Putting profits ahead of patients

By PAUL DeMARCO - Guest Columnist

This is a column I’d rather not write because it is critical of one of my favorite organizations. But I believe in the organization too much not to write it. Recently, the S.C. Medical Association missed an opportunity to stand up for those it was created 160 years ago to serve, the people of South Carolina.

Last year the Medical Association joined with the S.C. Hospital Association, the S.C. Chamber of Commerce and the insurance lobby (the S.C. Alliance of Health Plans) to form the Covering Carolina Collaborative. The collaborative set an ambitious goal, namely that “every South Carolinian (would) have access to affordable, quality health care by the year 2010.” But when its plan was revealed in January, it covered only a quarter of South Carolina’s uninsured. Some of the money would go to Medicaid expansion, which makes sense, but part of the plan simply subsidizes the purchase of high-cost private insurance.

I believe a growing number of S.C. physicians and patients are tired of these half measures. Therefore, I introduced a resolution to the S.C. Medical Association House of Delegates, urging the body to commit to covering all the state’s uninsured by creating a state plan and by advocating for a national single-payer system.

National health insurance in the form of a single-payer system (Medicare for all) would save hundreds of billions of dollars in administrative waste, eliminate job lock, promote entrepreneurship by providing coverage for the self-employed, increase American companies’ competitiveness in the global economy and end America’s isolation as the only developed nation that does not provide universal health care.

Recent polls of both physicians and lay people have indicated that a majority supports legislation to establish national health insurance. In addition, the American College of Physicians, an organization of 124,000 of internal medicine doctors, has endorsed single-payer as one option for covering all Americans.

The choice our state’s physicians face is stark. The Medical Association can remain allied with private insurers and allow them to dictate who has access to our care, or it can commit to health reform that covers everyone. The insurance industry has demonstrated again and again its willingness to put profits above patients. But physicians know medicine is a calling, not just a business. Physicians deserve to make a good living, but over the past 40 years, the profit motive has twisted our system beyond recognition. The practice of medicine is for the benefit of patients, not the generation of stockholder dividends.

After some vigorous debate on the resolution, it was soundly defeated, and we resolved simply to keep doing what we’re doing.

Many of the objections during the debate were about problems with single-payer systems such as waiting times, cost control and distrust of government. Those were well-taken. Single-payer, like every other model, has its problems. But international studies show that other countries with single-payer systems achieve better outcomes at lower cost than the United States, while managing to cover everyone.

Some present raised the objection that single-payer, particularly on the state level, is not politically feasible, but I disagree. Bills have been introduced in multiple state legislatures, including Arizona, California, Colorado, and Illinois, proposing single-payer plans. The California bill passed the legislature but was vetoed by the governor. In 2005, many observers thought tort reform was a pipe dream, but S.C. physicians mounted a powerful effort to enact it. During that campaign, the S.C. Medical Association applied every ounce of pressure it could; we were not going to be denied.

I asked my colleagues what I should go back and tell my uninsured patients. I told them about one in particular, a good friend who is a barber. He works long hours and is beloved in our community. “Tell him we’re trying” and “tell him to call his legislator and ask him to support the CCC plan” were the answers that came back.

That’s a far cry from 2005 when we stormed the General Assembly to reduce our liability rates. Three years ago, we gave our all to protect our practices. But when it comes to our patients, the Medical Association is content to advocate for a plan that would cover only a quarter of the uninsured and demands no reform by the private insurers. Our patients and our organization deserve better.

Dr. DeMarco is a general internist in Marion and a spokesman for South Carolinians for Universal Health Care. Contact him at pvdemarco@bellsouth.net.