Eugene weekly., September 21, 2017, Page 11, Image 11

imothy Burns is 27 years old. Before age 3, he un-
derwent six open-heart surgeries for a congenital
heart condition — mirror-image dextrocardia.
“I have no center wall of my heart, and my heart
planks to the right side,” Burns says. “My oxidized
and unoxidized blood mix, so I’m in a constant flux of a high
heart rate and a low heart rate.”
Some days Burns feels exhausted and doesn’t have the
energy to be physically active. During the last few weeks,
when Eugene’s air quality was deemed hazardous because of
nearby wildfires, Burns and his wife spent a day passing out
masks to the homeless.
“I got home, and I thought I was going to die — I thought
I was having like a micro heart attack or something and slept
for eight hours,” he says.
Burns’s worries are not without reason. Because he is a
graduate student living on a fixed income, Burns can afford
only student health insurance through Pacific University. Al-
though he’s insured, Burns cannot afford to see his cardiolo-
gist — a visit to a specialist is not covered by his insurance
— but he should be seen annually to monitor his heart.
When Burns was still covered under his parents’ insur-
ance and was still able to see his cardiologist regularly, he
says, “they were discussing a pacemaker. So it’s one of those
things of not if I need it, it’s when I need it.”
Burns says his health insurance situation is a matter of life
and death. And he’s not alone.
In 2009, the American Journal of Public Health found
that an average 45,000 uninsured Americans die every year.
In 2017, the United States was listed as the 13th wealthiest
country in the world with a GDP per capita of $57,293. De-
spite being one of the richest countries in the world, the U.S.
was also home to a reported 23,000 infant deaths in 2014,
according to the CDC.
Insured Americans aren’t getting their money’s worth for
the health care they pay for. The U.S.’s privatized health care
system is so complicated, expensive and exclusive that mil-
lions of people remain uninsured. Thousands die waiting for
health care and paying for health care also forces families
into bankruptcy.
Former presidential candidate Sen. Bernie Sanders has
introduced a “Medicare for All” bill that would overhaul and
expand the government-run single-payer system. In a New
York Times op-ed, Sanders writes, “I have heard from older
people who have been forced to split their pills in half be-
cause they couldn’t pay the outrageously high price of pre-
scription drugs. Oncologists have told me about cancer pa-
tients who have been unable to acquire lifesaving treatments
because they could not afford them. This should not be hap-
pening in the world’s wealthiest country.”
But Congress has repeatedly shown where its funding pri-
orities lie. On Sept. 14, the U.S. House of Representatives
voted in favor of a $1.2 trillion spending bill; it includes an
earlier package that secures $1.6 billion for a down payment
on a border wall with Mexico, despite a steady decline in
unauthorized immigration since 2007.
One population that has increased, however, is the num-
ber of uninsured Americans, which rose from 10.9 percent to
11.3 percent during the first quarter of 2017, according to the
Pew Research Center.
As Republicans decry the Affordable Care Act (ACA),
proposed alternative health care bills in both the House and
Senate would force the brunt of health care costs on the
American people. Those plans would result in anywhere
from 16 million to 32 million people becoming uninsured
over the next decade or so, according to the non-partisan
Congressional Budget Office.
“They’re so driven by the desire to deliver tax cuts to
people who have investment income over $200,000 a year,
that was the core of the House bill,” Rep. Peter DeFazio says.
“To them it’s more important to give those people a tax cut
than it is to provide affordable accessible health care to mil-
lions of people.”
As the debate spirals on about health care in the United
States, Oregon is gaining support and momentum for a state-
wide system that would cover all Oregonians. Doctors, along
with some of Oregon’s congressional and state representa-
tives — even citizens in the state’s eastern, Republican-vot-
ing counties — have been showing up to town halls to sup-
port a universal, single-payer Medicare-for-all system.
T
Under different titles and with slightly varying payment
structures, universal health care is mandated in approxi-
mately 75 countries in the world, according to “The Political
Economy of Universal Health Care Coverage.” The paper
says that researchers from Harvard, Oxford and the London
School of Hygiene and Tropical Medicine found “… a legal
commitment is insufficient on its own and must be translated
into policies that establish a comprehensive, largely publicly
financed system. An over-reliance on partial and private sec-
tor-focused care appears to disproportionately benefit richer
groups, reducing both efficacy and access to coverage.”
Thousands of Oregonians have been enrolled in the ex-
pansion of Medicaid under the ACA, but insurance instabil-
ity, access to health care and rising costs are issues that law-
makers and doctors say need to be addressed. At the national
level, repeal attempts have failed repeatedly, though a new
attempt, the Graham-Cassidy Bill, was introduced earlier this
month in the Senate. President Trump has vowed to stand
back and let the health care system fail with the support of
many Republican politicians.
HEALTH CARE FOR ALL OF OREGON
Oregon state Sen. James Manning was a chief sponsor of
Senate Bill 1046, which would provide comprehensive health
care coverage to all individuals residing or working in Or-
egon. The bill would repeal the state’s health insurance ex-
change, according to the bill’s summary.
The bill was in committee when the Oregon Legislative
session ended in July, but Manning says there are a number
reasons the bill needs to move forward. He says many Orego-
nians who are uninsured continue to use the emergency room
as a primary care facility.
“[It’s] a good bill for us to move forward on, we can cer-
tainly make it better, but we have to make a move on it be-
cause the uncertainty of what’s going on in Washington D.C.
has me really concerned,” Manning says.
Manning lived in Australia for three years and says he used
the universal health care system there, which he says focuses
on preventative care, and he never saw any excess wait times.
He says the model showed that they care for people and
that everybody having access to quality health care was really
important. “That really convinced me that this is something
we are lacking here in America.”
SB 1046 was also supported by Health Care for All Or-
egon, a coalition of 120 organizations supporting statewide
universal health care. “Our plan would be comprehensive
health care probably as good or better than what Medicaid
people get now, and it would cover eyes, ears, mental condi-
tions,” HCAO Eugene chapter president Lou Sinniger says.
“It would cover you from head to toe.”
Sinniger says it’s difficult to talk about universal health
care because “people have been brainwashed over the last 60
to 70 years that health insurance means health care, but health
insurance does not mean health care.” He says he frequently
meets people who can’t afford to use their health insurance.
“We have a plan in place that we’re taking along the way
to get to a ballot measure either referred by the legislators or
petitioned for by us by 2020, and it would be full coverage,
privately delivered, publicly funded health care for every-
body,” Sinniger says.
HCAO meets the first Tuesday of every month at the First
United Methodist Church in Eugene.
At the Eugene chapter meeting Shirley Kingsbury, a re-
tired nurse, says she supports universal health care. She’s 88
going on 89 and, throughout her career, treated people who
couldn’t afford to see a doctor. “A healthy and happy com-
munity is one that has health care for everyone — not putting
people into boxes of those who can afford to pay or those who
come from some other place or are critically ill or would cost
more to care for them than for others,” Kingsbury says.
Although Kingsbury gave up her nursing license at age
80, she continues to spend her time caring for people. She’s
a parish nurse at her church and helps people find health care
resources and coordinates health care education. Growing up
in Bend during the depression, Kingsbury says she and her
siblings received quality health care from their family doctor,
who delivered Kingsbury’s sister and removed Kingsbury’s
tonsils — despite her father only being able to pay a dollar
or two.
A universal system isn’t a radical idea or a foreign con-
cept in the U.S.; the federal government oversees Medicare,
Medicaid and the Veterans Health Administration. But the
separately run systems need improvements.
Marc Shapiro is also a member of the group and is a
Medicare recipient. He supports a universal system and says
Medicare doesn’t cover dental or eye checkups.
“Medicare Part D is a disaster. There are no cost con-
trols,” he says. Shapiro is 75 and has been living with lung
cancer for the past 10 years. “The drugs that keep me alive
cost $6,000 a month,” he says.
In the past 10 years, he says, he hasn’t ever used the same
Part D plan. “It is so complicated that many seniors cannot
figure out what their best deal is, and so they just stay in the
same plan, which invariably costs them more with increased
deductibles and co-pays each year,” Shapiro writes in an
email. “It’s a mess and another windfall for the insurance
companies.”
Shapiro also supports health care for all on behalf of par-
ents who have to choose between getting coverage for them-
selves and their children. He tells the story of a woman who
was in a car accident, but couldn’t afford coverage under the
ACA. She suffered serious injuries, he says. “What happens
to a kid if a parent gets sick?”
Peter Mahr is a physician and president of the Portland
chapter of Physicians for a National Health Program. He
cites a recent Kaiser Family Foundation poll, noting that
support for a single-payer system rose above 50 percent,
which is the highest the number has been since the founda-
tion began keeping track in 1998.
Mahr says people don’t realize that they’re currently
paying for universal health care and not getting it. “They’re
paying their premiums, paying your out of pocket costs and
you’re also paying taxes — four or five percent goes into
Medicare and Medicaid.”
Going to a universal system would not involve insurance
companies, Mahr says. “One-third of Americans do not
seek health care because of costs,” he explains. “The type
of insurance we’re spending money on oftentimes doesn’t
give you very comprehensive coverage, number two its ex-
pensive, and number three you don’t have your choice of
hospital.”
HEALTH CARE DISCRIMINATION
Rachael Phipps with the White Bird Clinic works on the
billing side of the Oregon Health Care plan and with both
insured and uninsured people. She says OHP’s restrictions
prevent people from getting the care they need. White Bird
is a nonprofit medical clinic, which prioritizes those who are
unserved, underinsured, disabled or homeless.
“Public insurance is very frustrating to deal with. A lot of
services are not covered,” Phipps says.
Patients struggle to pay for medicines and to get proce-
dures performed, she notes. “Procedures like getting a blood
glucose test, pregnancy test, a pap, or an impacted ear drum
treated — those kinds of things are usually not covered with-
out some kind of authorization.” Phipps says there’s also a
limit to the frequency of times per year they can be provided.
While Mahr says Medicaid expansion has helped many
people, he also argues that the system creates a bias.
“If you create a system where doctors get paid a certain
amount for people who have private insurance through their
job — let’s say for an office visit they get reimbursed $250
from the private insurance companies, $180 from Medicare
for that same exact visit, and then they get paid $75 from
that same visit from OHP,” he says. “Then you have a situ-
ation where they are biased in the system and people are
discriminated against.”
Mahr says such bias would be removed if we went to a
universal system where everyone could be seen regardless
of their income or type of health insurance.
Timothy Burns says his family was insured, but because
of the expense of his heart condition, they declared bank-
ruptcy. “Even though we had really good insurance, it still
wasn’t enough to cover all of the expenses,” he says. “So
because of that my parents had to file for bankruptcy and
get rid of their condo that they had, and move up to Oregon
where they had no work or anything, but they wanted to be
close to Doernbecher Children’s Hospital.”
eugeneweekly.com • September 21, 2017
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