Let Us Talk About Health Care
Full Disclosure
Before we get into the discussion of health care and my opinions and supporting facts about it, I must give you some of my personal biases and the reasons behind them.
My father was a hemophiliac. For the uninitiated, this is a hereditary “disease” that, in reality, is a genetic disorder that keeps the blood from clotting properly. When injured, depending on the specific type of hemophilia, the hemophiliac cannot stop bleeding. Even for the uninitiated, the outcome can be predicted. If you are injured, you can die.
In the modern era, today for example, there are treatments that do not paint as bleak a picture as I am describing. We need only go back 50 years to 1968 to see a time where this was the case. Ironically, what I am about to describe has a significant part in the improved chances of survival of hemophiliacs.
In 1968, my father had a ruptured spleen. I cannot remember anymore how many pints of blood they pumped into him to keep him alive as they tried to figure out what was going on. At the time there was so much blood in his body cavity the doctors did not have a clue. They just knew that he was bleeding out, faster that they could infuse him. Fortunately for my father, one of his doctors had heard of a new serum that would replace the missing clotting factor my father had. Added fortune as that the research doctor who was developing this was in the same city, San Francisco, that my father was dying in. A few phone calls, a police escort, and some government waivers later and my father had the serum. They were able to operate on him and saved his life.
Now here is the real twist to the story. My father was a commercial fisherman. At that time, the federal government still treated commercial fishermen through the Public Health Service program, free of charge. This was fortunate on several levels.
- Even though the outside surgeons donated their time and the clotting factor was donated, the cost of the surgery and recovery was estimated to be around $250,000 (and that was in 1968 dollars). This may or may not have been covered by an insurance company.
- It was using non-approved clotting factor. It was only approved for trials and was approved for this surgery. It is highly unlikely an insurance company would have approved its use.
- The other issues were moot. My father did not have and could not get insurance. Can you say “pre-existing conditions”. Hemophilia is the ultimate pre-existing condition. He was born with it.
If my father were not a commercial fisherman. If my father had any other profession in the world, he would not had a chance. Forget about the coincidences and circumstances that allowed the surgery to occur. Remember that without access the Public Health Service, my father would not have had access to health care. In short, he would have died.
Thus my pre-existing bias. The system existing in America in 1968, without his unique employment, would have meant the death of my father. Equally, a few years later, during the Reagan Administration, the Public Health Service would no longer have offered the coverage and he would have been dead.
I am not going to tone this down. I am not going to make this more correct and more palatable. My father would have been dead.
Because of this background, I have tried to understand more about health care, here in America and throughout the world.
What America Has
We have to look at America’s situation in pieces to understand where our health care system is currently at.
Medicare
At the crux of our health care system has to be Medicare. This system, along with state-level supplemental medical plans, provide government-provided medical care for the elderly and the legally-recognized disabled, with government-directed supplemental insurance to cover the gaps in coverage. This system, in one iteration or another, has been in place since the 1960’s.
Originally put in place to provide basic medical care for those that could not get insured. Insurance companies would not touch the elderly. Insurance companies would not touch the disabled. Quite frankly, there was no money to be made in it.
Anyone who knows anything about it knows that there are real problems with Medicare. It does not cover everything. That is why there is need for supplemental insurance, once again limiting access to medical coverage based upon financial ability. That, and Medicare can and do deny medical coverage for certain treatments and drugs based upon their guidelines, just like any other insurance company.
Affordable Care Act (ObamaCare)
Note: as I write this, the Affordable Care Act has not been stripped down to nothing, despite the attempts from Congress. They have reduced the coverage to benefit insurance companies and eliminate people from coverage. Below is a general definition of the basic premise as designed.
The Affordable Care Act has as its core two premises.
- All people will be covered, regardless of pre-existing conditions. Insurance companies will have to provide coverage. And coverage will have to be comprehensive.
- Government will provide supplemental financial support for people of lower income so that they, in theory, could afford the insurance.
There are problems with this however.
- Not the least of this is that it is still early days and Congress is still messing with it, and quite frankly, is trying to get rid of it.
- Another is that young people do not want to “voluntarily” pay for insurance. They think they are ten-feet tall and bulletproof and do not want to spend the money. To help keep prices down, the young, healthy, people need to participate.
- In order to make the plans as affordable as possible, there are multiple levels of insurance coverage, with associated premiums. Thus, once again people are not fully covered.
- As in all cases with insurance companies involved, they can and do deny medical coverage for certain treatments and drugs based upon their guidelines.
The only thing that has been any saving grace has been that a large percentage of people are already covered by employer-supplied insurance, either at little or supplemented cost from said employer. If it were not for that, the Affordable Care Act would have failed before it began. The problems with the interests of the insurance companies still exist, but people can afford it as it is part of the employment benefits.
Where We Should Go
The reality is that what we have in place in America is far better than what we had even 10 years ago. That should not even remotely suggest that it is even viable for this country. The best description is that it sucks – big time.
Let us start out with the basics. We have in the United States, the best medical care system in the world. The finest medical infrastructure. The finest medical equipment. The finest hospitals. The finest doctor and nurses. And we let people die because of lack of access to medical care. Repeat, we let people DIE because of lack of access to medical care.
Why? (Rhetorical Question, followed by obvious answer) Money! Doctors and medical facilities must be paid – no question. The way the get paid is through the profit-making insurance system in America. As long as that model is in place, people will not be covered and people will die. As long as that model is in place, insurance companies will determine treatment and not doctors.
What is the solution? (Rhetorical Question, followed by obvious answer) Cover everyone completely! The new buzz term is “Single Payer Insurance”. I guess it is more palatable than the old “Socialized Medicine” of yore, but it is a difference without a difference. People object to the term Socialized Medicine because it sounds too political where single payer sounds more benign. I do not care what you call it. Whatever floats your boat. What we are talking about is whereby everyone has full and complete access to health care. Period! End of Story!
Whether we use private entities (a.k.a., Insurance Companies) to administer the system like they do in Canada or administer it directly like they do in Great Britain the benefit to the individual remains the same. You need medical care; you get it.
Can we afford it? Hell yes, we can. We as a country already spend more than any other country on health care and we are the only major industrial country that does not provide health care. So yes, we can afford it.
Here is an interesting thought. We are pretty much paying for our medical system right now with the incomplete coverage that we have, so we should be able to provide for the same medical care system without incurring additional costs.
So, you need to pay taxes for your medical care. You already are in one way or another. Suppose you are a person who gets free or supplemented medical care as part of your employment. How about the idea of getting complete medical coverage, no limits, and you employer paying your health insurance taxes as a benefit. They would get a tax benefit as well. Win-win and now people do not die.
Because that is what we are talking about. Quit sugar coating it. Until we fix the health care system in America, people are dying. Do you want to continue this travesty?
