26 May 2009
Let Them See and Let Them Learn - Single Payer/National Health Service
I subscribe to too many RSS feeds and to too many newsletters online. This week I have begun to delete almost all but the few emails from people I know and those newsletters that continually provide provocative, well-written articles. Occasionally, I will subscribe to a web site because I want to voice my opinion or comment on an item I've read there. One instance involved a comment from a person in Texas whose logic and plain ignorance seemed to speak more about her lifestyle than about the article advocating a single payer health care system. I offered my response to her comments:
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As the Congress, the Administration, industry groups, media and private citizens try to address the way to change how we obtain medical care in the U.S., some 19th Century Liberals, such as the Comment by Ms. VanArsdall of Dallas articulates, seem unable to comprehend the willingness and ability of our democratic society, our community, to have a birthright or right of citizenship to a healthcare system that seeks to enable us to be healthy enough to enjoy our human entitlements to life, liberty and the pursuit of happiness.
In our Declaration of Independence and in the Universal Declaration on the Rights of Man, entitlement to life infers the right to a condition of health that enables one's life. Contrary to Ms. VanArsdall's assertation, every developed country worldwide, with the exception of the United States of America, provides health care as an entitlement. Debates about health care coverage in those developed countries focus on taxes and costs, not on entitlement. The healthcare debates in the United States, the debate's primary focus is on entitlement and secondarily on taxes and costs. The parties seem to divide between those who consider health care as a benefit of being employed and those who consider health care as a human entitlement per se.
The public instructs our government through our elected representatives, but the public does not instruct private insurance companies, hospital owners, or any of the professional clinical providers of health care. Our government policies frame our health care system by establishing the cost-recovery rules it will fund for professional care and support.
In other words, our government decides how much it will pay for health care provided by any physician, hospital, clinic that agrees to the Medicare rates. The balance of the cost of providing care, at the present time, includes payments from insurance plans, from a charitable grant, and from private sources.
Those interested parties, over whom we have no control--yet--are participating in the debate are 1) the employers/unions who negotiate and pay private insurance companies for group coverage for the employed; 2) the private insurance companies who create and set prices for insurance products sold to qualified groups and individuals; 3) the pharmaceutical manufacturers who provide branded and generic medications; and 4) the hospitals, clinics, medical equipment companies and physicians who contract with Medicare and Medicaid.
Our President has yet to include representatives of the public and Senator Baucus refuses testimony from proponents of a single payer system. So we will have to rely on our elected representatives--excepting President Obama--to look after our best interests. Those groups who are at the table have thrown $millions into the campaign buckets of members of Congress. But, we, the public, have thrown $trillions into the government's till from which our Congressional delegates receive their paychecks, their healthcare group plan, their retirement plans and their costs of running their offices. The campaign dollars might buy an election victory, but none of those elected works on a volunteer basis. (I do not understand the power of a lobbyist as being more influential than the power of the voters who not only voted but also pay taxes to sustain them throughout their terms of office. See prior entry on Corruption.)
If a military veteran qualifies, the Veterans Health Services (VHS) provides comprehensive care, including pharmaceuticals and extended care, for free to veterans with service-connected illness or injury and from co-payments from other veterans. I have had excellent care from the VHS and it offers a proven program for a national health plan, aka a single payer plan. As far as influencing the debate, I doubt the VA will have little if any input considered, which is too bad.
Any person who is not covered by private insurance through an employers or individually--due to the current economic depression the number of people without insurance must be approaching 50 million men, women and children--who is not covered by government insurance through Medicare and Medicaid, has to pay for all costs of any health care he or she might need or forego treatment.
To sum up, our health care system seems based on a framework of having to earn one's healthcare treatments and care as an employee, a retiree or a qualified veteran. If one does not belong in one of these three categories of qualification, then a person must have enough money to pay for individual or family access to professional treatment and care.
I must ask, without order, the following questions for the participants in the current debate about health care reform:
- What is it in the American psyche that prefers government mandates to entitlements as a citizen? Why are we so passively willing to let others decide for us?
- Why do Americans not grow up assuming that institutions for health care are essential to "... life, liberty and the pursuit of happines" unlike those who live in Europe and most of Asia?
- Why don't Americans link their own health with their inalienable rights to lives or living, liberty and their pursuits of happiness?
- Why is this health care reform considered separately or distinct from a reform of the national public health programs? Is not individual health part of national health?
- How can the public, local and federal government (and the judiciary) allow private enterprise, commercial, for-profit insurance companies and pharmaceutical manufacturers control the quality of public health in the United States?
- Why are the costs of medical care always increasing at rates several times higher than the economy's inflation rate?
- Is the health care industry [insurance companies, hospitals and clinics, pharmaceuticals, specialty equipment, specialty technology for diagnosis and treatment] anti-competitive throughout or only in some ways?
- Do the National Institutes of Health (NIH) and the Food and Drug Administration (FDA) contribute to the health care industry's anti-competitive nature by their regulation of research, development and approval for sale of drugs by brand versus generic manufacturing and merchandizing?
- Why do the President and members of Congress state their proposals assuming that participation by private insurance companies' products is a given?
- Why do the California Nurses Association and the SEIU state that their unions will not support any health care reform that includes private insurance companies? Why would the hands-on caregivers take such a definite stance?
- Why are employers allowed to change or to cancel health insurance coverage without sanction? Why are private insurers allowed to discriminate against customers for internally established, arbitrary and unregulated reasons at will, even retroactively?
Over the coming weeks, we will have to tell our Congresspersons and Senators what we want to happen in this radical reform. We should not have to impoverish ourselves before qualifying for public insurance coverage; we should not have to base our national health policies on ability to pay. Time is running out for us to influence Congress better than we did reforming credit cards, banking, or Wall Street.
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