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How can we fix it?

How can we fix our dysfunctional, expensive, chaotic and unmanageable health care system?

Health care in America costs almost twice as much per person as in any other industrialized nation (totaling $3.6 trillion projected for 2018 and heading to $5.7 trillion by 2026). Twenty-eight million Americans, 3 million Californians and more than 53,000 people in Sonoma County are without health insurance.

As a physician now retired from a Santa Rosa practice, one of us (Nick Anton) saw the consequences of our failed system when patients showed up with preventable diseases because they had deferred care. Shocking national statistics confirm what I saw. The U.S. ranks in the bottom half of industrialized countries for preventable mortality, infant mortality and maternal mortality rates — all indicators of a nation’s health care quality.

For the first time in decades, life expectancy in the U.S. has fallen for two consecutive years, driven by an opioid crisis that stems from failures in health care and social support. U.S. life expectancy is four years less than in Japan or Switzerland and 1.5 years below the average of other industrialized countries.

The Portrait of Sonoma County showed a staggering 10-year gap in life expectancy between the top and bottom ranked census districts, including gaps of that magnitude for districts within Santa Rosa separated by only a few miles.

California’s success in reducing maternal mortality is a model of a state’s ability to effect positive change. Stanford University developed a statewide collaborative approach by first identifying the major medical problem (maternal hemorrhage). By giving obstetricians and gynecologists statewide, including four Sonoma County hospitals, equipment and information customized for use in a crisis, maternal mortality was cut by half over 10 years. The state’s rate is now one-third the national rate and continues to drop as other factors are addressed.

California has the opportunity to lead in health care policy with the Healthy California Act (SB 562) which was approved by the state Senate but is being held up in the Assembly. This act would provide universal health coverage for every California resident without premiums, deductibles or co-pays. Economists from the University of Massachusetts at Amherst performed a detailed economic analysis of SB 562, concluding that the $400 billion cost can be met with current government expenditures, broad-based new revenues, savings from reduced bureaucracy and negotiated purchases from pharmaceutical and medical device companies, hospitals, and doctors. Better yet, universal coverage yields a $37 billion annual bonus from avoided health care costs.

But that’s not reflected in the California Assembly’s report this week (“California panel rejects government-run health care,” March 14). Instead of the strong leadership needed to start down the well-marked path to affordable health care for all Californians, our limp lawmakers would rather noodle at the margins with some lower cost changes.

Please join us tonight at 7 p.m. at Congregation Shomrei Torah at 2600 Bennett Valley Road in Santa Rosa for a showing of “Fix It,” a lively film that shows how single-payer health care works elsewhere, including in Canada with a population comparable to California’s. “Fix It” was commissioned and financed by the owner of a large Pennsylvania manufacturing company to educate the public and business owners about health policy options. Admission is free. The film will be followed by a panel discussion featuring experts in health care policy.

As Warren Buffet has said, “Medical costs are the tapeworm of American economic competitiveness.” Single-payer health care is the proven remedy.

Nick Anton is a retired Santa Rosa internist. Asher Sheppard is a biophysicist and social justice advocate in Santa Rosa.

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