{"id":2796,"date":"2020-02-26T14:50:19","date_gmt":"2020-02-26T19:50:19","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=2796"},"modified":"2020-02-27T12:06:47","modified_gmt":"2020-02-27T17:06:47","slug":"medicare-for-all-the-healthcare-our-nation-needs","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/02\/medicare-for-all-the-healthcare-our-nation-needs\/","title":{"rendered":"Medicare for All: The Healthcare Our Nation Needs"},"content":{"rendered":"
\"Frances<\/a>

Dr. Ue is a Chief Resident in Internal Medicine at Cambridge Health Alliance in MA.<\/p><\/div>\n

Over a month into the new year and feels like the world around us is in grave peril. There are many reasons to lose hope: the climate crisis with Australia\u2019s wildfires, the evolving COVID-19<\/a>\u00a0epidemic, the acquittal of the President\u2019s impeachment charges, and the list goes on. Combined with long hours, sick patients, and seemingly never-ending grey skies in Boston, it can feel challenging to find goodness in the world.<\/span><\/p>\n

In search of inspiration, I often turn to my colleagues at Cambridge Health Alliance<\/a>. One such colleague is Dr. Adam Gaffney<\/a>, a critical care doctor, public health researcher, activist, and president of Physicians for a National Health Program\u00a0(PNHP<\/a>). I had the pleasure of interviewing him for this blog.<\/span><\/p>\n

(Interview transcript edited for length)<\/strong><\/p>\n

Me: Tell us about yourself. How did you become involved in activist work?<\/i><\/strong><\/h3>\n

\"\"<\/a>Adam: Well I\u2019ve been pretty progressive politically for my whole adult life but, during residency, I began to be more active in PNHP<\/a>. It was a time when concern for inequality was rising, the aftermath of the great recession, occupy Wall Street, really a growing sense in the country that more and more people were being left behind and also clear that health care was a big part of that. I was fortunate enough to be able to join an organization that was on the front lines of speaking about the need for universal healthcare reform, and I\u2019ve been involved in that organization ever since.<\/span><\/p>\n

Me: In terms of feeling passionate about Medicare for All and PNHP, can you tell us a little bit about how you discovered this as your passion?<\/i><\/strong><\/h3>\n

Adam:\u00a0<\/span>The idea that <\/span>healthcare should be a right, and should be a social good, and not a commodity<\/strong>,<\/span> is an idea that I\u2019ve believed in for as long as I\u2019ve seriously thought about politics and how society should be structured. I think over t<\/span>he course of my medical training, I realized that this was an area where, fairly or unfairly, as a physician, I could have a much larger impact. I also had personal experiences in the course of medical training, that reinforced to me how essential it was to have a system that provided healthcare to everyone by their needs, not by their economic means<\/strong>.\u00a0<\/strong><\/p>\n

Me: What are the key arguments for Medicare for All and how would it work practically?<\/i><\/strong><\/h3>\n
\"\"<\/a>

Can we afford Medicare for All? Boston Globe, July 23, 2019.<\/a><\/p><\/div>\n

Adam:\u00a0<\/span>Medicare for All would be a different way of paying for healthcare in this country. Right now, we pay for healthcare in a few different ways. A lot of healthcare is still paid through the government, more than half and that\u2019s because we pay into taxes for things like Medicare for the elderly and Medicaid for low-income people. We also spend a lot of money on public employee healthcare benefits, and there is also the Veteran Affairs (VA), Department of Defense, and other federal, state, and local healthcare programs. Although we spend a lot of money on healthcare through the government, we also spend a lot through the private sector. Private insurance, co-pays, deductibles, out-of-pocket payments, also constitute a large amount of healthcare spending in the United States.\u00a0<\/span><\/p>\n

\n

We have this fragmented, multi-payer, partially privatized way of paying for healthcare and the price is that we\u2019ve left:<\/h2>\n