Finding a Solution to Medical Coverage

Story By: Chriss Swaney

When it comes to health care, no one can deny that costs are skyrocketing and coverage for many consumers remains out of reach.

But Samuel Arce, a New York physician and board chairman of the National Hispanic Medical Association, says the U.S. may want to emulate Cuba’s health system, where all care is government-run.

Arce, who has more than 30 years as a physician in family and internal medicine, said the Cuban government operates a national health system and assumes fiscal and administrative responsibility for health care of all its citizens.

“However, if you do not receive the care or treatment you desire in Cuba, there are no private health facility alternatives like here in the U.S.,” said Arce, a graduate of the Universidad Central del Caribe in Puerto Rico and a member of the governing board of the American Medical Society.

Still, Arce argues that access to quality health care and medical insurance, especially for the Hispanic community, is critical. He points out that more than a fourth of all Hispanics have no health care insurance, although they make up 15 percent of the U.S. population. That number is expected to double to 29 percent by 2050.

“We are seeing that more and more Hispanics are not getting the right access to health care and therefore and not getting the proper care for chronic health care problems on time,’’ Arce said. “Health care reform is necessary.”

While the health care coverage battle is becoming more and more politicized, Arce believes the U.S. needs a system that insures everyone equally. “We need a system that provides the population with a base plan that they can augment through time,’’ he said.

Because health care costs continue to rise at a rapid pace, and many of the deductibles have become outrageous, Arce says that people with insurance today are frustrated by the high premiums. They often can’t afford the deductibles.

“Right now the system only works if young people get involved and the young are asking the ultimate question: ‘Why should we pay into a system we do not need?’ Arce said.

At present, the proposed changes to the Affordable Care Act (or“Obamacare”) are marginal and include the elimination of the policy that all Americans must obtain coverage or pay a tax penalty. Businesses with 50 or more employees are required to provide insurance.

The American Health Care Act, passed by the House of Representatives in early May, also would replace income-based subsidies with refundable tax credits based on age and income; charge individuals a 30 percent surcharge if they buy a plan after allowing their coverage to lapse; and phase out the current law’s more generous Medicaid funding over time.

But Arce explains that efforts to restructure the Medicaid program by shifting from an entitlement-based program to one based on per-capita allocation will have the effect of making significant reductions in a program that provides care for the most vulnerable in the population.

And some of those most vulnerable consumers come from the Hispanic community, where diabetes and obesity are rampant. Because Hispanics have a propensity for being overweight, that condition also puts them at risk for other health issues, according to Arce.

Arce also explains that part of the health care challenge is tied to the cost of medical education in the U.S. Newly minted primary care physicians end up with more than $300,000 in medical school debt following graduation.

“We need to make medical education more affordable so we can increase the number of quality physicians,’’ he said. A recent medical survey of 1,900 newly graduated medical doctors revealed that 27 percent of them plan to close their practice within two years due to the high cost of malpractice insurance.

Arce points out that tort reform is needed to cap the amount people can sue for. “The overhead of running a primary physician practice is also increasing,’’ he said.

But Arce is quick to point out that the immigration issue is not part of the medical coverage problem.

“Most undocumented immigrants do not seek care unless they pay for it themselves because they fear deportation if they go to a hospital emergency room,’’ he said. “We will also get better health care if we look and sound like the people we see. I really want to encourage more young Hispanics to seek careers in the medical health profession. We can then truly make a bigger difference.’’