Abdul El-Sayed talks Medicare for All and COVID-19 during Public Policy discussion

Wednesday, March 25, 2020 - 7:03pm

Dr. Abdul El-Sayed spoke about his inspiration to make longterm impacts on global health throughout his life at Rackham Graduate School last February.

Dr. Abdul El-Sayed spoke about his inspiration to make longterm impacts on global health throughout his life at Rackham Graduate School last February. Buy this photo
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Political activist Dr. Abdul El-Sayed said the outbreak of coronavirus proves the need for Medicare for All in an online Ford School of Public Policy discussion on Wednesday.

Health care — particularly Medicare for All and how to pay for it — has been a major issue throughout the Democratic presidential primary. Now, the spread of coronavirus and growing concerns about how the nation’s hospitals will handle the strain have fueled calls for Medicare for All among some activists and politicians.

According to El-Sayed, one of the primary goals of passing Medicare for All is to prevent catastrophes like the COVID-19 pandemic from causing damage on a national level.

“Our responsibility is to articulate the future that is set in the past we wish we had,” El-Sayed said. “One where we had been able to address this, one where we could have been able to stop this.”

El-Sayed, an alum of the University of Michigan and former health director of Detroit, is a prominent proponent of universal health care, has discussed Medicare for All widely in various interviews, podcasts and in his upcoming book “Healing Politics: A Doctor’s Journey into the Heart of Our Political Epidemic.” He is a longtime proponent of the policy. During his 2018 gubernatorial campaign, he proposed MichiCare, single-payer health insurance covering all Michigan residents.

On Wednesday, El-Sayed outlined the ways in which Medicare for All would benefit Americans, pointing to the failure of the nation’s current health care system to adequately respond to the outbreak of coronavirus. 

“Whenever you have a public good, if you run the public good poorly, it’s poor,” El-Sayed said. ”If you defund the public good, it’s bad. I don’t want folks to fall for the trick of ‘Oh look, they’ve got a public system and look how bad it’s failing.’ Well, we’re two weeks away from seeing what the consequences of our system are, and it’s going to be awful. I wish we never had to see it, but we’re going to see a lot of these images.”

With respect to the COVID-19 pandemic, El-Sayed criticized the current health care system’s handling of the situation.

“Our current pandemic is substantially worse because there are 10 percent of people who are, in effect, locked out of health care,” El-Sayed said. “Coronavirus creates a very non-specific set of symptoms. You know how many other diseases cause a fever and a dry cough? Almost everything that people suffer from this time of year. So if you’re sitting there, and even if you have insurance but your health care is behind a deductible, you’re saying ‘Well look, alright, so I can get tests paid for but if I don’t have COVID, then I’m not going to get my care paid for and I’m going to have to pay for it. So maybe I just won’t.’”

El-Sayed also viewed the current pandemic and its implications for Medicare for All through a political lens, discussing the implications the COVID-19 virus may have on the passing of favorable legislation in the future.

“We’re talking about a mass trauma that we are all experiencing right now, and that’s terrible,” El-Sayed said. “But every time someone has to go bankrupt for their cancer care, every time someone who gets really sick can’t see a doctor — that’s a mini tragedy on its own. And even though it’s not collectively experienced, let’s not undersell the cost that that has on those individuals and the fact that it’s happening to 10 percent of our population or 42 percent of people who have cancer.”

El-Sayed emphasized the importance of preventative care over reactive care, stating the ways in which it would cut costs overall. 

“One of the most important aspects of Medicare for All is that it streamlines the incentive set to prevent disease, which reduces health care costs over the long-term,” El-Sayed said. “And because it’s the government, the only real intended outcome is, rather than making money off the system, to promote the well-being of the population.”

El-Sayed explained the way in which American insurance and medical systems currently work.

“One of these things we’ve seen in this system is this crazy amount of consolidation on either side,” he said. “The biggest hospital groups or the biggest payers are able to negotiate to consolidate the market around themselves, in effect creating local oligopolies or even monopolies.” 

El-Sayed further critiqued the American health care system’s current market structure. He explained the ways in which it does not display the traits of the free market championed by members of the American public and critics of a single-payer healthcare system. 

“The problem with American health care, and health care in general, is that you don’t actually know what you want,” El-Sayed said. “You have a deep information asymmetry. I walk in, and I know I’m sick and I know I want the sickness to go away, but I don’t know what I need to make the sickness go away.”

During this discussion, Rackham student Rebecca Copeland asked El-Sayed about the implementation of a sweeping policy like Medicare for All. 

“Something that I think a lot about when I think about Medicare for All is how a lot of the services and general operation of a program like this would be contracted out to private contractors because that’s how most of the (Affordable Care Act) implementation is happening,” Copeland said. “I was wondering what your thoughts were on that and how you see something like this being implemented.”

El-Sayed responded by explaining the infrastructure needed to create a Medicare for All system, noting that there could be variations from state to state.

“You look at Medicare as it stands, and it is actually operated through what is, in effect, the skeleton version of private health insurance companies,” El-Sayed said. “Some of that infrastructure could be brought in and done that way. I also think that it would be really interesting to implement this through the states and allow the states to come up with a way themselves, each state potentially doing it differently to build up their system. That way, they can be working on the ground locally with local health insurance infrastructure as it stands.”

Discussion coordinator and Rackham student Heather Kiningham expressed gratitude for El-Sayed’s participation with students.

“We don’t get enough speakers or conversations at the Ford School that hear different progressive voices and that’s something that I think is desperately needed,” Kiningham said. “I think a lot of students have a lot of different feelings that lean toward progressive ideas and this school doesn’t necessarily echo that all the time.”

Daily Contributor Kara Warnke can be reached at kjvarnka@umich.edu.