Jenni, a long time patient safety leader and advocate, is also actively engaged in the American movement for universal health care coverage. She campaigned for Obama, attended the Denver Democratic convention with her son, Joey, a leader in the youth for Obama movement during the campaign. She hopes that a powerful grass root movement will convince the President to make the right choices. Q: Could you explain what the Single Payer movement is about?
Jennifer Dingman: The Single Payer movement has been in existence for nearly 20 years officially, but it goes back much further from what I have been told. The movement began with a group of physicians who felt that having a system similar to that in England would best serve all players involved, providers, patients and facilities.
The movement stalled for a very long time during the 80s and 90s, but has been resurrected since the turn of the century with a much stronger and larger provider group complete with a website, literature and a speakers bureau. Things began to move forward after the physicians group made a difficult decision to endorse and join forces with consumer groups wanting the same outcome.
Congressman John Conyers of Michigan has introduced HR 676, medicare for all, as a universal health care single payer bill. Single payer opponents claim that the government will come between providers and patients. However, a single payer system would actually do the opposite in that relationships that have been lost in third party payer systems will be restored once again. Over head will also be reduced as private insurance has a 25 to 30 % overhead, while government sponsored programs have a 3 to 5% overhead. Patients will no longer be excluded for pre existing conditions, and profits in medicine will disappear. Therefore, it will be cost effective to keep people healthy rather then treat them when they are sick. In light of the new government rules regarding no payments for some substandard care, it will be more difficult for the present environment to survive and a one payer system will eventually become the only feasible way to provide healthcare in the USA.
Q: Since Kennedy's speech, have you had hopes that the Democratic candidate and now President Barack Obama endorse single payer?
Jennifer Dingman: I believed that at at the time of the election, neither candidate would embrace single payer. However, I also think that the Democrats are far more likely to usher in a single payer system than Republicans. I believe that pressure from the medical industry, in light of the new no pay rules, will actually convince legislators to entertain the notion of single payer. Therefore, we have hopes that President Obama, who has had contact with the founders of the Single Payer movement will go in that direction. But for him to do so, we need to get a powerful movement to help him make that decision.
Q: The talk today is about "patient centered care", in your view does that mean that patient safety advocate and single payer advocates should join hands?
Jennifer Dingman: Single payer and patient safety advocates have a huge common denominator, "quality". I strongly believe that it is only a matter of time before these two powerful advocacy groups join forces and demand a safer, efficient and affordable system. We must remember that many bankruptcies due to medical costs are a direct result of medical errors that are not addressed, admitted or compensated for.
Q: Fundamentally why is the health system so unsafe in your country?
Jennifer Dingman: There are three reasons: I believe it has to do with a for profit system, a litigious system, and greed. Huge profits are made on illness and disease. Over testing and over treating exists due to unnecessary fears of litigation by providers who are not aware that the legal system is actually very ineffective. Lastly, sheer unadulterated greed where unnecessary treatments and procedures are done for the income brought to providers.
Q: Do you think the legal system involvement as a sort of 'intermediary' between patients and providers worsens the situation, with patients thinking they may sue and health providers being paranoiac and expensive because of insurance-costs and fear of the Courts?
Jennifer Dingman: I think that it does as patients/consumers see the legal system as a safety net and assume that the care provided will be top grade. Nothing could be further from the truth due to the fact that less the 5% of all victims of medical error and other preventable outcomes ever sue. Healthcare is highly unsafe and basically a free for all, hodge podge of conflicting standards, opinions and patient care. Complacent providers who know that there are little to no consequence if things go wrong, and no incentives to make things go right. If the public knew the truth about the tort system, most would pay more attention, ask more questions, and get more information. Blind faith and trust would be replaced by real partnerships and productive patient education programs.
Q: Who benefits, insurance companies and lawyers...?
Jennifer Dingman: Insurance companies see far too much profits in the USA, while denying care to those who need it most. Lawyers benefit only when large judgments are paid out, which is rarely. Defense lawyers actually do much better then plaintiff attorneys, as they are not limited as to how many hours they can bill the client. That is the reason malpractice lawsuits take 3 to 7 years to settle. Alternatives to the tort system are the only way to begin to repair the healthcare system, but sadly, not one patient safety leader is willing to tackle this issue. There is one other way however, and that is a single payer system with a no fault plus system built into it. This is the only way single payer would work effectively as well in a nation like the USA.
Q: You were in Washington with the Community health group, could you explain to us how it works, this Administration did support 4000 Community health centers...
Jennifer Dingman: The project is something I would rather wait to discuss, but will go on to answer other question. I was very impressed when I learned that the Bush Administration has expanded funding for community health centers all throughout the USA. I understand that the number of clinics has more then doubled since 2000.
Q: How did you see patient safety entering the picture?
Jennifer Dingman: The United States Government has the power to create changes needed in order to make patients safer in this country. We have already seen great things happening through AHRQ (Agency for Healthcare Research and Quality), CMS (Centers for Medicare and Medicaid services) and now HRSA (the official: Health Resources and Services Administration). The new no pay rules for substandard care will be the real change agent. I also believe that our government is sending a loud and clear message to "White Street", (healthcare industry), to straiten up and get with the program. Healthcare has gotten sloppy and become too much of a business, it is time for us to get back to basics and build foundational relationships between patients and providers. The most effective way to do so is with a healthcare team, in which the patient is a intrical part. Medical homes will replace the scattering of patient care in the future, and patients will hopefully and finally find a sort of a safe haven, something that is no longer part of the American dream or American healthcare.
For more information on advocacy for patient safety, single payer in the USA advocating a universal health care system, see:
Physicians for a National Health Program (www.pnhp.org/)
or
Healthcare Now (http://www.healthcare-now.org/)
For more information on PULSE, see www.PULSEAmerica.org
About PULSE - Founded in 1996, PULSE is a grassroots nonprofit 501(c)3 organization dedicated to raising awareness about patient safety and reducing medical errors through advocacy, education, and support. We work to empower patients and their families to make informed decisions, increase effective communication and respect between healthcare providers and clients, and create community partnerships that will foster and ultimately lead to safer healthcare.
