Open enrollment for health insurance is a gambling game

To The Daily Sun,

At this time annually, enrollment opens for health plan coverage. The for-profit private insurance industry has thousands of plans offering “affordable” packages. Personal predictions of health status for the following year govern choices, often dictated by financial means. Affordable plans offer bare-bones coverage; deductibles and co-pay must be met before it can be used. Unforeseen emergency or catastrophic events are not covered. In this multi-payer health care game, for-profit insurance and drug companies hold the cards and are the winners. Their profits are guaranteed; the health of players are often the losers.

This annual guessing game will disappear with universal health care — Single Payer Medicare for All. Everyone will be automatically enrolled from birth throughout life, and receive quality health care.

To many accounts with private health insurance denied or delayed medical services, I add my story.

I am a retired physician, with Medicare for 13 years and supplemental private health insurance whose premiums significantly increased every year. Recently, I developed diplopia (double vision), affecting balance and navigation. Dreading possible serious causes, I was taken to the nearest hospital ER. After diagnostics, and hospital admission for more tests yielding negative results — brain MRI (magnetic resonance imaging) was scheduled. MRI was canceled because the MRI agency was “out-of-network” — my insurance would not pay. A “surprise medical bill” could cost $3,000. MRI was rescheduled at the hospital where my PCP works — delaying crucial determination of what caused my double vision.

Limited “in-network” violates “freedom of choice”. Universal health insurance would deliver needed care without delay anywhere.

Our multi-payer system delivers profits, not health care. With diagnostic tests or treatments delayed or unaffordable, death or disability can result; also depletion of savings and bankruptcy due to medical bills.

In 1966, the Covenant on Economic, Social and Cultural and Rights (CESCR) treaty was ratified by all U.N. countries except three (U.S., Palau, Comoros). Article 12 clarifies “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.” “Health” in this context is not just health care, but a right to control one’s own body, including reproduction.

United Nations 193 member states are subject to “Universal Periodic Review” (UPR), on rights protected by UDHR (1948 Universal Declaration of Human Rights). The U.S. government 2015 report to the U.N. touted the Affordable Care Act (ACA), regulated private health insurance instead of a health care law. Not basic rights to health.

The U.S. UPR is due in 2020. Call on legislators of both political parties to represent us, not the private health insurance and drug industries; instead, support nonpartisan bills in Congress, House bill HR1384 and Senate bill S1129. Time to adopt Single Payer Improved Medicare for All which recognizes health care as a fundamental human right. Social Security and Medicare benefits are enjoyed by Americans age 65 up. Improved Medicare for All brings health benefits to all Americans throughout life.

Marcosa Santiago MD

Rumney