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Members Respond: Stories of a Broken Healthcare System

By Tayyiaba Farooq, Jasmine Geonzon, and Chloe Walker

Refinancing your house. Forgoing graduate school. Falling into unemployment.

This is the reality of everyday Americans continually failed by the current health care system. Today, countless Americans struggle to pay for necessary health treatments and medications.

More than 30 million Americans are currently uninsured and an additional 44 million are underinsured, meaning in order to receive the care we need, many must pay exorbitant out-of-pocket costs and deductibles or go without care.[1] The result is a growing number of families unable to pay for their care without worry of spiraling into debt or poverty. Close to one-third of insured Americans skip recommended tests, treatments or follow-ups, cannot afford to fill prescriptions or forgo doctor’s appointments and specialist care when experiencing medical problems.[2]

Behind every statistic is a person — a mother, brother, child, friend, loved one — who needlessly suffers under our current for-profit health care system. Public Citizen members have shared their personal stories with us, adding to the millions of voices of individuals afflicted by the pitfalls of the current health care system.

But it doesn’t have to be this way. Medicare for All would provide guaranteed care to everyone living in the U.S. by eliminating the profit-making from the current system.

Consider the story of Amber, a Californian living with multiple sclerosis.

Due to her debilitating disease, she has become accustomed to insurance companies retracting her coverage time and time again. Amber has been paying egregiously high out-of-pocket costs for vital medication after being forced off her employer’s insurance. These overwhelming costs left her in danger of losing her house and the associated stress spun her health into further decline.

Amber is one of many Americans forced to make needlessly difficult decisions when it comes to their medical wellbeing. Spouses must decide between themselves who can receive care or medication at what times, with some couples going as far as filing for divorce in order to qualify for treatment or for disability benefits through Social Security. Parents consistently go without necessary care to ensure that their children are provided for.

Mother and health care advocate Rebecca Wood was forced to delay a necessary dental procedure in order to pay for her child’s health bill, leading to the spread of infection throughout her mouth and jaw. Due to the high cost of general anesthesia, Rebecca was forced to have all her teeth pulled, infection drained and parts of her jaw scraped all under only local anesthesia.  “I don’t know what the worst part is,” she said. “The excruciating pain I live with every day, how I worry whether I’m drooling when I smile, how eating is awkward and challenging or how I love jazz but will never play the trumpet again.”

Coverage in the U.S. today is considered a privilege and not a right, requiring individuals to check a series number of boxes in order to receive care. A great number of these factors lie outside of one’s personal control. For example: though no one should have to wait until they are in critical condition to receive treatment, the severity of a person’s illness often remains a significant factor in whether someone receives the care they need.

This was the case of Kathryn, a Public Citizen member from Michigan*, who was forced to watch her husband gradually lose renal function until insurance companies deemed his symptoms serious enough for a kidney replacement. Despite years of employment in the federal government, quality health care was not guaranteed as compensation for his life’s work.

In increasing number of Americans now look beyond their employer for health insurance. Since 1980, the number of individuals insured through employer-based programs dropped from 80% to just over 50%.[3] However, even these programs can be restricting with limitations on how much is covered. Ultimately, having health insurance is not enough to protect a person’s livelihood.

Medicare for All would close the existing gaps in coverage, regardless of factors that previously barred individuals from receiving care such as employment status, gender, disability, income, sexual orientation, immigration status or age. Recurrent fears regarding pre-existing conditions, lack of a stable income, and aging out of a parent’s insurance plan will all become concerns of the past. Americans will no longer have to worry about choosing their homes over their health or giving up essential medication in order to ensure that a loved one is able to receive care as well.

As a solid foundation for reform, Medicare already achieves universal coverage for seniors and highlights the potential for Medicare for All to do so for everyone in the country.

Mikki is a mother from New York with a child of complex medical needs. She is all too familiar with the rigid nature of America’s current health care system. As her daughter has preexisting conditions, expensive private insurance was never an option, and the family continuously relied on Medicaid for life-saving care. During a recent visit to the hospital after her daughter developed severe pneumonia, the doctors were relieved to learn she was on Medicaid.

“It has regulations that make saving her life an obligation,” the doctors said. “Private insurance has no such onus.”

The circumstances fortunately aligned for Mikki’s daughter to receive the necessary care and recover without significant repercussions for her or her family. Sadly, this is not always the case. Private insurers make profit-maximizing decisions that allow sick children to die. Under the provisions of Medicare for All, stories like Mikki’s would become the standard instead of the exception. This program would maximize health outcomes rather than profit, putting the patient ahead of corporate greed.

Medicare for All would also reduce the extreme stress caused by the unnecessary red tape and inflated costs associated with healthcare in America. Rather than worrying about paying for her medication, Amber could invest in the next chapter of her life. Instead of sacrificing her oral health, Rebecca could continue to play the trumpet. As opposed to watching his condition plummet, Kathryn and her husband could move over this hurdle in less time. Medicare for All would ensure that personal finances do not stand as a barrier to receiving quality care and remaining healthy.

*To protect anonymity, some of the names included here have been changed.

Do you have a healthcare story that demonstrates the urgency of Medicare for All? Click here to share your experience with us.