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Testimony in support of Medicare for All

Damian Lima, Providence Resident

In 2018 my husband caught strep. He had just switched jobs and the waiting period for his new insurance was three months. He had a fever of almost 102 degrees and was delirious in the middle of the night. At this time, we were not married yet, and so he was without insurance. He refused to go to the emergency room. The next day we tried to look for a place that would see him and finally found a minute clinic. Fortunately, we had the resources to pay for the $200 cost of the visit and the price of the medication. We were fortunate that we could afford this but many in our state can't and resort to crowdfunding for care. I can't think of a bigger systemic failure than relying on charity to provide a basic service that can be relatively easy to make a reality in a small state like ours. Instead, we have an insurance company whose primary goal is to make a profit. The central role of corporations to make a profit for shareholders and preserve the insured's health comes second. This means that Doctors and healthcare systems have to spend more time caring for paperwork than people's health. Our current healthcare system prioritizes private enterprise over community well-being and preserving life. This framing reduces health to a political-economic discourse rather than a lived reality that causes suffering and death.

I am advocating for a change that would allow us to create an actual healthcare system. Our current "system" is a mix-and-match Adhoc patchwork that lets people die by falling through the cracks. It comprises "many actors and organizations working independently and with little coordination... keeps haphazardly evolving shaped more by economic incentives and opportunities than by a central or logical design" (Knickman 2015). We need to get the middlemen out.

The changes that this law is advancing are not an experiment. Sweeden has a political system similar to that of the US. In contrast with the United States, healthcare is overwhelmingly publicly funded, obtaining only 5 to 18% of its revenue from patient payments (Qixin et al. 2017). Thus it is not surprising that the US spends almost double on healthcare than Sweden to achieve similar results. This amount comprises nearly 1/6 of the GDP compared to 1/10 of GDP in Sweden (Qixin et al., 2017). Advancing this legislation will set us up for an actual health system that prioritizes the health of Rhode islanders.

Marginalized populations are often economically disenfranchised and prohibited from accessing healthcare because of prohibitive costs. It is essential to note that health inequities are almost nonexistent in Sweden (Glenngard 2017). In contrast, in the United States, health disparities are a growing concern as the number of vulnerable populations grows alongside chronic illness prevalence and income disparities (Knickman 2015).

A single-pay healthcare system facilitates the integration of public health priorities and healthcare delivery/administration. It reduces costs by establishing appropriate priorities and directing efforts toward cost-effective preventive measures (Knickman 2015). Integrated efforts help not only collaboration but also the avoidance of competing priorities (denying care that becomes more expensive in the future) that might compromise the pursuance of health. Single-payer healthcare and prevention services systems increase access and equity and reduce costs.

In conclusion, single-payer healthcare can aid the integration of our fractured health system, reduce costs, decrease health inequities, and increase the quality of care. Our goal needs to be to make people healthy sustainably, not make money at any cost.

Knickman, James R., and Anthony R. Kovner (Eds.). 2015. Health Care Delivery in the

United States. 11th ed. New York: Springer Publishing.

Ahgren, Bengt. 2014. "The Path to Integrated Healthcare: Various Scandinavian Strategies." International Journal of Care Coordination 17 (1/2): 52–58.

Glenngård, Anna Häger. 2017. "The Swedish Health Care System." Research Institute of Industrial Economics.

Qixin, Wang, Menghui Li, Hualong Zu, Mingyi Gao, Chenghua Cao, and Li Charlie Xia. 2013. "A Quantitative Evaluation of Health Care System in US, China, and Sweden." HealthMED 4: 1064–74.

Wettergren, Björn, Margareta Blennow, Anders Hjern, Olle Söder, and Jonas F. Ludvigsson. 2016. “Child Health Systems in Sweden.” The Journal of Pediatrics 177 (October): S187–202.

WHO. "Countries." n.d. World Health Organization Statistics. Accessed December 1, 2019.

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