Inequitable health care is a national scandal

March 19, 2018

Bennington Banner

To the Editor:

"Equity" and "equal" have the same derivation. In the case of health care, it means that necessary care would be provided to everyone and not be dependent upon income, social status, race, etc. Is our current system of health care equitable? I think not.

In spite of Obamacare, there are still 28 million of us who are uninsured. There are about 1,500 uninsured people in Bennington. If you had to pay out of pocket, had limited income, and got sick, might you hesitate to go to the doctor?

An additional 18 million of us had a gap in coverage at some point during the year (eg. lost coverage when changing to a different job).

Compared to higher income enrollees, lower income enrollees in high deductible plans use very little preventive care.

- 16 percent reported skipping a recommended test or treatment because of cost.

- 33 percent of non-elderly adults reported a problem paying a medical bill.

- 20 percent of adults do not get their prescriptions filled because they don't have enough money.

It is clear that economically disadvantaged citizens are not served well by our system of care. Health care has become unaffordable for many (there is no equity). For all of us, health care should be a right. We should not be put in a position in which we have to decide whether to buy medicine or buy groceries.

The cost of health care is literally killing us. Uninsured citizens are dying because the cost of care is so high that they avoid seeking care. Another burden is borne by the working poor who don't qualify for Medicaid and can't afford to purchase a policy through Vermont Health Connect. The high cost of an insurance policy (ranging from bronze to platinum) is a real barrier to many, even when they receive a subsidy. It now costs nearly $20,000 per year for a commercial family plan with a low deductible. We spend about twice as much on health care as other wealthy nations, yet important outcomes such as life expectancy are worse.

The cost of health care is also killing the nation. About 19 percent of our
gross domestic product goes to payment for health care — almost twice as much as other industrialized countries. If we spend that much on health care, there is less left for other important projects such as infrastructure upgrades, housing, education, etc.

Our health care system, which is based on insurance companies' profiteering, is a failure. Wouldn't it be better if we were all insured from birth to death? Wouldn't it be better if coverage were more comprehensive and included dental, vision, hearing aids, long term care, and negotiated prices for prescription drugs? Wouldn't it be better if there were no deductibles? Wouldn't it be better if the cost of care were less? A system change to "Improved Medicare for All" is what is needed. Lack of universal health care is a national scandal. In the coming elections, support a candidate who will work for universal single payer health care.

G. Richard Dundas, MD,