Last week, we officially began our careers as physicians in the middle of a global pandemic and public health crisis. Over the previous four years as medical students, we saw countless examples of patients wronged by our health care system, which incentivizes disease treatment and not disease prevention. We saw patients lose their limbs to diabetes when they could not afford to begin insulin until it was too late. We saw patients whose access to comprehensive healthcare began with their enrollment in Medicare only after they were placed on dialysis, when we know that preventing kidney failure is more cost effective than treating it. We held the hands of our dying patients knowing that, if they could have afforded care sooner, they would be holding their loved ones’ hands instead.
Prior to COVID-19, over 40,000 New Orleanians were without health insurance. Now, with unemployment numbers rising daily, the uninsured rates will rise steadily as insurance plans tied to employment are lost. The costs of COVID-19 treatment have amounted to tens of thousands of dollars for the uninsured and could exceed $1,000 for patients with employer-based insurance. The promises of private, profit-based insurers to cover COVID-19 treatment are not enough. Many of these corporations exploit gaps in coverage to avoid having to pay for this treatment, like refusing payment for care performed by an out-of-network provider or when a patient does not receive or qualify for a COVID-19 test. As we have seen with our patients, commercial health insurance is a defective product, like an umbrella that melts in the rain. With skyrocketing premiums, copays, and deductibles, even insured patients are forced to choose between paying for rent and food or the bills for supposedly “covered” procedures. Not surprisingly, most choose food and rent. Many are avoiding treatment for symptoms concerning for COVID-19 due to concerns over the bills they will receive later in the mail.
Medical bills amounting to $1,000 or more could send many into medical bankruptcy. Medical problems have contributed to two-thirds of all bankruptcies in America, a figure that is virtually unchanged since before the passage of the Affordable Care Act (ACA). This means, even though more people have private health insurance, 530,000 families suffer bankruptcies each year that are linked to illness or medical bills. In the U.S., a whopping $450 billion of unpaid medical debts are sent to collections agencies every year. This problem disproportionally affects Louisiana and the greater New Orleans area; our state ranks second for the proportion of people living with unpaid medical bills. In Orleans Parish, the percentage of residents living with medical debt is higher than the national average. It remains to be seen how COVID-19 will continue to worsen this statistic as New Orleans has become a hot spot for cases.
We must fix our broken health care system once and for all. The only way to eliminate the nightmare of medical debt and bankruptcy is to cover everybody for all medically necessary care without the financial burden of premiums, copays, and deductibles, during and beyond a pandemic. In our view, the only way we can afford to cover everyone is through single-payer Medicare for All. Medicare for All would cut through the wasteful administrative costs and go-betweens of private insurance, and pay doctors and hospitals directly for patient care, saving our nation as much as $600 billion annually — enough to cover the uninsured and upgrade coverage for everyone else.
We don’t want to practice medicine in a system that rations healthcare based on ability to pay, or that punishes people who get sick with a lifetime of financial instability. We have seen our government take steps to cover COVID-related costs during this pandemic. However, this is not enough. The people of New Orleans deserve more comprehensive medical care that will not drain their pocketbooks. As recently graduated physicians, our first prescription is for single-payer Medicare for All.
Dr. Ashley Duhon is a recent New Orleans area medical school graduate. She will begin her residency in Obstetrics and Gynecology in the Bronx, New York in July.
Dr. Sara Robicheaux is a recent New Orleans area medical school graduate. She will begin her residency in Emergency Medicine this July and is excited to continue to serve the people of Louisiana.
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