Single-payer health plan would be good for all of us

By Laurence Lewin, M.D.
Marin Independent Journal, August 12, 2018

As a physician, I am convinced that we need a single-payer system or Medicare for All to provide cost-effective, quality health care to all Californians.

In 2017, after 50 years in private practice, I began to volunteer at the Marin Community Clinic, seeing referral patients with kidney disease long before they reached end stage, and universal coverage for hemodialysis, preventing death in uremia. How logical. Treat everyone early when the disease could be arrested, or slowed, at a fraction of the $80,000/year that dialysis costs, often for 20 years! Why wait until it is too late to include everyone?

Why doesn’t everyone have access to a kidney specialist like these safety net patients do? California has a shortage of medical specialists willing to see charity patients, or even those “insured” by MediCal. Nephrologists in private practice volunteered their time, but the numbers overwhelmed the best of intentions.

Younger practitioners, facing $250,000 or more in educational loans, simply can’t afford to fill their offices with MediCal patients when the reimbursement per hour, $100, is not enough to cover overhead, alone. Delays in diagnosis and treatment are inevitable.

Effective primary care is the answer, and that can come about, with no additional cost to what is currently being spent, if a California single-payer program is instituted.

I joined Marin’s chapter of Physicians for a National Healthcare Plan to advocate for a California single-payer system.

In the November election, just ask your candidate what he has done to preserve your health.