Thoughts from an RN Regarding the Healthcare Emergency Guarantee Act of 2019
Photo by Tai’s Captures on Unsplash
By Kathryn Lewandowsky, BSN, RN
One Payer States, Inc. Treasurer
Senator Bernie Sanders and Rep. Pramila Jayapal have both released bills in the House and Senate to address the harsh realities that our nation’s citizens are currently experiencing. On the one hand, in the summary of that bill, it states that 87 million Americans are uninsured or underinsured and that 35 million Americans may lose their employer provided health insurance. On the other hand, we currently have a President who is planning on using his”instincts” to best decide when our country can come out of quarantine. And yet it’s been pretty obvious that using his “instincts” is exactly what has gotten us where we are currently. The country with the highest number of cases and deaths in the world. In his mind he has “total authority” to make decisions regarding reopening the country and saving the economy is how we can fight this pandemic. If our people go back to work too early it will only serve to put more of their lives at risk and to increase the costs to our economy in the long run. But, I digress, this is supposed to be about the Sanders/Jayapal emergency response bills.
Currently, COVID-19 testing and some treatment costs are covered by the CARES Act. Realistically though, these are not the only concerns during this pandemic for people without insurance. There are still many other health disorders that will need to be treated and they can be treated for far less money and much improved chances of recovery if those patients do not delay being seen due to fear of uncovered health insurance costs. Many people will not have the money to pay the COBRA premiums once they lose their employer sponsored health insurance. Those premiums have always been far more than the $400 that most people don’t have in their savings account. Millions of Americans will find themselves without any form of health insurance coverage.
We do have Medicaid, healthcare for the poor. Maybe those Americans will all fall into that bucket? Yes, many will! Unfortunately, this is not helpful to our providers, especially in the acute care services as our hospitals say they cannot keep the doors open at the reimbursement rates of Medicaid and that fact has been proven in our rural areas with ever increasing numbers of hospitals that have closed due to a high percentage of uninsured and medicaid patients. I have heard a few providers claim that Medicaid was designed to treat patients on an out-patient basis as it is much less expensive to keep people out of the hospital and they are very happy with their Medicaid reimbursements. I am personally not hearing that from any of my local, private providers, although that may be true at our Community Health Clinics.
What I truly love about the Sanders/Jayapal bill is that it doesn’t let our for profit health insurance companies and our large, self insured corporations off the hook. During this emergency pandemic they will still be obligated to provide for the services that they are obligated to provide. For the last 50 years they have been profiting off of our healthcare dollars, all the while designing a system that works to control costs by denying the care that your doctor feels that you should have; providing a system where patients and doctors have to spend hours of their time fighting to receive authorization for the care that they and their patients need: slowly evolving a system where the covered person bears too much of the costs of going to the doctor for preventative maintenance and all the while increasing the costs of their healthcare premiums in order to squeeze as much from their “customers” as they can endure. It’s truly a double edged sword and it’s killing middle class and poor Americans!
Another pillar of this bill is that Medicare rates will be used for reimbursement. Although I can agree that Medicare rates should be increased, I feel that during this pandemic using Medicare rates is best. It’s an emergency and the issues involved with Medicare rates can be debated later. Our elected officials have been kicking this debate down the road for too long. The need for expediency here is real to get a plan in place that will provide for the healthcare needs of our citizens.
I commend the Obama/Biden administration for making a valiant effort to improve our healthcare system with the passing of the ACA. Unfortunately, the ACA was doomed to fail because in my opinion creating a fair and just healthcare system just cannot be done by allowing an unregulated, for-profit industry to control the process. And our 50 year history requiring providers to try and determine costs based on what their patient’s insurance companies will pay and then guessing how many of those patients versus how many uninsured patients will show up on their doorstep has always been absurd in my mind. We should only be looking at how we best take care of our people with the least amount of cost and the most benefit to both patients and the system as a whole. This is exactly what other countries have done in designing their healthcare financing systems, costing them half of what we are currently paying in the US and with much improved outcomes for patients.
I completely agree with the restrictions of drug prices to what the VA has negotiated with pharmacological companies, although I would like it to clearly include in-patient drug prices also. Maybe it’s there, but I didn’t clearly see it. The assault on the American people from Big Pharma is particularly disturbing. Their glutenous profiting off of their own customers is another blatant example of the problems with allowing unregulated profits to large corporations who are more beholden to their shareholders and overpaid CEOs than to their neighbors, friends and family. Their reasonings for charging the US the highest prices of all other countries in the world was simply stated “because we can”!
This emergency bill extends the relief until a vaccine is developed. Some people I know feel that the time frame may be a little long. I think it’s BRILLIANT, because clearly our elected officials keep ignoring our cries to fix the system! It may be a while before a vaccine is developed (unless there is one hiding in a lab somewhere) and this bill will continue to require our government to cover the uninsured while giving themselves more than enough time to effectively design an Expanded and Improved Medicare for All health care system that covers all people living in the United States. Health care that is free at the point of service with no copays, no deductibles, no out of network fees, no supplemental insurance required! I have no doubt that everyone now understands the futility of tying healthcare financing to our place of employment.
This bill not only addresses the needs of the moment, it also allows for the benefits to continue long enough in order to adequately address our long term health care financing issues. Although, I am hopeful that our elected Representatives and Senators will eagerly and emergently pass this bill, historically, I know our chances are rather slim. And so I do feel that it is important that they seriously consider and pass HR 5010, the State-Based Universal Health Care Act of 2019, introduced by Ro Khanna (D-CA). This bill would allow individual states to more easily implement their own universal, non-profit healthcare systems at the state level and those legislative plans could be emergently instituted by each state’s governor. If the federal government is not going to act now then they need to get out of the way of states trying to protect their citizens. You can go to OnePayerStates.org to see what’s happening in your state and then give your Governor a call and demand they emergently institute a universal healthcare plan in your state.
