I share primary care physician Dr. Douglas Douville’s concern about the 2020 election, but I disagree with his opinion that support for Medicare for All will lead to rejection of Democratic candidates at the polls.

He states that 70% of people are happy with their health insurance coverage. I believe 70% of people are happy to have health coverage, though it is chosen by their employers, not by them.

A Kaiser Family Foundation study found that households with incomes of $50,000 for a family of four were spending on average 14% of their income on premiums, deductibles and medical bills. That number that jumps to 18.5% if someone in the family suffers a serious illness. Is it any wonder that most GoFundMe appeals are for medical bills and pharmaceuticals?

Douville raises the alarm about “uncertain government plan.” England’s socialized medicine is very much like our Veterans Affairs system. The government owns the medical facilities and hires the medical and nursing personnel. All the bills go to one agency.

Canada’s Medicare is social insurance, very much like our Medicare for the elderly and disabled. Facilities and physicians operate independently and all the bills go to one agency. Allowing the government to request bids on pharmaceuticals, as Veterans Affairs does, prevents price gouging and insures adequate supply.

Douville makes reference to long waits for orthopedic procedures in other countries. What he fails to mention is that in the U.S. we have an abundance of orthopedic surgeons and other specialists but a critical shortage of primary care physicians. Other countries have a more balanced supply of primary care physicians because specialists do not win the jackpot on compensation.

In an article from the journal Health Affairs, Sept. 8, 2011: “The public fees paid to doctors for hip replacement ranged from a low of $652 in Canada to a high of $1,634 in the United States. The difference in fees to doctors paid by private insurers was substantially higher still: fees paid to U.S. physicians were double that charged in other countries — for example, $1,340 in France versus $3,996 in the United States ... The study underscores that the biggest disparities in U.S. pay to physicians are on the private side. Fees paid by large private national insurers in six markets in the United States averaged about one-third above Medicare rates for primary care and 50 percent higher than Medicare for hip replacements. Private insurers have been less successful in negotiating fees with orthopedic surgeons than with generalist physicians, says the study ... The gap in salaries between the primary care physicians and orthopedists was also significantly higher in the United States, where primary care physicians earned just 42 percent as much as orthopedic surgeons did. In contrast, primary care physicians in Canada, France, and Germany earned about 60 percent as much as orthopedic surgeons did there.”

The Health Care Cost Institute recently analyzed large commercial health insurance claims for 34 million Americans and found that a common, routine metabolic blood panel can cost anywhere between $11 and $952. These are real, negotiated prices, paid by health insurance companies to laboratories. And we are worried about disruption to the health insurance industry?

The administrative burden on individual physicians for billing is estimated to be $100,000 per physician. Yes, Dr. Douville, a good number of the 499,300 employees who work for the health insurance industry, that you cite, will need to change jobs, as do 5.6 million Americans do every year. The $1 billion spent on health insurance CEO compensation will stop.

Yes, Medicare for All is health care reform and we can’t afford to keep kicking this can down the road for another 25 years.

Christine B. Helfrich

Christine B. Helfrich, Millcreek, worked in and around the health care industry in Utah for 45 years.