Money and Health

May 11, 2023

Happy Thursday Healthcare Advocates

 Please enter requests for research using the comment button at the bottom.  Remember our advocacy educates our representatives and lets them know what we want them to do for us.  

This will be especially important after May 16th when Universal Healthcare will be reintroduced into both houses of Congress by Rep. Jayapal (WA) and Sen. Sanders (Vt.)

Money and Health?

Does money or privilege mean you are healthier?  

We will examine this today. First, let’s get a myth out of the way.  Popular legend in the US is that members of Congress have free healthcare.  Not quite true.  When the Affordable Care Act passed an amendment was added by Senator Chuck Grassley that provided that Congress will choose from available ACA plans.  They pay about 28% of the premium and the government picks up the rest.  This is similar to an employer sponsored plan.  However, they can also be treated for free at federal medical installations, like Walter Reed Medical hospital or the VA.

Is your health worse if you are poor?  

If you are at or slightly above the federal poverty level (depending on the state where you reside) you will have Medicaid and that’s a big help.  But there are about 70 million in the US that are uninsured or underinsured and they often delay seeing a doctor due to cost.  Of course, that can result in more expensive treatments and often worse outcomes. So the answer is generally yes but each individual is different.

The environmental social determinants of health also come into play.  These include having a safe, healthy place to live (think about lead), having access to clean air and water, access to healthy food and not working someplace particularly toxic or dangerous.  Sadly, the poor suffer on all of these fronts and that negatively affects their health. Additionally, the stress of poverty often leads to behaviors that are unhealthy such as alcohol and smoking.

Access to Healthcare

In our peer industrialized countries that have Universal Healthcare those with more money often purchase additional (optional) insurance. You can read summaries of each major country’s system at the Commonwealth Fund site.  Most often those policies cover things like the level of care (like private or shared hospital room), vision, and dental. In some countries, not all costs are covered 100% so there is top-up insurance to cover more of the costs.  Almost everyone in France has that.  In England, about 10% have optional coverage to get more rapid access to care.  But every English resident has healthcare, regardless.

What about the well connected in the US?

A friend of mine was a top level healthcare provider and is well connected in the medical community where she lives.  Of course, she has detailed knowledge of her health and the care she requires.   Recently, she had to contact her doctor for care and even though she is well known she was connected to the nurse practitioner.  She wasted time teaching the nurse instead of being connected to the doctor and did not get help.  It took several days for her to be able to talk to the doctor and to get the advice she needed. So, not always.

I have another well connected friend who utilizes a concierge doctor.  There is a cost for this but the doctor  gets in touch with you right away and provides personalized service that is convenient.  Recently, the doctor’s advice was to get to the emergency room now.  Once in the ER they were able to contact hospital donors to get admitted  and not linger in the ER but the hospital did not have the specialized equipment needed. The family was able to determine what hospital had the equipment and had my friend transferred.  This took several days and sadly tht was too long and it  was too late for her and she passed.  Highly placed people with lots of contacts and concierge doctors does not guarantee good results.

When researching this subject I did find an article in the NY Post about a different type of concierge system. An example company is called Private Medical and here is their website..  Their cost is very high, $60K for 1 person to over 6 figures for a family per year.  They will cut down the wait time for a specialist to days instead of weeks because they maintain relationships with specialists around the country.  Of course, you still need to pay for medical care and they insist on clients having insurance.  More research on this type of care is needed and the kind of outcomes they have.

However, according to the Harvard Gazette, research on variations in spending and outcomes among geographic regions and hospitals has produced mixed results, but most evidence suggests that greater spending does not reliably translate into better outcomes.

Medical Tourism

Millions of Americans, according to the CDC, make use of medical tourism.  They travel to other countries for healthcare.  Sometimes it is for cost, sometimes it is for personal convenience, say you grew up in another country, sometimes it is to have procedures that are not available in the US and sometimes it is to have rapid access to healthcare.  The CDC link is here.  The CDC says the most common procedures that people undergo on medical tourism trips include dental care, surgery, cosmetic surgery, fertility treatments, organ and tissue transplantation, and cancer treatment.  They also indicate that there are serious risks to medical tourism including infection, quality of care, antibiotic resistance, and even air travel before or after procedures.  Check their site.

Universal healthcare does not fix everything.  It does not fix the social determinants of health related to poverty, but it makes sure that money does not stand between us and going to the doctor.  It makes sure that we all have preventive health care cradle to grave.  It will cost our country far less than we pay now and will put money into the pockets of those who pay premiums.  That includes those who get health insurance at work and their employers. 

I know we told our representatives we want Universal Healthcare yesterday, but they need to hear it over and over to get the message.  Tell them again. 

Action

Here is a sample script to call or email your Congressperson and Senators and the White House.  Here is a link for their contact info or use Resistbot below.

“Hi, My name is _______ and I’m calling from [zip.].  I am your constituent. Next week Congresswoman Jayapal (WA) and Senator Sanders (VT) will be introducing their Universal Single Payer Healthcare Bill.  There are so many reasons we need this now.  It will save lives in the next pandemic, it will provide access to 70 million people who are uninsured or underinsured, It will dramatically cut what the US pays for healthcare by about $400 billion/year (according to the Congressional Budget Office  - 2020 report.  It will lower costs for employers and employees and make us more competitive as a nation.  I need you to do this for all of us.”

RESISTBOT VERSION

Text SIGN PMUHIL to 50409 to send the message above to your representatives.  More on RESISTBOT in the references below.

References

Find My Elected Officials

Contact the White House  https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

https://www.commoncause.org/find-your-representative/addr/

Important Healthcare Resources

League of Women Voters Healthcare Reform Toolkit

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Organizations to Contact

NARAL - Pro Choice America

Planned Parenthood

Physicians for a National Health Plan

Claims Denials and Appeals & What to Do

Appeal a Healthcare Decision

Appeal/Negotiate a Hospital Bill

Save Democracy

Chop Wood, Carry Water by Jessica Cravens

RESISTBOT

Link to the RESISTBOT site to learn more

Link to Chop Wood, Carry Water Resistbot write up