Thursday, January 17, 2008

Practical Universal Health Care

The government run health insurance program in place now, Medicaid, is woefully insufficient in a modium of ways. Run individually by the states, it often finds itself running budget shortfalls. The coverage for prescription drugs is adequate, but hardly sufficient. I know this just from personal experience. In an effort to cut costs, doctors are forced to prescribe lower cost alternative drugs. If a doctor persists in prescribing a higher cost medication, he or she must show evidence that a patient has tried and failed to obtain adequate results from these lower cost alternatives. To wit, additional paperwork must be filled out in that situation, else Medicaid will refuse to cover the expense.

Beyond prescription drug coverage, it is insufficiently set up to cover visits to doctor, dentist, and other specialists. Those who rely on Medicaid for their base coverage are required to visit one particular clinic, wait in line, have their needs addressed by a priority basis, and are often treated by mediocre physicians who have little financial incentive to improve themself or do an adequate job of treating their partients. Medicaid pays out at such a low rate and often so delinquently that many physicians, particularly psychiatrists and psychologists, simply will not take it. This same phenomenon is evident for other specialized fields.

Medicaid is difficult to obtain, first of all. Receiving it requires a person to fill out exhaustive paperwork, satisfy a multitude of requirements, and jump through a vast number of hoops. Even then, doing so is no guarantee coverage will be granted. The system is so convoluted and overly complicated that many people who need Medicaid are summarily denied coverage simply because they do not have the acument, knowledge, and persistence necessary to be able to properly apply for it. If this were a matter of providing ID at polling places, activists of all shades would be jumping up and down decrying this system as racist and unfairly discriminatory.

The best first step towards universal health care, in my opinion, is to mandate that all people be covered. The state of Massachusetts has put this requirement into place. Doing so would open up the floodgates and create competition among health care providers/insurance companies. As it stands now, the market is dominated by only a handful of big names, who dictate price and keep costs artifically high. If insurance was expanded to all American citizens, competition and growth in the industry itself would bring costs down to reasonable levels and lower premiums for all of us. The free-market capitalist approach may be the best means by which we are able to circumvent the demands of the health care industry and the powerful lobby which controls it.

Single-payer universal coverage, as proposed by candidates like Dennis Kucinich contains a multitude of problems. How to fund it without substantially raising taxes is the first concern I have. If our financial situation at the moment was more sound, stable, and robust then raising the money would not be nearly as much of a concern. However, now that we have trillions of dollars of debt, particularly to foreign nations, are involved in a war in Iraq that is a financial drain, and have begun to move into a period of recession, our options in that direction are growing ever more increasingly limited. American borrowing power has suffered over the years and our ability to borrow more money from other countries is reaching its maximum limit. The more we borrow, the more the dollar is devalued compared to the rest of the world's currency and the more inflation we create in our own monetary system.

Socialized medication makes a convincing argument and certainly I would entertain it if I knew the particulars of how those willing to implement it would put it into action. However, systems in place in the United Kingdom and Australia have proven to be immense money drains and whatever approach is considered will need to take into account the failings of both of those systems in formulating a new plan. A modified capitalist/socialist system, i.e. The New Deal, may be the best alternative. I would certainly entertain any and every plan if it made sense and could be accomplished without creating more problems in the long run.

7 comments:

Dr. Zaius said...

How dare you suggest that our country step out of the Dark Ages. Why, you are probably against torture, too!

Comrade Kevin said...

Yes, Dr. Zaius.

I am so liberal I think all people should eat!

datacine said...

Good post comrade.
For a starter position on universal health care check out Matt Miller's "2% Solution"
http://www.mattmilleronline.com/

You can here him via the internets on KCRW. The show is "Left, Right and Center" (iTunes public station listings)

FranIAm said...

Dr Zaius! Please respect Comrade Kevin and his unique outlook!

In all honesty CK, I think you have done this brilliantly!

chris said...

I'm not afraid of the "s" word. it's shameful and immoral that people in this country cannot get healthcare when they need it. I don't like the massachusetts plan because the way I understand it, you're required to purchase a product from a private corporation and if you don't, you're fined. that seems crazy. what's next? the govt says you have to eat at mcdonalds 4 times a month, or you'll owe a fine? same thing, in my mind. medicaid needs to be fixed, run properly and extended to all. cut the insurance companies out. they devote more effort to denying claims than to paying them. they're hugely profitable, and it's simply wrong to make it a LAW that they be more profitable.

the other night I attended a panel discussion on health care where Artur Davis, the congressperson, said one problem with changing the system was that 85% of people with health insurance are satisfied with their plans. I walked out to the parking lot with a woman who said "that's because they haven't had to use it for something serious. wait till they do, they'll see it differently"...I suspect she's correct.

Jaimie said...

This following is comming from a nursing major:

They want to make money. It's as simple as that. Without money where will they get their fancy cars and big homes. Why should the doctors and nurses and insurance agents suffer for the few.

I all to many people who are going into the medical profession because they can make money off of it. I am gald to say that I am not one of them. I just want to make lifes better in whatever way I can.

The bigest change will have to come into play when it comes to the newer generations. When going into the field, they are told that they are going to make a lot of money. What needs to happen is stop trying to get them to think about the money but they good that they are doing to their fellow humans. Many doctors loose site of that due to the knowldege that they are going to make money.

Comrade Kevin said...

Chris,

Excellent point. I like your comments so much that I'm going to take them into account on today's post, which will be a follow up to this entry.

Datacine,

Thanks for the link. I will also take it into account when I write today's post.

Fran,

*hug*

Jaimie,

Profit drives this society and as you point out, unfortunately the pursuit of money gets in the way of treating other people and ending their suffering.