Oregon's Universal Health Care task force, charged by our Legislature to design a statewide health care insurance plan, canceled its first meeting when COVID-19 spread across the state. But when the epidemic recedes and the task force reconvenes, this mission becomes critically important. What did we learn from our COVID-19 experience?
Humans are more alike than different. Sometimes we need a virus to remind us that, on the inside, we share the same mitochondria, the same respiratory systems and indeed the same hearts. When COVID-19 threatens our community, we can't claim immunity because of our voting record (or lack thereof), or firearms collection (or lack thereof), or our intelligence. All families look alike to a microorganism. And the health care needed to protect us is the same.
Deductibles kill. Deductibles delay health care, discourage treatment and erode family and community health. Even if COVID-19 testing is free, the average family with a $1,200 insurance deductible but only $400 in cash resources might avoid seeking health care altogether in hopes of escaping bankruptcy. Expenses for a COVID-19 hospitalization can exceed $20,000. Many of us with a suspicious cough believe our best financial bet is to ride out the disease at home and hope we recover quickly. But with a 3% mortality rate, COVID-19 is not a disease to face alone in your bedroom.
The free market isn't free. A health care system that encourages insurance and delivery systems to enhance solvency by seeking only the healthy and wealthy leaves many of us without health care. Sometimes, like now, we need a health care system that welcomes all patients, not just profitable ones.
We don't need different insurance for different families: One size does indeed fit all. Who among us knows if our policy will cover a disease so new it didn't have a name when we acquired it? Some "skinny insurance" benefits don't cover diseases we already know about.
The unique American convention of offering different benefits to different families is expensive, dangerous and too often disastrous to families who guess wrong.
For Oregonians dependent upon employer-sponsored insurance, lost employment means lost health care. When COVID-19 closes a small business, health care access disappears just when families need it most. Our convention of employer-sponsored insurance magnifies the devastating consequences of an epidemic that shuts down businesses.
Satchel Paige, baseball's famous philosopher, offers a final lesson: "Don't pray when it rains if you don't pray when the sun shines."
Oregon was unprepared for this health care emergency because we thought the sun would shine forever. But when rain came and brought an epidemic with it, fragmented and dysfunctional health care insurance made the consequences all the more heartbreaking. Saving money by clinging to bad insurance is expensive.
Bottom line: We're in this together. When our communities are healthier, we and our families are healthier. Even if our neighbors don't look like us, talk like us, or vote like us, we share the same air, the same oxygen, the same metabolism. Creating a health care system that cares for all of us, all the time, means a better state.
Dr. Samuel Metz of Portland serves on the Universal Health Care Task Force. He is a member of Oregon Physicians for a National Health Program and a founding member of Mad as Hell Doctors, both of which advocate universal health care.
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