Dr. Diljeet Singh talks about America’s deepening health care crisis with a focus on the expiring Affordable Care Act health insurance subsidies and her work at Physicians for a National Health Program advocating for the adoption in the U.S. of a universal, comprehensive, single-payer national health program.
SCOTT HARRIS: But we begin our program this evening by welcoming to our show Dr. Diljeet Singh, president of the group Physicians for a National Health Program. Dr. Diljeet, Dr. Singh, I should say, is a women’s health advocate as well as an integrative gynecological oncologist in clinical practice since 1999. Dr. Singh, thanks so much for making time to come on our program this evening.
DR. DILJEET SINGH: So glad to be here. It’s such an important topic.
SCOTT HARRIS: Very much so. Well, before we get started on the current and impending worsening healthcare crisis in our country, I did want to ask you to tell our audience briefly about the work you and others do at your group, the Physicians for a National Health Program.
SCOTT HARRIS: Very much so. Well, before we get started on the current and impending worsening healthcare crisis in our country, I did want to ask you to tell our audience briefly about the work you and others do at your group, the Physicians for a National Health Program.
DR. DILJEET SINGH: So PNHP is a 30-plus-year-old organization that has been working in multiple ways to advocate for a national health program that is free of all the conflicts of interest that come from profit-driven motives. And the work has included research projects that we have done as well as advocacy. And the majority of our members are physicians, but we also have a growing contingency of students, medical students who are also working for the same. And for the longest time, our focus was teaching physicians about health policy and helping them understand it.
But in the last five to seven years, as the healthcare crisis has worsened in America, we have also engaged more actively with working with policymakers and legislators, both at the state and national level to understand the real solution to fixing healthcare in America beyond the ongoing little tweaks that are constantly made to deal with the gaming of the health insurance industry.
SCOTT HARRIS: But we begin our program this evening by welcoming to our show Dr. Diljeet Singh, president of the group Physicians for a National Health Program. Dr. Diljeet, Dr. Singh, I should say, is a women’s health advocate as well as an integrative gynecological oncologist in clinical practice since 1999. Dr. Singh, thanks so much for making time to come on our program this evening.
DR. DILJEET SINGH: So glad to be here. It’s such an important topic.
SCOTT HARRIS: Very much so. Well, before we get started on the current and impending worsening healthcare crisis in our country, I did want to ask you to tell our audience briefly about the work you and others do at your group, the Physicians for a National Health Program.
DR. DILJEET SINGH: So PNHP is a 30-plus-year-old organization that has been working in multiple ways to advocate for a national health program that is free of all the conflicts of interest that come from profit-driven motives. And the work has included research projects that we have done as well as advocacy. And the majority of our members are physicians, but we also have a growing contingency of students, medical students who are also working for the same. And for the longest time, our focus was teaching physicians about health policy and helping them understand it.
DR. DILJEET SINGH: So PNHP is a 30-plus-year-old organization that has been working in multiple ways to advocate for a national health program that is free of all the conflicts of interest that come from profit-driven motives. And the work has included research projects that we have done as well as advocacy. And the majority of our members are physicians, but we also have a growing contingency of students, medical students who are also working for the same. And for the longest time, our focus was teaching physicians about health policy and helping them understand it.
But in the last five to seven years, as the healthcare crisis has worsened in America, we have also engaged more actively with working with policymakers and legislators, both at the state and national level to understand the real solution to fixing healthcare in America beyond the ongoing little tweaks that are constantly made to deal with the gaming of the health insurance industry.
SCOTT HARRIS: Thank you for that, Dr. Singh. So right now, the U.S. is approaching a major crisis in healthcare. Not only has President Trump and the Republican-controlled Congress failed to restore vital subsidies for the Affordable Care Act, which means that more than 20 million Americans will face double, triple, or even more exponential increases in their monthly health insurance premiums, making it unaffordable for many. But after the ’26 midterm elections, Donald Trump and the Republican Congress have a plan to impose over $1 trillion in cuts to Medicaid, Medicare, SNAP and other vital social safety net programs that many millions of working class and poor Americans rely on. And I would ask you, Dr. Singh, just to review for us what this confluence of events means for the already ailing and inadequate and broken, in the opinion of many, U.S. healthcare system.
DR. DILJEET SINGH: The cuts are stunning really. And this is really hard to imagine. So, the Medicaid cuts that are coming are going to impact many of our states. But most strongly those states that —both things—the ACA cuts that are coming are impacting mostly the states that did not expand Medicaid. And then there’s Medicaid cuts coming on top of that. And there’ve been several studies that have come out looking at what the impact of those changes will be. And I think the nicest study comes from a group that some collaborators at Yale and Penn basically showed that this combination of Medicaid cuts and then lack of extension of the enhanced ACA premium tax cut credits—that that combination is likely to lead to over 50,000 preventable deaths just from lack of insurance. And that’s on top of we have roughly, for every million people who don’t have insurance, we think that there’s somewhere between 1,000-1,200 preventable deaths. And so we already, from our uninsured, had something like 40-plus preventable deaths that were happening.
The downstream effects that we often think of like, “Oh, well Medicaid cuts, that’s not going to impact me because I don’t personally have Medicaid,” not realizing that so many rural hospitals, so many hospitals in smaller towns count on that Medicaid funding to keep their doors open. So even people who don’t actually have Medicaid as their source of insurance have the strong potential to lose their local hospital. And we already have such dramatic maternity care deserts and just care deserts in general in rural areas. And I’ll be honest, I think that there’s things that even those of us who think a lot about this aren’t foreseeing.
And then I’m not even bringing up because it’s slightly separate healthcare, but the nursing home cuts to the kinds of regulation and assessment of nursing homes that will be cut in the same bill. That reconciliation bill very, very deliberately seems to target healthcare access and seniors in rural areas, but across our country in multiple different settings.
SCOTT HARRIS: The very sad political reality is that the Republicans and Donald Trump put all these cuts in place to start after the 2026 midterm elections so that unless there’s a very strenuous education campaign, there’s a lot of Americans who won’t know what’s coming down the pike when they go to vote for their Congress people next November. How do you see that task in terms of your group, PNHP, the Physicians for National Health Program? What kind of education do you think is necessary so that people don’t get caught unaware of where all this is headed?
DR. DILJEET SINGH: Well, there are a number of things that will show up in January. The things that will show up in January are the lack of subsidies for people who were getting their healthcare from the ACA marketplace. And of course, those are states that are mainly ones that did not expand their Medicaid. So we’ll start seeing that in January, and hopefully that will give us an opening, so to speak, to help people be able to foresee those changes that are coming.
But beyond that, I mean, this is horrible to say, but even a lot of Republican lawmakers who voted for the reconciliation bill are unaware of these impacts, right? That’s a whole different conversation of the things that our legislators vote on, that they don’t have a full awareness of when we create these huge package bills. But we are working at every level, educating physicians, educating patients.
We have enough state chapters throughout the country that are working to do the work of educating both constituents, regular everyday Americans as well as physicians. I mean, the challenging thing is and we could spend the entire time we have talking about these little pieces of access to Medicaid and the ACA and the ACA offering care to these number of people.
But all of the above fail to really solve the problems that we have. And that is that healthcare in America is weak on so many levels. Number one, it is not affordable. Number two, it is not universal. Number three, it is not trustworthy. People don’t trust science and people don’t trust their hospitals consistently, their doctors, and certainly they don’t trust their health insurance companies. And all of that is because there is this constant profit motive and this driver in our system that are basically trying to keep people from getting the healthcare they need.
SCOTT HARRIS: Right.
DR. DILJEET SINGH: I’m happy to spend as much time as you’d like talking about the small fixes that we could make, starting with keeping the ACA subsidies in place and then rolling back the cuts to Medicaid, rolling back the cuts to CMS nursing home staffing, etc. But I think if we could spend some time thinking through how do we really fix healthcare in America—how do we make it something affordable and accessible to all? I think that makes the most sense.
SCOTT HARRIS: Yeah, that’s on my agenda. I think I have one more question just in terms of some news stories that came out today, but let me reintroduce you to our audience. This is Counterpoint and my name’s Scott Harris here on listener-supported WPKN in Bridgeport. We’re speaking this evening with Dr. Diljeet Singh, president of Physicians for a National Health program. And we’re talking about many levels of the crisis that is only set to get worse in the coming months.
Just on a news item, Dr. Singh, I wanted to ask you about, President Trump said in recent days he had a plan to restore the Affordable Care Act subsidies—it was really the central issue that closed down the government for 43 days. And unfortunately that closure and the pressure exerted did not win the day. There was no solution for it, but there was supposed to be an announcement today by Donald Trump about what his proposal was for restoring these subsidies. It was canceled at the last minute. Just want to spend a moment on this. Do you know anything about what Trump’s plan is or his concept of a plan as Trump famously said during the 2024 presidential debates?
DR. DILJEET SINGH: I’ll be honest, I just got out of clinic 20 minutes ago, so I haven’t heard of something that came out today. But what he has been talking about and with some members of his administration have been talking about— again, it’s so difficult and twisted. So they started with this comment saying, we think the money should go to the people and not health insurance companies. Now, this is contrary to every other move they have ever made, which has given more and more money and power to the health insurance industry. But these are the words they’re using. And they’re proposing this concept of creating health saving accounts where they would give some small sum of money to individuals. And the problem with this is severalfold. Like one, if you gave me $1,000 to spend on my own healthcare and I took that $1,000 to pay for my own health insurance, well, of course I’m giving the money to the health insurance company, right?
It’s like a completely falsehood to say, “Oh, if we give money directly to people, they can somehow not give the money to health insurance companies.” Now, the tricky thing about that giving people money to potentially put in a health savings account is that people, so many of the decisions we make about healthcare are because we’re making decisions about where to put our money. So for a mom who’s given a $1,000 and she has diabetes and she has to think about her own healthcare, but what is she likely to spend the money on? Her kids’ healthcare, right?
And so there’s just a deep falsehood to that. And then the way our healthcare is currently structured, there’s really no such thing for the vast majority of people to spend money on their healthcare that doesn’t in some way profit the health insurance industry. The only people who are able to sidestep this are people who are over the age of 65 and so have the option of accessing traditional Medicare, which currently is about 50 percent of people who have Medicare, and they can access a form of healthcare that isn’t supporting the health insurance industry. But I don’t know if he’s really done this. There was a lot of pushback. I haven’t heard, Scott, that it’s actually some kind of real plan that has been proposed unless you’ve heard something different and I’m happy to comment on that.
SCOTT HARRIS: No, I haven’t heard anything different with Trump’s track record on this kind of thing, especially this issue. I don’t expect we’re going to see a lot of breakthroughs there, but we can hope something positive comes out of it.
Dr. Singh, as you were saying before, the Affordable Care Act, Obamacare did provide health insurance to millions of Americans, but it failed to repair a broken system where millions more Americans still have no health insurance. And as you mentioned earlier, studies have found 40,000 to 50,000 Americans needlessly die each year because they have no health insurance and can’t afford to address serious health issues. Last resort, they go to the emergency room and we all pay for that anyway. And of course, we have a system where health costs unaffordable health costs are really the biggest cause of bankruptcy in our country.
So I wanted to get to this central question, Dr. Singh. I was just going to finish here with asking you: Please summarize for our audience Physicians for a National Health Program’s proposals for a single-payer universal and comprehensive health insurance coverage system that would cover all Americans. Tell us what you’re thinking and have been thinking about for years now, and we can look to other nations around the world. Most other industrialized nations do have a universal single-payer system. We don’t. But what are you proposing for our country in the midst of this crisis?
DR. DILJEET SINGH: Well, I think what a lot of people don’t realize is that we don’t actually need healthcare insurance. We just need healthcare. And the health insurance industry essentially uses somewhere between 25 and 35 cents of every dollar to do nothing related to healthcare, right? It’s either a profit—there’s pure profit for them, something that goes to the shareholders, or it’s just kind of bureaucracy administration that’s been created by, “Well, if you have Aetna, this is approved. And if you have United Healthcare, this is approved.” And so there’s layers and layers of bureaucracy at the individual physician office at the hospital level and then at employers level.
And then of course, the insurance industry calls it their administrative overhead, but it’s this created thing. And so I think that’s one piece that people don’t always perceive that if we just got back that, let’s just use a round number, 30 percent, if we just got back 30 percent of the whole healthcare budget in America, we could actually cover everybody and we could give everybody vision. We could give everybody dental. We could give everybody adequate mental health coverage, things like hearing aids and etc., that managed to bankrupt people because it’s not part of their healthcare.
All of those things could be included if we just took that money back. And there’s a lot of people who say, “Well, no, I’m worried if we have a socialized system, maybe we’ll have long wait times.” Well, I’ll tell you, it doesn’t matter what city you live in, it takes a long time to get in to see a primary care doctor. There’s parts of the country where it takes weeks to get in to see specialists. And then there’s of course parts of the countries where there aren’t even specialists. And I’m saying specialists, but there’s parts of the country where you can’t even see a gynecologist or an OB GYN, because there’s not enough.
And I think the other thing that people I don’t realize, and I think this is one of those hidden things, is that when I take care of people and they’re sitting in front of me and we are having these difficult conversations, like you mentioned, I’m a gynecologic oncologist. I take care of people with ovarian, cervical uterine cancer, and we have these really tough decisions to make. When does surgery make the most sense? When does the hormone therapy make the most sense? When would it make sense to do chemotherapy? How do we think about what scans we do for them and when do we get those scans?
And the good news is all of the organized physicians organizations put out great guidelines. The National Comprehensive Cancer Network puts out great guidelines for the right tests to do and the range of treatments that make sense for people with cancer and the ENT organizations, the American Academy of Pediatrics, all of these organizations look at the research and put out recommendations.
And we don’t need prior authorization. We don’t need an insurance company to tell us whether this is the right test or that’s the right test because we have organizations that are trying to make money off those tests who can tell us what’s the right test? And the other place I was going was, when someone’s sitting in front of me and I recommend surgery, the truth is that person wants to trust that. What am I thinking about? I’m thinking about them. I’m thinking about their goals of care. I’m thinking about what’s the right thing for them as individuals.
They don’t want to worry that I’m worrying about what my hospital wants me to do and what the insurance company wants me to do, and how much money might be made, or how many PET scans are available at this hospital. They want to think, I’m just thinking about what’s in their best interest, that I don’t have any conflicts of interest. And the truth is that’s what doctors want. Doctors don’t want to have to worry about what the insurance company says or what pharmacy Benefit Manager allows. They want to just pick the medicine that works the best for the person sitting in front of them. And I think that’s the thing that we kind of lost this idea that you can have somebody taking care of you who just has your own best interest in mind when they help you make decisions.
SCOTT HARRIS: Well said. Dr. Singh, with all that you said there, in terms of the opportunities for change and a blueprint to get there, what are the major obstacles preventing our country from adopting a lower cost universal healthcare system that most other industrialized nations have managed to have? Nations that aren’t as wealthy as the United States. Most of these countries have had these systems for decades that are popular and effective at keeping the nations’ populations healthy.
DR. DILJEET SINGH: I think there’s several things. The biggest thing in the way are the huge profit motives of these health insurance companies and of hospitals that continue to block the way to our legislators making good decisions. That is the biggest thing in our way because they have a ton of money, and they’re very, very effective at lobbying our legislators, lobbying our policy makers, and putting ads on tv, convincing people that they’re getting something better than they are.
I think the other thing that is in our way is literally people just understanding, people understanding what they should have access to. I think in America, we don’t realize that the rest of the world, including places that have a lot less money than us, have a lot better healthcare and a lot better prevention in place, and a lot more access to the things that can keep them healthy.
So I think the big work that we need to do is we need to stand up as citizens of the country and demand that our legislators not get in giving to pressure from healthcare or Humana or Aetna and just say, No, we think our people deserve access to healthcare. And it’s not even just affordable. We shouldn’t worry about how much does something cost. We should worry how effective is it, right? And so what I think we really deserve, we deserve high quality, trustworthy healthcare, period. I don’t even think affordable comes into it. The truth is cost effective healthcare, like all of those things are things we can do, but we have to start with health, high quality, and the second demand. Be completely trustworthy that the people who are helping you make decisions are doing it for you, not because they’re worried about how much money the hospital’s making or how much money an insurance company’s making.
SCOTT HARRIS: Right. Well, Dr. Singh, I just have one last question for you before we run out of time here. Is this moment of crisis in the U.S. healthcare system, an opportunity for the…
SCOTT HARRIS: Right. Well, Dr. Singh, I just have one last question for you before we run out of time here. Is this moment of crisis in the U.S. healthcare system, an opportunity for the…
DR. DILJEET SINGH: I lost you for a minute there. Can you repeat that?
SCOTT HARRIS: Sure, sure. I was wondering if you think in this moment of crisis for the U.S. healthcare system could be an opportunity for the American people to rise up and demand a structural change in our healthcare system system and for politicians to respond and make these major changes that would benefit most Americans. Are you optimistic we’re at that time?
DR. DILJEET SINGH: Absolutely. I hear more and more and more from people that they are starting to see. They’re starting to see that we don’t have something that a lot of people have—that it has to change. We cannot keep living like this. We cannot keep having the highest infant mortality rates in the world, the highest maternal mortality rates. We can’t keep seeing life expectancy for men, women of all races drop in this country while other countries do better and better. And I do think that as people were once given access and then have their health insurance taken away, that they’re starting to see that, you know what? I deserve healthcare. I absolutely deserve it. Healthcare is a human right. I think we hear that more and more and more. And mostly, again, we just have to put pressure and just say, “You know what? I’m not voting for somebody who’s not trying to get me universal healthcare so I don’t have to worry about the costs.”
So I don’t have to worry about, well, I really hate my job, but I can’t leave it because it has good health insurance. We don’t want that in America. We want everybody to do the job they want. We don’t want people to be afraid to start a small business because they can’t afford to pay for health insurance for their employees. We want everyone to start the small business that they’re dreaming of. Right? Yeah.
So I do think this is a time for real change and I think it’s very, very interesting that whether it was bent in honesty or not, the fact that even President Trump is making comments saying, “Well, I don’t think we should be giving the money to health insurance companies.” I think we have to hold onto that and reiterate it and say it over and over and over. Yes. We don’t want to give our money to middlemen who aren’t helping us be any healthier. We want our money to go to the people who are making us healthy. We want our money to go to drugs that are keeping us healthy and strong.
SCOTT HARRIS: Extremely well said. That will conclude our conversation tonight, Dr. Singh. But I want you to leave our listeners with a web address where folks can go to learn more about your group. The Physicians for a National Health Program. Where can they go?
DR. DILJEET SINGH: Absolutely easy. PNHP.org. We have tons of information, tons of resources, and there’s chapters in every state that you can find, depending on where you live. Or you can go to our national organization and read our reports that we’ve written recently about Medicaid, deprivatization that some of these states who have the potential to have to push people off Medicaid, that they could make the choice right now to deprivatize their Medicaid so they don’t have to kick anybody off. Connecticut did it a number of years ago, and they improved their cancer detection rates and their cancer survival rates and they saved $13 billion.
SCOTT HARRIS: Wow.
DR. DILJEET SINGH: So please come to our website, PNHP.org. You just search for us, Physicians for a National Health Program, and that should get you to our website.
SCOTT HARRIS: Thanks for all the important …
DR. DILJEET SINGH: And Scott, thank you. Thank you so much for having this conversation. Really appreciate it.
SCOTT HARRIS: Thank you. And we’ll be posting this up on our website. I’ll make sure to get you a link to that once we post it. And Dr. Singh, thanks for all you do, all the important work you and others do at Physicians for National Health Program. This is a crisis that we’re deep into and thanks for your work to address it.
DR. DILJEET SINGH: It is our honor and our pleasure, and we are excited. Like you said, there’s potential for change and we’re going to do it.
SCOTT HARRIS: Absolutely. I hope so. And we’ll stay in touch to talk more about it. Thanks, Dr. Singh.
DR. DILJEET SINGH: Sounds great. Thanks, Scott. Take care. Bye.
SCOTT HARRIS: Bye-bye. That’s Dr. Diljeet Singh, president of Physicians for National Health Program. Dr. Singh is a women’s health advocate and an integrative gynecologic oncologist.
