Time for a new prescription
By Jason Westin, M.D.
“This means the world to me” she said as I left her exam room. In my first year of medical school, I learned countless lessons, but perhaps the most important was that healthcare is a human right. Working in the student run Equal Access clinic, a place where I provided care for people without insurance, was one of the most formative experiences of my career. The people I treated knew they had problems, but because they lacked insurance they were getting sicker and felt no one cared. When I helped them, their gratitude was about more than getting their diabetes or blood pressure controlled, it was about feeling valued as a human being.
In my 15-year career as a doctor, I have seen many amazing things across the full spectrum of the human experience. I remember my first patient that recovered after a critical illness, and my first patient that did not. As an award-winning researcher at the top-rated cancer center in the world, I remember my first patient whose cancer went into remission on a clinical trial I designed, and others who were less fortunate. The doctor-patient relationship is truly unique: patients tell their doctors things they would not tell anyone else, and in exchange doctors make decisions that decide the fate of their patients’ lives. It is an awesome responsibility.
Unfortunately, my ability to provide the best care for my patients is not entirely up to me. Many times, my plans are blocked by a for-profit insurance company denying payment for my patient’s treatment plan. Most medical practices have a large team whose sole job is to navigate the complex insurance regulations, often with infuriatingly random results. This makes healthcare less efficient and effective. The amount of time, effort and money wasted dealing with paperwork or appealing denials of universally accepted standard treatments is truly astounding. The Center for Economic and Policy Research estimates America wastes over $100 Billion each year on private insurance overhead costs, more than 12 times of what Medicare spends on operating costs. The bottom line is this: insurance companies are motivated to maximize profits and bonuses for their executives, not improve our health.
The Affordable Care Act, or ObamaCare, has been a great step forward, but still leaves nearly 30 million Americans without coverage. The ACA slowed the rapid growth of healthcare costs, but it has not impacted medication prices, use of treatments or testing that lack value, or lifestyle choices many of us make that lead to poor health. As a doctor, I know we can do better.
I believe that healthcare is a human right and the best way to fulfill this duty is a single-payer system. Medicare and Medicaid cover nearly 125 million Americans, 33% of our population, but more should be done. The United States is the wealthiest nation in the history of the world, but is the only developed country without universal healthcare. We spend more than any other country per person on healthcare, over $9000 each year and rising, but rank 28th according to the United Nations. Why do we pay more for less? The price of prescription drugs, inefficiencies in insurance, and a lack of prevention and cure of chronic illnesses are all a part, and they are only getting worse. Healthcare today reminds me of my patients in the Equal Access clinic: we know our problems are getting worse, but we feel powerless to act. Our current system is not sustainable, and the only viable long-term solution is universal healthcare.
It is now time for a change. The Pew Research Center reported 60% of Americans believe the federal government is responsible for providing healthcare coverage to all Americans. This is an astounding number. “Medicare for all” should do more than just insure all Americans, it should tackle the unsustainable rising costs of prescription medications and healthcare, and even more importantly, make us healthier and more secure. Greater access to care and a focus on prevention and finding cures of dreaded diseases, would reduce long term costs and increase our productivity and longevity. America does great things, like leaving our world and setting foot on our moon, why can’t we do great things for something as fundamental as our healthcare? If a doctor continues to use the same failing treatments over and over, a patient should find another doctor. Our leaders in Washington are elected to lead, and if they refuse to do so on healthcare, we should elect leaders who will.
Dr. Jason Westin is an award-winning cancer doctor and researcher at MD Anderson Cancer Center in Houston, and candidate for the 7th Congressional District in Texas.