By Lori Kersey
The Charleston Gazette, April 25, 2013

DAWES, W.Va. -- The Affordable Care Act is an experiment that will fail, the head of an organization that advocates for a single-payer health system argued Thursday.

"People will not be able to afford the health insurance that they're being pushed to buy," Dr. Andrew Coates, president of Physicians for a National Health Program (PNHP), said during a visit to West Virginia on Thursday. "And when they do buy it, it won't be good enough to cover health-care calamity."

Under the ACA, health insurance premiums and deductibles will not be affordable, Coates argued.
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"I think it's a big experiment to drive people to [the health insurance] marketplace but the health insurance marketplace hasn't worked for years now and I don't see any evidence that's going to change," he said.

Coates, an assistant professor of medicine and psychiatry at Albany Medical College, practices at a community hospital in upstate New York. During a visit to the Charleston area Thursday, he spoke to the staff at the Cabin Creek Health Center in Dawes.

Later on Thursday, Coates spoke about the pros and cons of the Affordable Care Act at the University of Charleston, where he shared a platform with Perry Bryant, executive director of West Virginians for Affordable Health Care.

Coates' visit was sponsored in part by the West Virginia chapter of PNHP.

"People say [a single-payer system] can't work here," said Dr. James Binder of the West Virginia chapter. "That's not true."

Instead of the Affordable Care Act, which would potentially expand Medicaid to millions of low-income Americans, Coates is campaigning for expanded Medicare for all Americans. That would include an expansion of what Medicare covers. For instance, dental care should be covered, he said.

Research shows that this would actually help provide comprehensive care to everybody and also reduce costs, Coates said.

He argues that by eliminating private insurance and using a single-payer model, the United States could save more than $400 billion a year used for paperwork.

Private insurers, Coates said, do not contribute to the health-care system.

"It's really not a legitimate or justifiable way to make money," Coates said. "We're talking about human illness. Think of the morality."

The government is already raising and spending enough public money to cover everyone, Coates said.

"Health care is such a necessity of modern life and it's so unaffordable in many ways for working people," Coates said. "If everyone could not have to worry about their loved ones getting the care they deserve, it would be liberating for the whole country."

Coates said the single-payer system differs from socialized medicine because private physicians would care for patients.

The U.S. Department of Veterans Affairs, in which the federal government owns the hospitals and pays the medical staff, is a better example of socialized medicine, he said.

"The veterans administration is working very well," Coates said. "Being under public control is a very good thing. The attention that Congress puts in to improving the quality of care for veterans is completely appropriate."

The single-payer system is a small step to a socialized health system, not a big one, Coates said.

"Any reform effort in health care -- for decades now -- someone has shouted 'socialism,'" Coates said.

He added that in countries like Canada and New Zealand, where single-payer systems have been put in place, it hasn't been a threat to democracy.

Reach Lori Kersey at lori.ker...@wvgazette.com or 304-348-1240.