If Minnesota ever adopts a single-payer heath care system, the work of Dr. Elizabeth Frost will be remembered as one of the key reasons for its passage.
Together with her friend, Dr. Ann Settgast, Frost co-founded the Minnesota Chapter of Physicians for a National Health Program (PNHP) five years ago. The group holds rallies and speaks at hospitals across the state to recruit new members to its cause — and now boasts more than 1,000 members in Minnesota. Frost also has the ear of state lawmakers such as Sen. John Marty and Rep. David Bly, who hope to expand healthcare access in Minnesota.
“Single-payer” healthcare would make health care universal and ensure equal access to best treatment, expanding President Obama’s Affordable Care Act. Under single-payer, everyone would be entitled to the best available care, no matter the size of their wallet. Citizens could keep their health insurance coverage even if they lost or changed jobs, and be allowed to retain their preferred doctor or caregiver. By encouraging preventative care, proponents say a single-payer system would significantly lower costs (as much as $350 billion a year, they estimate). Perhaps most importantly, a single-payer system would end health insurance industry meddling. Patients could make decisions based on health needs, not on what a billing department dictates.
Frost, 39, is a Washington, D.C., native who went to medical school at Case Western Reserve in Cleveland and serves as a family physician at the Hennepin County Medical Center’s East Lake Clinic. She came to Minneapolis 11 years ago to live near her sister and her niece and nephew. One of the reasons she has stayed here is Minnesota’s focus on improving healthcare services which, while far from ideal, offer better access to care than many other states do. Frost, who refers to herself as “something of a do-gooder,” believes that her work as a physician extends beyond diagnosing defects or prescribing medicine.
Her tireless advocacy for single payer stems from her experience caring for her patients, and her concern that the present health system doesn’t offer adequate care.
“I had a patient who came to see me who was 64 years old and had chest pains,” Frost says when asked to illustrate the problem. “I recommended he go to the emergency room to get evaluated for his chest pains, and he refused because he didn’t have health insurance. He said ‘I’m gonna wait until I’m 65 to have this evaluated.’
“About a week later he went to the ER after having a massive heart attack. He died a few weeks later. If the Medicare age limit was 64 instead of 65, then that patient would be alive today.”
The frustration in Frost’s voice signals her impatience with a system in which patient outcomes often depend on arbitrary and unfair rules and requirements. She compares the current, broken system of health care to a skimpy hospital gown: The coverage looks fine, until you walk around and study it from behind.
Frost believes physicians have a duty to get involved in the healthcare debate that extends beyond caring for patients, a duty that should take them out of the clinic and into the public square: “Our goal is to figure out how to solve things on a grander scale,” she says. Physicians who heed their own advice, Frost and Settgast joined together to found the local branch of PNHP five years ago. Today, it has over 1,000 members and supporters. Nationwide, Physicians for a National Health Program boasts 18,000 doctors.
Frost and Settgast organize an annual rally at the State Capitol to pressure lawmakers to push for single-payer healthcare in Minnesota (This year’s rally was held Feb. 7). Perhaps no lawmaker has been more allied with their work than Sen. John Marty a DFLer from Roseville, who consults closely with Frost and Settgast on organizing strategy and bill drafting. The two physicians helped Marty craft language for a single-payer bill that Marty introduced last month as SF18. The bill, which is unlikely to win approval this year, would “guarantee that health care is available and affordable for all Minnesotans.”
“Elizabeth is a perfect example of a doctor willing to advocate for the well-being of her patients,” says Marty. “Her advocacy to make sure they have access to health care is consistent with the work she does in her clinic.”
“I was impressed by her commitment to the issues, and commitment to really want to make change,” echoes Rep. David Bly, DFL-Northfield. “It’s really important that you have someone of her experience and stature step forward. I think they have had a tremendous impact in their effort to bring single-payer to reality.”
When she’s not helping patients, speaking at hospitals to recruit new single-payer advocates or lobbying lawmakers, Frost often uses demonstrations to push her message that health insurance executives don’t deserve to profit while her patients suffer. Every winter she takes part in a Protest on Ice, a bit of political theater performed on the frozen surface of Lake Minnetonka in front of UnitedHealth CEO Stephen Hemsley’s house. Hemsley is one of the highest paid health industry executives in the country, taking home almost $50 million in 2011.
“That $50 million is our money,” said Frost. “He gets it off the backs of you and me.”
Frost’s message that adequate healthcare should be considered a basic right, not a privilege, resonates with lawmakers like Bly.
“You don’t have to go far to find (family or community) efforts to raise money to cover someone’s traumatic illness,” he said, referring to common fundraisers at homes or at Legion Halls to help pay for health crises such as a family’s cancer bills. “Those days have to be numbered. We have to get beyond that. Healthcare should be seen as a right. It’s a public good, like public schools or public safety.”
But is the public ready to support government-administered, single-payer healthcare of the kind advocated by Frost?
“If I could have a dollar for everyone who told me that single-payer is not going to happen because it’s not politically viable, I would be a millionaire,” Frost admits. “(But) we all just need to close our eyes and jump. We need to get people in the streets demanding that healthcare is a human right.”
Single payer — in which the government pays all medical bills, has been adopted in Canada and already exists, in limited form in the shape of Medicare in the U.S.. Still, it was viewed by many politicians as a radical option during the healthcare reform debates before Congress passed the Affordable Care Act (ACA). Nevertheless, single-payer advocates may already have made their impact on U.S. history. Frost believes that the arguments of single-payer healthcare advocates helped prompt conservative Supreme Court Chief Justice John Roberts to cast his crucial vote in the Court’s decision to uphold “Obama Care.”
“I think that single-payer supporters might have been influential in him changing his mind to uphold the Affordable Care Act,” says Frost. “A lot of people that I work with were protesting against ACA on the steps of the Supreme Court — alongside members of the Tea Party — because they wanted the Court to overturn the Affordable Care Act in order to pave the way for single-payer. The threat of single-payer, the threat of the progressives, may have encouraged (Roberts) to change his mind and uphold ACA.”
Closer to home, Frost, Settgast and Physicians for a National Health Program are using a more grassroots approach to push for single-payer in Minnesota. With 14,000 doctors in the state, they believe they can have strength in numbers. PNHP gives talks in hospitals, clinics and churches to reach those potential allies. They have presented at the Mayo Clinic in Rochester as part of the Grand Rounds forum, in which doctors discuss a topic once a week. Frost estimates the group added 15-20 converts from the 200 people who attended last year’s Mayo speech.
Frost and Settgast also have a long-term hope that single-payer will become more politically feasible, at least in Minnesota, in the next few years, perhaps as soon as 2015.
“We want to push for single-payer passing in Minnesota in 2015,” says Frost. “Gov. (Mark) Dayton would be in his second term (if he wins re-election in 2014), and he’ll feel more liberal to push for something like this.”
It may seem like a stretch now. But don’t underestimate the effect that Frost, Settgast and the grassroots campaigning of Physicians for a National Health Program may be having on the debate. They are not going to quit anytime soon.