Imagine a fair, equitable, quality health care system for all Americans.
That’s what Dr. Francis Collins, outgoing director of the National Institutes of Health, recently said he’d wish for first if he could have one thing. And it is a vision that many people believe could be realized with the passage of “Medicare for All.”
Motivated by a desire to fix a system they say consistently fails to address health disparities and contributes to poor health outcomes, members of the Yale School of Medicine community campaigned this year in favor of a local resolution supporting the passage of Medicare for All. Their work highlights the growing activism of many in the medical field who see involvement in the public sphere as a moral imperative inseparable from their health care roles.
Annie Harper, PhD, a research scientist at the Yale Program for Recovery & Community Health, is among those who got involved. She studies the connection between money and health. She said Medicare for All, by eliminating the cost of medical care, and in particular the medical debt that millions incur, would improve health outcomes for millions of people and save the U.S. money.
Harper explained that although we often focus our policy discussions on income inequality, “there’s an even bigger factor influencing who is healthy and who is not: wealth inequality, a person’s savings and accumulated assets.” People who lack wealth are much more likely to incur “bad” or high-cost debt that in turn prevents them from building wealth.
Medical debt is one of the most common types of bad debt. Bad debt often leads individuals and families into a cascade of interrelated problems, including more debt, high stress, hunger and homelessness, and poor physical and mental health. Dr. Harper has conducted some of her research at Connecticut Mental Health Center (CMHC), the public psychiatry clinic in New Haven that is a longstanding collaboration between the Yale Department of Psychiatry and the Connecticut Department of Mental Health & Addiction Services. When CMHC clients first walk through the doors for mental health care, they often have debt, but no income or insurance.
By eliminating medical debt and making health care accessible, Medicare for All “would make a significant difference in the health outcomes of low-income people,” Dr. Harper said.
Tanvee Varma, a third-year student at Yale School of Medicine and member of the New Haven Medicare for All Coalition, said the United States is the only OECD country that lacks universal health coverage. As a result, uninsured Americans are either denied necessary care or accrue exorbitant medical bills. Furthermore, she noted, “Black patients are more likely than others to have past-due medical debt due to historical and ongoing structural racism.”
“The COVID-19 pandemic has only exacerbated this problem and laid bare the cracks in our current healthcare system,” Varma added. “The Medicare for All Act would guarantee health insurance to all Americans through a single-payer health insurance program.”
Varma played a leading role in the New Haven Medicare for All coalition, which was founded to pass a Medicare for All resolution in New Haven. The campaign is a part of a larger effort to pass Medicare for All resolutions in local municipalities across the country.
Along with other members of the YSM community, Varma and Harper worked hard to advocate for the local resolution. Varma testified before the Health and Human Services committee of the New Haven Board of Alders. She also wrote a letter to the editor in the New Haven Register, where she discussed some of her and her classmates’ experiences taking care of un- or under-insured patients.
Varma said she got involved in this work as one of the student leaders of the Students for a National Health Program (SNaHP) chapter at YSM. SNaHP is the student branch of Physicians for a National Health Program (PNHP), an advocacy organization that supports a universal, comprehensive single-payer national health insurance program. Through her work with SNaHP, she met local activists from Medicare for All Connecticut, a grassroots organization that advocates for a single-payer health program. She now serves on the Board of Directors for Medicare for All CT.
Dr. Harper also testified in support of the Medicare for All resolution, and she wrote an op-ed explaining her findings on the burden of medical debt in New Haven.
“There are so many ways that we can engage locally to make sure our research translates into positive action on the ground,” Dr. Harper said. “I believe it’s our responsibility as members of the New Haven community to do everything we can to support the needs of our city.”
On August 2nd, the New Haven Board of Alders voted unanimously to pass the resolution supporting Medicare for All across the United States.
According to Varma, supporting New Haven’s Medicare for All resolution is just one of many ways the YSM community is advocating for a more equitable and just health care system. Recently, students have pushed for eliminating stigmatizing language from USMLE Step 1 materials and have created resources for first-generation and low-income medical students nationally, to name a few examples. Varma and Harper plan to continue integrating health justice into their careers—for Varma, that means working for patients “both inside and outside of the hospital.”
“Advocating for Medicare for All in New Haven has been the most meaningful thing I’ve done during my time at YSM,” Varma added. “I’ve had the opportunity to translate what I learned about health policy during my first-year Professional Responsibility course into action by advocating for local change.”
“It was incredibly affirming to see people involved in direct care taking the time to write testimony,” Dr. Harper said. “The presence of others from the YSM community really encouraged me to get involved in a more public way.”