Jun 15, 2009

Seeing Health Care as a Right and Not as Priviledge Should be the Starting Point

For many years I went without health care coverage. It started when I was in grad school when Blue Cross upped its premium and I couldn't afford it. In the last couple decades, some of my jobs offered health benefits some didn't; during the latter, I hoped that I'd stay healthy, and thankfully I never needed to go to the doctor or a hospital. Now I have coverage, and I've been paying into the system for years without having drawn benefits. But, it's OK, I don't mind. I'm glad I'm healthy, I'm glad I have good options [hey, as far as I know], and I know that I'm paying for others' treatment. I hope this is always the case... Empathy is good.

A few things first. If health care is a priority, then simple logic says that if other less-wealthy countries can do it (yes, Canada's system is superior to ours), then the US can do it too. We tried the private insurance route and it hasn't worked. Medicare--a socialized way to offer coverage to people--is more efficient and much less bureaucratic. After all, if we socialize the risk while privatizing the profit why can't we do it for something that will make Americans live longer, healthier lives.

Obviously, costs must be reduced. The American Medical Association (only a minority of doctors & medical students belong to it; fewer still support its policies) is against any public plan. Well, maybe they could suggest how we can save some big bucks by stopping those doctors from prescribing unnecessary treatments because they get bonuses for such. Something is wrong with spending far more (as % of GDP) than any other nation on health care and yet we have 1/3 of the population uninsured or underinsured.

My sister is in the medical field and earlier this year she lost her job. Her hospital in Queens closed because it wasn't profitable and/or was in the red. It served a poor to middle-class community and it was very busy. The system is overwhelmed. The other hospitals in the borough will be hard pressed to cover the gap. But, health care is a necessary service, like other services an advanced society offers to its citizens. Most doctors, indeed there's a whole big administrative staff, deal with paperwork--some estimates, up to 30% of running a hospital. Infinite amount of bureaucratic maze focusing on fighting, negotiating and getting insurance companies to pay for patients' treatment.

The insurance companies, the HMOs, are in it for the money. They're concerned about the bottom line. That's why they reject a certain number of claims, and they fight to deny benefits and coverage. And, this for-profit mode is part of the problem.

Not everything has to be evaluated on a cost-profit basis; that is, in monetary terms, because society profits from having a healthier population. Some things work better being private, some don't. The police, the fire department, public parks and libraries, and so many other institutions should not be in private hands. They should operate for the public benefit and not for private profit. Therefore, I think health care has to have a public option in it. I know language matters, but we've already have socialized benefits--anytime there's a program open to a greater number of people, it's a form of social policy that benefits the commonwealth. Instead of being shy about certain "red flag" terms, let's explain what they really mean.

I know someone who's been trying to get a good job for years but she's only found low-paying jobs, the per-hour kind, with no health insurance. She's been paying hundreds of dollars every month to maintain health coverage. The other day, I asked her if, hypothetically, she was willing to pay the equivalent of two months worth of premiums in additional taxes in order to insure all Americans. Her reply, "I don't want socialism in my country." Invariably, she repeats the "horrors of the Canadian system." Now, many Americans parrot this conservative mantra, although I'm happy to see that finally most Americans do want change, including greater government role in health care.

Here are some experts from varying viewpoints discussing Obama's proposals, as appeared on the Washington Post's website. Now, I understand why the president wants a public dialogue, but not everyone comes to the table ready for an honest discussion. Most Republicans will opose anything; they'll now vote against the military supplemental spending bill--but when it was Bush's, they accused those who voted against it as "America-haters," and "unpatriotic."

Anyway, Obama has to make a more forceful case and push for a major overhaul of the health care system. Now it's the time. Not so long ago, we had the same rhetoric and charges against Medicare and Veterans benefits. Going back a little further, the conservatives and the big business opposed Social Security, labor laws, safety belts, consumer protection, public education, and so many other good things, including electrification. And, yes, it took bold government action for these to happen. Once it's done, most of the arguments against good-sense policies deflate. It's natural for people to be afraid of the unknown, especially when they hear irresponsible and false claims by those whose interests lie with the status quo.

I would ask all those Republicans (and some Democrats, who hail from conservative states) in Congress who oppose universal health care, why are they so selfish? They have the best coverage but they're not willing to extend the same to their fellow citizens. It's even more offensive if you consider that most members of Congress are wealthy individuals who can afford their own insurance but opt to enjoy a benefit paid by the American taxpayers.

PS. Here's good documentary, PBS Frontline, Sick Around the World, with a comparison of several countries' health care systems.

PS2. Initially, I didn't know what to make of Daschle's nomination to be in charge of health care reform but I gave the benefit of the doubt to Obama for selecting him. Anyway, then we learned that Daschle has worked closely--and at great profit--with those who prefer the status quo. It's a relief not to have him on the "inside" of the Obama team pushing against what most of us want [new poll showing big majority supporting public plan].... Daschle now urges Obama to drop public health care plan! Tsk.. What was Obama thinking? How can he nominate someone like that? In a way, we should be thankful that Daschle cheated on his taxes...


Brent said...

The Canadian model has lots of problems, I'm not sure we should copy it.

George said...

When the federal gov. was contributing 1/3 of the total in health care coverage, the system operated much better. Since the feds tightened the outlays, the provincial govs didn't make up the difference. Since then, the waiting lists for non life-threatening procedures have increased. For example, it may take a year to get a hip replacement in Quebec.

Yet, most Canadians would defend their system of universal coverage, not wanting to have the one we have in the US.

Of course, for something to work here it has to be implemented nationally (not state by state) and the federal gov. should set the standards.

Anonymous said...

we spend 17% of GDP and we have 1/3 of us exposed to unnecessary risk of diseases.

I think the next big spender is Switzerland with 11%... but they insure everyone.

George said...

Here's a brief discussion of the Canadian health care system