Saturday, January 27, 2007

The Choice

The debate for improving our health care system is nationwide. Many, like Governor Schwarzenegger and Mitt Romney, have devised plans that make all Americans have health insurance. This is corporate-based, profit-driven health care. Just a different version of what we already have that does not work; that does not provide the medical care we need to be a healthy, productive, competitive society. The only difference will be that insurance companies will make more profit because they will have more enrollees.

Individuals that cannot afford the high price of premiums and yet do not fit into the economic range of those that can receive adequate government subsidies might be forced to break the law and not have any insurance at all. Others might opt to try to buy policies that are insurance in name only with unthinkably high deductibles, high co-pays, and outrageous limitations of coverage. All of these individuals will still put off care until they need to go to the Emergency Department and in the end everyone else will still have to pay for their care.

You cannot say you have Universal Health care for your citizens if millions of them still cannot receive appropriate care due to insurance policy inadequacies.

What's the other choice?

Single-payer, single standard of care, universal health care.

This is patient-centered (not profit-centered.) Everybody pays into a single agency and this agency pays out to the providers.

Every doctor gets paid for every patient treated. Every hospital gets paid for every patient cared for. And every citizen gets the health care they deserve.

Ask any doctor or hospital how much time and money they spend trying to collect debts; how much they overcharge paying patients to cover for those who cannot pay. It is a huge problem. Single-payer solves this economic problem. Ask any Emergency Department nurse how many patients they see that should go to a primary care doctor for colds, flu, and minor injuries. Single-payer will free up EDs to take care of true emergencies. Also ask the ED nurse how many patients they see that could have averted their medical crisis had they received preventative care like the diabetic who comes to the ED in renal failure or the patient with high blood pressure who comes in with a devastating stroke. These high cost emergencies (high financially and high in terms of human suffering) could be averted with preventative care that would be covered under a single-payer system. And again this would free up Emergency Departments even more to be ready to handle your heart attack or catastrophic injury where waiting time can be the difference between life and death.

Given this, the choice is not hard at all. If we want to fix our health care problems, we do not need mandates for all to buy insurance, but we do need a single-payer system.

In California support Senator Shiela Kuehl's bill (SB 840 California OneCare) and nationwide support Congressman John Conyers' bill providing Medicare for All.

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Tuesday, January 09, 2007

Schwazenegger's Plan is off; Single-payer, Universal Care is the Answer to Our Healthcare Crisis

Today California's governor announced that he wants to help all Californians have healthcare coverage. It is good news to hear that Governor Schwarzenegger wants to fix our broken healthcare system. The only problem is that those he has asked to participate in the solution ARE the problem.

Last year Schwarzenegger held a conference to determine just what his healthcare reforms should entail. The "stakeholders" present at the conference who got to give the Governor input were those in healthcare who had contributed greatly to his fundraisers: the health insurers and the pharmaceutical companies.

Health insurers take up to 30% (some even as much as 50%) of our healthcare dollars and spend them on various adminstrative costs like lavish executive compensation packages and advertising. (Medicare's administration costs are around 3%.) And of course there are those armies of adjusters who review claims and petitions for care looking for any and every reason possible to deny coverage.

Highly profitable pharmaceutical companies charge Californians outrageous amounts for medicines that Canadians and Kaiser patients pay pennies for.

No where in the Governor's plan are these excesses adequately restrained. No where in his plan is a universal quality of care demanded. Insurers are allowed to sell insurance that very well could cover next to nothing except the next bonus cheque for the insurance company's CEO. Californians would be required to pay for such bogus coverage.

There are Californians who are just as healthy as the Governor (previous hip replacement, heart valve replacement, multiple trips to the Emergency Department, and broken bones requiring hardware to keep them together) who cannot buy health insurance at any price; insurers red line them out. I am not convinced that insurance companies would not find ways to continue redlining. And there are Californians out there who will not be able to afford the State mandated insurance and keep a roof over their heads and food in their families' mouths all at the same time. Those people will choose, just as there are still uninsured motorists, to go without the insurance.

When my family was young, neither my husband nor I had jobs that provided health insurance. Since the cost of independently insuring our family was way out of our reach, we went without. We gambled and got away with only a few visits to the Emergency Department and a few extra visits to our pediatrician. But we knew we were one step, one illness, one accident away from disaster.

My husband had to have eye surgery which was covered by Medi-Cal and the largess of the hospital at which I was employed. The surgery greatly improved his sight and made it possible for him to be gainfully employed; thus being a good for our little family, as well as a Good for Society in general.

Now we all have some sort of coverage but we have seen up close and personal that if your insurer denies you the care you need, even though you are paying the pricey premiums, you still have no health care.

I want universal coverage, effective cost controls, and high quality care that I, as a registered nurse, would be proud to deliver.

That kind of universal coverage, California Healthcare for All (California One Care), was approved by the Legislature last year (SB 840 by Senator Shiela Kuehl) but vetoed by the Governor. Senator Kuehl's single-payer, single (high) standard of care, universal healthcare bill will be introduced again and must pass this year.

That kind of care is also possible for all of America in the Medicare for All bill sponsored by Congressman John Conyers of Michigan. Being the only nation among our economic peers in the world that does not have universal health care, it is way past time we got serious about it and did it. For ourselves. For our children. For our economy. For our future.