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How To Get Health Insurance in Other Countries: Be Born

October 25, 2023

Summary: Dr. Danielle Ofri, an insightful commentator on the practice of medicine, overlooked annual re-enrollment for her health insurance at work due to an email glitch. So she was automatically bumped to “basic coverage”, excluding her husband and kids. Panic ensued. Other wealthy nations avoid this inefficient and upending bureaucratic hoop. So would single payer.

It Shouldn’t Be This Easy to Lose Your Health Insurance
New York Times
October 25, 2023
By Danielle Ofri (NYC primary care doctor & thoughtful author on the practice of medicine)

A few days before New Year’s Eve, an unfamiliar health insurance card for me arrived in the mail. I assumed there must have been an error and called the human resources department of the medical center where I’m employed as a doctor.

“No,” the representative replied, “it’s not a mistake. You didn’t enroll this year, so you automatically got put on the basic plan.”

“That’s … that’s impossible,” I stammered. “I’ve always signed up my family for the same health plan.”

“I’m sorry, Dr. Ofri,” the representative said, rechecking her records, “but you didn’t enroll this year.”

Could that be? Could I have somehow forgotten? Or missed the notification? “But don’t worry,” she said. “We’ve put you on the basic plan.”

“OK,” I said, starting to relax and thinking out loud. “I guess my kids will get to meet some new doctors.”

But the representative did not match my tone. “I’m sorry, but the basic plan is just for the employee,” she said, “not your family.”

[Dr. Ofri recounts the emotional and bureaucratic turmoil this created, and ends by stating …)

Of course, none of this would be necessary if the only requirement for getting insurance was – as it is in most countries – being born. Instead, Americans are forced to live within an illogical patchwork of plans and regulations that so easily allows people to fall through the cracks.

Comment by: Don McCanne, et al.

To no surprise, this New York Times article provoked a large number of reader responses, still pouring in as this was composed. A handful of selected excerpts from their responses:

“As the good doctor has said, ‘There’s gotta be a better way.’”

“I just wish that America had even one political party that believed in Universal Healthcare. Not ’near universal.’ Not ‘a path to universal.’ Not ‘affordable.’ But actual, everyone-is-covered, universal healthcare.”

“Most Europeans I know do not have this problem. Their healthcare systems are focused on healthcare and not the care of and feeding of corporations and esp corporate execs and shareholders.”

“Even better: a single-payer system like the one in Canada. You don’t have to sign up.”

“The people of this country clearly want the national health plan like other developed countries enjoy.”

“Time to evict private/for-profit players from the health care system and turn to universal, single payer.”

“It would be far better to have a single payer or national coverage.”

“That Congress, for many decades, has not passed single payer/universal health care legislation is proof of the insanity & or greed in our country.”

“A problem easily solved. Medicare for All. Original Medicare. Not Medicare Advantage.”

“Every comment I read here appeals for single payer health care.” (Not quite, but impressive. – DMc)

“The AMA confirmed Thursday that it is leaving the Partnership for America’s Health Care Future, an industry group that opposes Medicare for All. The decision does not signal a policy change.” (I’m a special lifetime member of AMA, and I strongly support Medicare for All. – DMc)

“The only genuine workable system is single-payer Improved Medicare for All. It’s time to start listening.”

“We’re at a point where a little over 60 percent of Americans support single-payer healthcare for all.”

“Medicare for All”

“Yet another problem universal health care would solve.”

“Or maybe we just need universal health insurance?!”

“We need a national health care system.”

“It’s high time to have Medicare for All.”

“Medicare for All is the only sensible, fair and equitable way to distribute the financial burden of health care in this country.”

“Healthcare should be a right for all of our citizens.”

“A single payer system is far simpler, less costly, has better outcomes.”

“We need Medicare for All.”

“Agree that it’s time for Medicare for All.”

“Say it, Dr. Ofri – Medicare for All! We’re finally hearing about the widespread egregious problems with U.S. healthcare, for which the only realistic solution is Medicare for All.” (finally?! for decades! – DMc)

“I’m surprised that no one has pointed out that doctors don’t want a single payer system.” (I suppose that it is time for those of us at Physicians for a National Health Program to turn up the volume again! – DMc)

From Don McCanne: “An improved version of Medicare for All as a SINGLE PAYER, takes care of the problem for everyone, forever!”

The point is, support for a single payer, Medicare for All program in this nation is very strong, and we are long overdue for our political leaders to move forward with bringing health care justice to all of us by enacting and implementing such a system.

About the Commentator, Jim Kahn

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Jim (James G.) Kahn, MD, MPH (editor) is an Emeritus Professor of Health Policy, Epidemiology, and Global Health at the University of California, San Francisco. His work focuses on the cost and effectiveness of prevention and treatment interventions in low and middle income countries, and on single payer economics in the U.S. He has studied, advocated, and educated on single payer since the 1994 campaign for Prop 186 in California, including two years as chair of Physicians for a National Health Program California.

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