Dr. Andrew Coates agrees with some critics of the Affordable Care Act. In many ways, he says the federal law “reinforced or worsened some of the most egregious inequalities and injustices in the health system.”
Coates, a New York physician and immediate past president of Physicians for a National Health Program, suggests that the United States, like other developed nations of the world, should adopt a single-payer plan, such as Medicare. The federal program could be expanded to all citizens, not just those 65 and over or disabled.
He’ll be in Charlotte on Thursday, at the invitation of Health Care Justice-North Carolina, to make his case for expanding Medicare. His free talk is 6-7:30 p.m. at Myers Park Baptist Church, Heaton Hall, 1900 Queens Road.
As Medicare marks its 50th anniversary this year, Coates said it’s interesting to note the contrast between that popular “model of publicly financed comprehensive” health insurance compared with the “current mess” in the private health insurance market, “including the exacerbation of that mess by the Affordable Care Act.”
Like many others, Coates praises the ACA for expanding insurance coverage to many who previously had none or who were excluded because of pre-existing medical conditions. But he added that it “entrenched the interests of the private insurance companies.” He said that the mandate for electronic medical records was a good idea but has not produced the projected cost savings.
“In terms of sweeping health reform, we did not get that with the Affordable Care Act,” said Coates, chief of hospital medicine at Samaritan Hospital in Troy, N.Y., and assistant professor of medicine and psychiatry at Albany Medical College.
Coates acknowledges that a single-payer plan is not popular with leaders of either major political party. But he said there is agreement in the country that everyone should have comprehensive health insurance. “In Main Street America, that is absolutely a consensus. I’ve talked to big groups and small groups. Republican town councilmen and liberal Catholic clergy. The idea that everyone should have access to health care is not a real debate.”
Despite arguments to the contrary, Coates said a single-payer plan would not be “a government takeover.” Services would still be provided by private hospitals and doctors. The payment system would be administered by the federal government, and that would save millions of dollars in administrative costs that could then be spent on services, Coates said.
As Americans face higher deductibles and co-pays for insurance, the need for reform remains great, he says. “A health care crisis is still very likely to cause personal bankruptcy,” Coates said. And when that happens, it’s seen as a personal failure rather than a societal one.
“It’s kind of a private shame. You see the collection jars at the fire company or the church. It’s not seen as a collective shame and a scandal.”