Opinion: Memorialize those we lost to COVID. Pass the NY Health Act Now.
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Dr. Duncan Maru is a physician who lives in Jackson Heights. Photo Courtesy of Maru
By Duncan Maru
Our state is moving toward opening this summer, giving all of us a breath of life during this terrible pandemic. May we all take individual and collective moments to memorialize the more than 50,000 New Yorkers lost. To truly honor our neighbors who died of COVID-19, I would ask we all take one simple action: call or write to our state senators and assembly members and demand passage of the NY Health Act. The NY Health Act, or a state level proposal similar to Medicare for All, is a legislative reckoning for the fundamental failures of our healthcare system to protect us against COVID-19.
Let us never forget the humanitarian crisis we faced last spring. During the COVID-19 surge, I cared for patients at Elmhurst Hospital. Sons and daughters who asked their parents, married for decades, to sleep on couches to self-isolate. And then one would get sick and come to the hospital to die, alone. They expressed the unimaginable feeling of guilt that on the one hand, they should have separated their family in their tiny apartment sooner; on the other hand, had they known their parent would die anyways, would not have separated their parents at all, and let them die together at home.
People dying alone in the hospital was one of the many traumatic aspects of this crisis. My smartphone was my nonstop primary tool, for video calls with families that connected them to their loved ones, to help make decisions, and be with them in their dying moments. After some time, we were able to get family members onto the unit. For a tearful bedside moment with a patient who died with his wife of fifty-plus years, I felt like medicine was medicine again and the essential, painful rituals of love and life and death adhered. But then I looked at the wife in all her PPE, I remembered her husband should not have died in the first place, and how deeply alone his wife was, standing outside his room after he passed, asking what to do next.
Let us remember the root causes here. Many of my COVID-19 patients lacked health insurance or access to primary care. For years prior to the pandemic, they have been denied care necessary to protect them from conditions that put them at greater risk.
Patients and families I have cared for teach me about my own complicity in a system that benefits people that look like me and physicians like me at the expense of everyone else. Private insurance enriches physicians and executives in the private hospital systems at the expense of Black, brown, and poor folks.
To honor patients who have died, traumatized, or left destitute because they have been denied healthcare, I realized I had to engage in the struggle for guaranteed, universal healthcare. While I had always supported universal healthcare initiatives, I had thought incremental expansion would be less disruptive and ultimately succeed. Governor Romney’s healthcare plan in my native Massachusetts, which became Obamacare, seemed pragmatic. Medicare for all seemed politically infeasible.
COVID-19 proved that our healthcare system is beyond reform. Our system has fundamentally failed us. Rather than proving resilience in the face of a pandemic, it broke even further. Because health insurance is tied to employment, over 300,000 New Yorkers were added to the one million uninsured pre-pandemic. If New York were itself a country, we would rank at around 15th out of approximately 200 countries in the global COVID-19 death count.
What does the NY Health Act guarantee for my patients? It guarantees that my patients do not have to go bankrupt to become eligible for long-term care under medicare. It guarantees that my patients who are undocumented receive the care they need and deserve. It guarantees that my patients can get the homecare they need instead of being hospitalized. It guarantees that nobody with diabetes should lose their kidneys or their feet because they cannot afford co-pays for insulin. It guarantees that clinicians like myself can spend our time working with patients and families. It guarantees that if my patient wants to change jobs, go back to school, or shift industries, they can focus on their careers, not worry about losing health insurance.
Shouldn’t Medicare for all be taken on by the federal government? Medicare for all nationally is unlikely to happen anytime soon. As with Romneycare’s successes in expanded coverage in Massachusetts ultimately becoming Obamacare, state-led initiatives often lead our country. We do not have to wait for the federal government to take care of our state. And, ultimately, when we prove that Medicare for all improves quality, reigns in costs, prevents death, and reduces inequities, the nation will follow suit. That’s what happened in Canada in 1962, when Saskatchewan Province initiated single payer; and the country followed. Canada as a country has had less than half as many COVID-19 deaths as New York State alone.
Who will pay for the NY Health Act? The private insurance system will be eliminated, and with that the egregious salaries of their top executives and enormous amounts of bureaucratic waste. The NY Health Act has clauses to protect workers whose jobs will have to be transitioned. It is vital that workers in the insurance industry make a just transition into new roles within our transformed healthcare system.
Will providers suffer? Our private hospital systems, under the Greater New York Hospital Association, are opposed to the NY Health Act. There is a tiny sliver of executives and physicians who profit from the gross inequities will see their paychecks reduced. But the vast majority of providers will not see changes in their compensation but rather in the meaning, fulfillment, and quality of the care they can provide. In fact, I believe Medicare for All will help my profession to re-discover our calling, enable us to focus on healing and not haggling with insurance companies.
Please join me in demanding our legislators to pass the New York Health Act. Time is short. This legislative session ends June 10th. Ensuring the right to healthcare is an essential part of how, as a state, we recover from COVID, we heal our communities, and we memorialize those we lost.
Dr. Duncan Maru is a physician who lives in Jackson Heights; his views do not represent those of the institutions with which he is affiliated.
