Dr. Philip A. Verhoef is a physician in the adult and pediatric intensive care units at the University of Chicago.