To The Daily Sun,

Medicare, now 54 years old, is the government managed health insurance plan for seniors age 65 and older. Medicare had improved health outcomes for seniors where chronic diseases, and multiple health conditions requiring several medications, are common. A beneficiary of Medicare for 13 years, my initial contentment turned to uncertainty when supplemental, individual, and employer sponsored private-for-profit insurance premiums and drug costs sky-rocketed. The American health care system became a consumer driven, free market, multi-payer, complex infrastructure of private insurance and drug companies. The result is unchecked freedom of private corporate insurance and drug industry to impose excessive price gouging on premiums and drugs. On average, premiums rose 19.6 percent. On the ACA exchanges, older Americans, those aged 50-64 who do not yet qualify for Medicare, but must have coverage, get hit the hardest. Drug examples: insulin maker Novo Nordisk's Novolog price jumped from $289 in 2013 to $540 this year, and Sanofi’s Lantus from $244 to $431. Unaffordable premiums and drug costs are clearly the principal problem of U.S. health care. When a majority of Americans began voicing opposition and demanding reform to this practice, private corporate insurance and drug industry started vigorous misinformation against true health care reform. The opposition's intent is to strengthen the private stronghold to pocket more profits instead of providing adequate health care to all Americans.

The most disturbing campaign of the corporate insurance and drug industry which created the dysfunctional, inequitable, and collapsing health care infrastructure is to promote themselves as the solution. The problem cannot be the solution, as in "Obamacare," where taxpayer-subsidized premiums and enforced enrollment entrenches instead of reduces private insurance and drug companies' role. The number of Americans with health care insurance increased through taxpayer subsidy and Medicaid expansion, coverage for pre-existing conditions was guaranteed, children could stay on their parent’s plans until age 26 and so forth. This gave an illusion of progress but did not address the problem of health care multi-payer infrastructure. We're paying more, but get less health care compared to other countries. Shameful results cannot be ignored — increased administrative wastes, continuing plague of millions uninsured and underinsured, bankruptcy due to medical bills, sky-rocketing premiums, drug prices, co-pays, out of pocket expenses, and surprise bills for out-of-network care.

"Go Fund Me," bake sales, social media begging to pay for medical needs, are praised as American generosity, hiding shameful inequity and inadequacy of America's crumbling health care infrastructure.

Sugar coating non-existent values of private-for-profit insurance that cost lives marches on. Examples: "Protect Our Care", a misnamed insurance-industry lobby group; incremental or piecemeal approaches that guarantees the existing situation at the expense of American health care.

Protecting Medicare and expansion to cover all Americans such as "Medicare For All" are no longer muted voices; 70 percent of Americans now support "Single Payer Medicare for All." As Medicare gained popularity, variations of proposed bills carrying the copy-cat Medicare name blossomed: "Medicare Buy-In", "Medicare with Public Option," and others. The latest outright push for private insurance/drug industry grip on America's for-profit health care system is Kamala Harris' plan with the copied label "Medicare for All." Medicare copy-cats try to put blinders on consumers promising: "if you like your insurance you can keep it," "excellent benefits at a price you can afford," and "choices." For the majority of Americans, the price you can afford offers bare-bone coverage; "choices" are severely limited by the "in-network" system.

The American health care system, as it stands, is beyond patching. Failures of the piecemeal strategy should be faced candidly, and plans retaining the private for-profit insurance and drug industries is a strategy to repeat failure.

There should be no compromise in health care. The only sensible solution is abandoning the crumbling infrastructure, and adapting a robust publicly financed, non-profit single payer national health program covering necessary medical care for all Americans. Premiums would disappear, 95 percent of all households would save money. There will be no financial barriers to care such as co-pays and deductibles, freedom of choice for doctor and hospital, insurance would no longer be tied to jobs, coverage is lifelong — no second guessing if the plan you can afford would cover maintenance and unexpected medical needs. Doctors would have freedom to deliver care without private insurance obstruction.

"True Medicare For All" bills have provisions for retraining and job placement for would-be unemployed private for-profit workers.

Now in Congress, are Rep. Jayapal's HR-1384 in the House, and Sen Sanders' S-1129 in the Senate. Both are the Medicare For All Act of 2019 that would establish an American single-payer health insurance — the cure for America's moribund multi-payer health care system.

Call your representative/legislators to support these bills.

Marcosa J Santiago MD

Retired Child Psychiatrist


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