Steffie Woolhandler. MD, MPH, Associate Professor, Harvard Medical School and co-founder of Physicians for a National Health Program (PNHP) came to Louisville September 14 and 15, 2006 to address the General Session of the Annual Meeting of the Kentucky Medical Association.
On arrival she met with the editorial board of The Courier-Journal. They discussed the economic and humanitarian concerns of an American health care crisis of 47,000,000 citizens without health insurance and an equal number with inadequate coverage, “paper thin”, as Dr. Woolhandler calls it.
She told the editors about her research demonstrating that more than half of bankruptcies in this country are a result of medical debt — bankruptcies affecting middle class Americans, three-quarters of whom were insured when they first became ill. “They paid their premiums in good faith,” she said, only to discover that they had skimpy coverage that would not cover their illness costs, forcing them to face the ignominy of bankruptcy.
She explained why health care “markets” inevitably fail to provide adequate medical services, and how a one-risk pool, government-financed national health insurance plan could provide high quality comprehensive care for everyone. She stated that $300 billion in wasteful administrative expense in the present complex system could be saved, enough to fully fund a single payer national plan in the U.S..
Dr. Woolhandler at the Louisville Free Public Library
She spoke at the Louisville Free Public Library in the evening to approximately 150 guests of Kentuckians for Single Payer Healthcare and PNHP-Kentucky. Dr. Woolhandler described a worsening health care crisis with ever decreasing quality and increasing costs. She said that the average U.S. expenditure is $7,000 per capita, compared to the average of other developed nations (who provide national health programs) of $3,500, yet we have worse healthcare outcomes in many respects. “The only place we lead other [developed] countries is in overhead costs”, said Dr. Woolhandler.
She cited case after case from her medical bankruptcy research of individuals, who thought they had adequate insurance, only to wind up bankrupted by medical bills. She spoke of the effects of globalization and of “Walmartization” — big box employers offering no coverage, funneling low paid employees into Medicaid, or offering skimpy coverage and simultaneously screening out all but the healthy to”insure.”
Dr. Woolhandler, from a strong background in economics, said that the market model doesn’t make sense with health care. Efficient markets don’t exist in health care, because a sick people can’t be prudent consumers.
She defined the problem of escalating American health care costs on the national economy, causing loss of manufacturing jobs, particularly in the automotive industry, but affecting the competitiveness of American business worldwide.
The Canadian system, she said, is under-funded by our standards, but it serves the Canadian people well and is a proven model of effective publicly financed, privately delivered health care that could cure the systemic problems that afflict our failing system — 18,000 Americans die annually due to lack of health insurance. She recommended a “Canada-Deluxe” system for the U.S., and said that a strong majority of Americans favor this plan.
General Session, Annual Meeting of the Kentucky Medical Association
This year the KMA dedicated its General Session to discussion of the problems of the uninsured (www.kyma.org). Dr. Woolhandler joined three other experts; Professor Michael Samuels of the University of Kentucky, who described the status if uninsurance in Kentucky; Dr. Jack Evjy of Massachusetts Medical Society, who described the Massachusetts plan; and Dr. Jeremy Lazarus, who described the AMA plan.
The meeting was well attended, and there was intense interest, evidenced by a barrage of comments and questions in the panel discussion moderated by retiring KMA president, Dr. Don Varga. The speakers agreed on the seriousness of the problem. Dr. Woolhandler was impressed by the audience’s receptivity to her single payer message as a solution. The Courier-Journal covered the program in a front-page article by Laura Ungar on Saturday, Sept. 16, 2006.
Dr. Woolhandler joined 30 PNHP-KY members and guests for a luncheon following the KMA session. PNHP-KY’s summer interns, 2005 and 2006, joined the group, as well as five other medical student activists from University of Louisville School of Medicine. Our intern from last summer drove all the way from medical school in Birmingham, Alabama. Members from around the state enjoyed sharing together and talking one-on-one with Steffie Woolhandler.