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.