Sunday, May 2, 2010

The United States and Embracing Change: Universal Healthcare

I am getting so tired of hearing about the Universal Health Care debates…so here is my debate and that is all I have to say about that.
The media keep giving examples of how in Canada, or other countries with socialised medicine, a person may have to wait 6 months or more for something like a kidney transplant and that, on rare occasion, a person may die before they can get that transplant. What they fail to mention is all the people who have lived b/c they got the surgery their life depended on.
What they are ALSO failing to remind the public is that a person in the United States with the same affliction and no healthcare, which 15.3% or 45.7 million don’t[1], has a 100% chance of dying before they get their transplant - because they can’t afford it unless they mortgage their home, sell belongings, or hold fundraisers, meanwhile the people who can afford houses and belongings in the United States generally have money for health insurance.
Furthermore, even if you are lucky enough to have healthcare in the United States, if the insurance company deems your illness to be a pre-existing condition (a condition that you were afflicted with prior to being insured by said company) then they don’t want to and won’t cover you anyway.
The public debate on government funded healthcare, from my perspective looks like this: The people who can afford healthcare don’t want the people who can’t afford it to have it. How many debates seen or articles read have interviewed someone who can’t afford health insurance – what do you think THEY think about it? My bet is they think it is a great idea.
Maybe most of the people who can afford healthcare forget, or never had to know, the feeling of living without healthcare; of being a child who is ill but can’t be taken to the hospital because their parents have no money; of being an adult who has to go to work, despite the fact they are sick, because they can’t afford the appointment required to get a note from a doctor to be granted a sick day; learning to suck it up when you are sick because there would be no doctor to prescribe something that would make pain mineralized so you can function through a day; or how about being sick for an extended period of time until you have no choice but the take a big bite out of your pocketbook only to find out that “if they had only caught it sooner” you might not need this operation, or that medication or you might have a better chance of staying alive.
Universal health care is in all but one of the wealthy, industrialized countries, the United States[2]. It is also provided in many developing countries and is the trend worldwide. While certain US demographics have government sponsored healthcare, namely the disabled, some poor and children, the coverage is limited and people fall through the cracks by not making enough to afford health care or making too much to be qualify for low-income status.
Having lived in the United States most of my life (part as an insured person, part without insurance) and having experienced socialized health care in Canada I feel I can offer a better opinion that those who are only on one side of the fence.
Yes, socialized healthcare has it’s downfalls, but so does the system employed by the United States.
The first time I ever went to a Canadian clinic I waited over 4 hours for my “appointment”, however after that and a few other experience with that doctor I decided to find a new one. I had many people warn me about how hard it would be to find a doctor in the city who was taking new patience but once I needed to find one, I found one easily and she is great! I never have to wait more than 10 minutes for my appointment, she listens to me, she sends me to the specialists I need/request, answers my questions and so far has been the best doctor I have ever had – the same cannot be said for my experiences with American health care physicians.
I will give you just one example of an experience with healthcare in the United States (I had insurance for this one – thankfully). I experienced a horrible accident in the United States in 2004 and while I will not discuss details here I will share the experience I had with my neurosurgeon. It was apparent that he didn’t read my file before his first visit to me in the hospital the day after my accident, and when he told me I could be out of bed and walking the next day I expressed concerns about this with my father. I had broken my back in two places – upper and lower – and had an understanding of how my back supports me when I walk (duh!). My father talked to the doctor who then realized his mistake, a mistake that could have cost me a lifetime in a wheelchair. Throughout my entire experience with this physician, he had extremely poor bedside manor, I did not get a sense that he wanted to care for my condition, I felt neither safe nor secure. When I shared these feelings and detailed experience in passing one day to a lawyer in the city where this doctor practices, he stated that he had heard about him and had even assisted in a few malpractice cases against him. This “doctor” still works in the healthcare industry to this day – much to mine and I am sure others, dismay.
From me to you: No healthcare system is without flaw but it makes a person feel safer knowing that if they were ill or injured they can go to the doctor and it will be covered. It creates a certain sense of empowerment in a person when you have the means to take care of their health, just like everyone else.
Bottom Line: Health care in the United States is out of control. Everyone should be able to see a doctor, if only for routine checkups and a routine doctor appointment shouldn’t cost over $500 dollars to the public or to the government. Something needs to be done. And like with everything else that needs improving in the United States you can either sit on your hands, bitch about what is wrong and hope that it miraculously fixes itself or you can pull up your sleeves, embrace change with all it’s uncertain outcomes and support the governments attempt at fixing things. Or you can move to Canada;)
:!:Common arguments forwarded by supporters of universal health care systems include [3]: * Health care is a basic human right or entitlement. * Ensuring the health of all citizens benefits a nation economically. * About 59% of the U.S. health care system is already publicly financed with federal and state taxes, property taxes, and tax subsidies - a universal health care system would merely replace private/employer spending with taxes. Total spending would go down for individuals and employers. * A single payer system could save $286 billion a year in overhead and paperwork. Administrative costs in the U.S. health care system are substantially higher than those in other countries and than in the public sector in the US: one estimate put the total administrative costs at 24 percent of U.S. health care spending. * Several studies have shown a majority of taxpayers and citizens across the political divide would prefer a universal health care system over the current U.S. system. * Universal health care would provide for uninsured adults who may forgo treatment needed for chronic health conditions. * Wastefulness and inefficiency in the delivery of health care would be reduced. * America spends a far higher percentage of GDP on health care than any other country but has worse ratings on such criteria as quality of care, efficiency of care, access to care, safe care, equity, and wait times, according to the Commonwealth Fund. * A universal system would align incentives for investment in long term health-care productivity, preventive care, and better management of chronic conditions. * Universal health care could act as a subsidy to business, at no cost thereto. (Indeed, the Big Three of U.S. car manufacturers cite health-care provision as a reason for their ongoing financial travails. The cost of health insurance to U.S. car manufacturers adds between USD 900 and USD 1,400 to each car made in the U.S.A.) * A 2008 opinion poll of 2,000 US doctors found support for a universal health care plan at 59%-32%, which is up from the 49%-40% opinion of physicians in 2002. These numbers include 83% of psychiatrists, 69% of emergency medicine specialists, 65% of paediatricians, 64% of internists, 60% of family physicians and 55% of general surgeons. The reasons given are an inability of doctors to decide patient care and patients who are unable to afford care. * According to an estimate by Dr. Marcia Angell roughly 50% of health care dollars are spent on health care, the rest go to various middlepersons and intermediaries. A streamlined, non-profit, universal system would increase the efficiency with which money is spent on health care. * In countries in Western Europe with public universal health care, private health care is also available, and one may choose to use it if desired. Most of the advantages of private health care continue to be present, see also two-tier health care. * Universal health care and public doctors would protect the right to privacy between insurance companies and patients. * Public health care system can be used as independent third party in disputes between employer and employee. * Conservatives can favour universal health care, because in countries with universal health care, the government spends less tax money per person on health care than the U.S. For example, in France, the government spends $569 less per person on health care than in the United States. This would allow the U.S. to adopt universal health care, while simultaneously cutting government spending and cutting taxes.
:!:Common arguments forwarded by opponents of universal health care systems include: * Health care is not a right. It is not the responsibility of government to provide health care. * Universal health care would result in increased wait times, which could result in unnecessary deaths. * Unequal access and health disparities still exist in universal health care systems. * The performance of administrative duties by doctors results from medical centralization and over-regulation, and may reduce charitable provision of medical services by doctors. * Many problems that universal health insurance is meant to solve are presumed caused by limitations on the free market. As such, free market solutions have greater potential to improve care and coverage. * The widely quoted health care system ranking by the World Health Organization, in which the US system ranked below other countries' universal health care systems, used biased criteria, giving a false sense of those systems' superiority. * Empirical evidence on the Medicare single payer-insurance program demonstrates that the cost exceeds the expectations of advocates. As an open-ended entitlement, Medicare does not weigh the benefits of technologies against their costs. Paying physicians on a fee-for-service basis also leads to spending increases. As a result, it is difficult to predict or control Medicare's spending. Large market-based public program such as the Federal Employees Health Benefits Program and CalPERS can provide better coverage than Medicare while still controlling costs as well. * Universal health care systems, in an effort to control costs by gaining or enforcing monopoly power, sometimes outlaw medical care paid for by private, individual funds.
[1] Income, Poverty, and Health Insurance Coverage in the United States: 2007
[2] OECD Health Data 2009 How Does the United States Compare

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