Medical Care

My long career in medicine has informed my position on health care

I have worked as a surgeon, a Director of Trauma Surgery and Director of Surgical Education as well as a Professor of Medical Ethics. Training medical students and surgical residents has been a large part of my career. 

I believe all people should be able to access medical care regardless of income or insurance status

During my practice, I never refused to care for a patient because of income or insurance.

As a doctor, i know We have a medical care access problem

I prefer to draw a distinction between health care and medical care. While health care can encompass a wide variety of actions people and communities take to stay healthy, medical care is largely concerned with care of persons with disease, injury or a dysfunction. There are many low cost ways to improve health. But all people will need medical care for an injury or illness at some point. In our current system, medical care is expensive, and so is medical insurance.

I support medicare for all

My position on how to ensure everyone can access medical care is simple: I advocate for Medicare for All. There are several reasons I support this solution:  

  • Medicare is cheaper than for profit insurance. Medicare spends about 4% of its budget on administrative functions. Most of the for profit insurance companies spend 10 to 30% of their budget on administrative functions. In addition, for profit insurance companies pay out about 12% of revenue to stockholders. Private insurance for Americans costs about $5.2 trillion dollars per year.  Medicare for all would cost about $4.2 trillion a year, saving our country a trillion dollars per year.

  • Over 27 million Americans do not have insurance. Many do not seek medical care until their condition is advanced and more difficult to treat. Providing medical care for all is estimated to prevent over 114,000 deaths every year! For comparison, About 100,000 American soldiers died annually in World War 2.

  • Medicare has a fairly clear policy about what conditions are covered. Meanwhile, there are over 6,000 different healthcare policies offered by private insurance companies. There is confusion and frequent complaints from both health care providers and patients about what an insurance policy will or will not pay for because there are so many different policies with different rules on what is covered.

  • When employees change jobs, they frequently need to change medical insurance, which can cause changes in which medical care providers they can see and which treatments are covered. This complicates their life, and can be a disaster if they are already ill.

  • Insurance companies have a profit motive, which focuses their mission on revenue, not necessarily on the best outcomes for patients.

  • Buying insurance for employees places American businesses at a disadvantage compared to other countries which already have universal insurance. This is especially difficult for startup businesses and small businesses. Medicare for all makes it easier start a new business.

  • Our current system of Medicaid is run by each state for those unable to afford medical insurance. Each state makes their own budget. Every time a person moves from state to state, they must apply for a different Medicaid program. Almost every state Medicaid system is underfunded, and the One Big Beautiful Bill which will kick in (cynically in 2027, after the midterm elections) by cutting one trillion dollars from Medicaid. The health of Missourians will undoubtedly get worse. About half of Missouri children use Medicaid at some time in their lives. About 40% of pregnant women will need it. Medicaid is used slightly more often in rural Missouri than in metropolitan areas. The Medicaid program should be eliminated in favor of Medicare.

I know changing our medical care system won’t be easy

There will of course be challenges in implementing Medicare for All: 

  • We will need the federal and state governments to cooperate to make it happen.

  • It will probably take 5 to 10 years to implement such a program. 

  • Although it will cost less than our private insurance based system does now, the turnover will require some starting costs to expand Medicare. 

  • Access to medical care in rural and poor areas will still need to be addressed.

There are actions we can take at the state level now to improve public health and medical care access for all missourians

Achieving medical coverage for all Americans would take action at the federal level, and it may take some time to reach that goal. But there are things we can do now to make medical care more accessible for Missourians by working at the state level in the Missouri State Legislature. I support funding a strong public health system in Missouri. I also support taking action to keep hospitals and clinics open and accessible to all Missourians regardless of whether they live in cities, suburbs, or rural areas. And as a medical educator, I want to make sure we have a strong education system in our state that continues to produce well educated doctors, nurses, and medical technicians who can work to keep Missourians healthy.