At a recent gathering, I had on my “Medicare-For-All” (MFA) button and I was asked whether I thought it would ever pass. I found myself answering that I felt that the problems with our health care “non-system” were so deep that a fundamental change in reimbursement such as MFA was inevitable but that I doubted that I would live to see it. This got me thinking about why I thought this.

Our society reacts pretty well to crises but not to ongoing problems regardless of their severity. It is like an alcoholic or drug addict needing to reach “rock bottom” before accepting the needed but very painful therapy and its associated changes. What is “rock bottom” for our health care? We are seeing women die because they are denied needed obstetrical care. We are seeing primary care fail because of inadequate reimbursement and paperwork overload. We are seeing hospitals close because the profits have been sucked out by for-profit companies such as private equity (see the recent and ongoing Steward hospital crisis). Our neglect of public health, even in the face of the worst pandemic in a century leaves us unprepared for the next one. We, as a society, and our leaders shake our heads, complain and move on. Why are we not seeing this as “rock bottom” and what more is required?

As a society, we think about health care mostly when it directly affects us or our family. (Of course, it is then too late to seek changes so we deal as best we can with the flawed system we have and go on with our lives.) Those in power are protected from the worst of this situation even when it affects them. Our legislators have excellent health insurance and the power to ensure this forever. The pharmaceutical companies, the health insurance companies, the for-profit companies and even the large teaching hospital chains are happy with their ability to keep and enlarge their slice of an ever-growing financial pie. Even our state medical society leaders are beholden to large insurance companies! In the absence of any planning, these powers can stay in control. Do we need to wait for the moneyed interests to experience some sort of crisis and share our pain?

When will we decide, once and for all, that health care is not only a right but must take precedence over profit? Medicare-For-All, as embodied in legislation proposed in our state, would create a trust fund which would plan for the future and would rationalize reimbursements while saving money. Our legislators, especially the speaker of the Massachusetts House, have bottled up this legislation in committee for 25-plus years. We need to pressure our legislators to support MFA legislation. Change is scary and uncomfortable but, without it, the future of health care is bleak.

Dr. Christopher Flory lives in Williamsburg.