Separate and Unequal Care

Separate and Unequal Care

By Margaret Flowers

This week the Star Tribune learned that the CEO of the Mayo Clinic in Rochester, New York made a blunt statement to hospital employees that underscores the urgency with which we need to abandon the current health system in favor of a universal system. In a videotaped speech last December, John Noseworthy said:

“We’re asking … if the patient has commercial insurance, or they’re Medicaid or Medicare patients and they’re equal, that we prioritize the commercial insured patients enough so … we can be financially strong at the end of the year to continue to advance, advance our mission.”

Think about that. What was once an unspoken rule in the United States, that some lives are to be prioritized over others based on the ability to pay, is now out in the open as standard operating procedure.

Medicaid and Medicare are public insurances that are part of the US’ welfare system. Medicaid, a state-based insurance, has had chronic problems with low reimbursements for care that drive providers to limit the number of Medicaid patients they will see. Medicare, a national system for the elderly, has undergone cuts, especially for hospital care, as part of the Affordable Care Act. Medicare was once the benchmark for reimbursement, with higher rates than some commercial insurance, but that has changed and hospitals are now under increased pressure to find revenue to keep operating.

This illustrates why the welfare system doesn’t work. It allows certain groups to be segregated into programs that are then vulnerable to cuts, especially in an environment that fuels the idea that hardworking people shouldn’t have to pay for other people’s needs and that the young shouldn’t have to pay for older people’s care.

The welfare model was abandoned in other countries and replaced with universal systems for this reason. They recognize that programs for the poor are poor programs. Instead of welfare, other countries adopted universal programs for education, health care and pensions. When everyone is in and uses the same system, it is a stronger system. And another plus is that these publicly-financed systems spend less per capita than the US does and have better outcomes.

We must not proceed any further down the path that allows some lives to be valued less than others based on money. Make a commitment now to demand National Improved Medicare for All. Everybody in, nobody out.

 

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