Underinsured Chicago doctor wants Medicare for all

By James Ronayne, M.D.
Chicago Sun-Times, July 22, 2015

Medicare has become one of our nation’s most beloved social programs. Today it’s part of the U.S. tradition, as American as apple pie.

The health insurance program covers 55 million Americans — people older than 65, along with younger people with disabilities. It has made health care accessible to many millions and has reduced health inequalities based on race and socioeconomic status. Moreover, under traditional Medicare, patients can go to the doctor and hospital of their choice – something unheard of in today’s health care scene.

On July 30 Medicare will turn 50, and celebrations will take place nationwide. I will celebrate Medicare’s achievements but also call for improving and expanding it to cover everyone in the country.

That’s right — I think we need an efficient, nonprofit, improved Medicare for All.

Unfortunately, just a few days later, I have plans to experience another American tradition that I’m less enthusiastic about – going to see my doctor and paying out of pocket. You see, I don’t have insurance to cover my visit.

What makes my situation unusual is that I’m a doctor at one of Chicago’s hospitals. I’m also a researcher, and I also work in private practice. Because I have three different part-time jobs, I’ve become ineligible for insurance through my workplace.

Now, I don’t want to mislead – I just got insurance through my wife’s plan. However, my doctor is now “out of network.” My costly medication isn’t covered either.

I couldn’t find an appointment with a doctor who takes my wife’s insurance until August. I like my doctor, but I am being forced to find another, and to change medications, because I cannot afford to pay the full freight.

Keep in mind that I have a detailed understanding of the medical system.

Many of my patients can no longer come to my clinic because of insurance changes, and some have lost everything — house, car, college funds for the kids — due to illness.

Indeed, ours is the only developed country where it’s commonplace for medical bills to result in bankruptcy.

In contrast, consider this: when I was a medical student in England, I was treated by that country’s National Health Service. I had zero out-of-pocket costs. 

While a politician in Illinois, Barack Obama supported expanding Medicare to all. As president, he bowed to pressure from the insurance companies and instead elected to mandate that Americans buy private health insurance, or enroll in Medicaid, a substandard plan compared to Medicare. 

Private insurance puts 30 percent of every health dollar into administration (UnitedHealth’s CEO took  $66 million last year). The insurance companies like it this way, and spend lots of money to keep politicians in line. Contrast that with Medicare, where only 2 percent of each dollar goes to administration. 

So next time you hear a politician demanding we cut or dismantle Medicare, and you think to yourself, “That’s got nothing to do with me,” I want you to think again.

I know I will. If a doctor in this country can struggle to pay for medical care, so can the rest of us — if not today, then tomorrow.

The simplest solution, though the hardest politically, is to improve and expand Medicare to cover all of us. There is legislation in the U.S. House and the Illinois General Assembly that would do this. Urge your lawmakers to sign on.

By passing these bills, we can restore confidence in our medical system, and all of us can enjoy healthier, richer lives.

Dr. James Ronayne, a pediatrician in Chicago, is a member of Physicians for a National Health Program and the Illinois Single-Payer Coalition.