POINT OF VIEW | Single-payer offers inequality solution
Studies have shown that unless care is free at the point of service, it will discriminate against lowincome patients and prevent them from receiving the care they need.
In “An opportunity to improve health care” (Point of View, Sept. 30), Dr. Ross VanHooser calls the Graham-Cassidy repeal of the Affordable Care Act an “opportunity to radically improve the health care of our population.” To clarify: This bill would take away health insurance from hundreds of thousands of Oklahomans and remove protections for those with pre-existing conditions (among other, equally terrible things). Nevertheless, the opportunity that this bill would create, he argues, is one of technological potential.
VanHooser’s argument that telemedicine is the key to improving health care in Oklahoma makes sense on the surface — increasing access to health care through technology can help people connect with providers more easily. However, his claims that technology holds the key to health care reform in Oklahoma ignore the root causes of health inequality, and his argument that a repeal of the Affordable Care Act would provide a benefit to Oklahomans is a dangerous misrepresentation of the realities of ACA repeal.
For Oklahoma to make real progress in creating an equitable and just health care system, we need universal, singlepayer coverage.
By any measure, the United States has a problem with health inequality. Men in the highest socioeconomic class live, on average, about 15 years longer than men in the lowest class (this gap is about 10 years for women). Additionally, low-income Americans are more likely to have a disability and suffer from chronic diseases like diabetes than wealthy Americans. These problems exist on a national level, but they are exacerbated in Oklahoma, which has some of the worst health outcomes in the country.
This inequality exists for several reasons — social determinants of health, such as lack of access to healthy food or substandard housing, create conditions that promote disease. The greater prevalence of disease in low-income communities is worsened by the fact that high health care costs prevent people from receiving the treatment they need. When patients do get treatment, they often end up straddled with overwhelming medical debt.
Telemedicine can do a lot of good, particularly in rural areas, but it doesn’t address any of the root causes of health inequality. Lowering health care costs isn’t enough; studies have shown that unless care is free at the point of service, it will discriminate against low-income patients and prevent them from receiving the care they need.
A comprehensive, single-payer system is one way we could begin to tackle the problem of health inequality that plagues Oklahoma and the rest of the country. While single-payer health care isn’t an overnight solution to health injustice, it is a feasible and hugely beneficial first step. We shouldn’t be content with a system that leaves low-income and middle-class Americans drowning in medical debt and unable to get the care they need to live. With single-payer health care, we can target the causes of this inequality and create a system that works for all Oklahomans, not just the wealthiest.