Universal Health Care: An Opinion

¶ … Universal Health Care: An Opinion

Looking at the current numbers of uninsured Americans, and it is obvious that steps must be taken for Americans to have access to affordable healthcare. American cannot continue to provide billions of dollars in aid to third world nations without being responsible to its entire population of uninsured people. The question is: What is the best approach to bringing universal healthcare to Americans? It is a question that we saw the 2008 presidential candidates debate the issue, and make an effort to develop their own plans of healthcare for Americans. The problem was, and is, none of the plans were a viable solution, and did not give Americans the most important element of healthcare delivery: access to coverage and services. Also, the plans really did not go to the heart of the healthcare service: access.

When we talk to the insured and uninsured Americans, there is a common factor. Both groups are worried about their healthcare access. Uninsured Americans know that they can go to the emergency room of a hospital, be admitted, and receive care. They cannot, unfortunately, be directly admitted to a hospital for care, because they have no insurance, and would be required to pay in advance or forced to agree to payment arrangements that not realistic. Insured Americans cite horror stories along the same lines as those people without insurance, that they are prohibited from using their health insurance plans by the people who have control over the benefits they have paid to have access to. Managed care nurses or physicians - and assuming the gatekeepers have those credentials is probably a stretch - often disagree with primary physician diagnoses and the referral for admission to a hospital.

Even if President Elect Barak Obama puts into effect a health insurance plan, the plan will still be monitored by managed care entities worried about the bottom line of their profit margin, and will not allow people to access their health insurance benefits. We'll see the general public become sicker, and the insurance companies become wealthier because Americans are forced to pay premiums for insurance they cannot afford.

Perhaps a different way to go about this is this. Rather than force Americans to purchase healthcare insurance, subsidize existing hospitals and physicians to provide care to anyone who walks into their door, or who makes an appointment at their office. In order to keep the who process from becoming quite hectic, the only access restriction should be that a person must receive care offered in their state - unless it requires a special service that can only be provided elsewhere. To ensure the "elsewhere" clause, we use gatekeepers. The "anywhere" in the state clause will keep the providers competitive on quality of care. The hospitals that now complain about poor managed care contracts, will be the recipients of the subsidy instead of the individuals.

As cost containment, we let the community choose their certain components of their service. Why would we want a woman who has been sterilized to be eligible to receive maternity care? We would not, therefore no labor and delivery services are available to that person, but laparoscopies are available for non-delivery type of services. Additionally, we would not want a person who has no history of mental health problems or alcoholism to be eligible to receive those services.

The restrictions that could keep the costs down, can be worked out. As can certain other dynamics. However, there is no incentive for an insurance company, and that is perhaps the problem with this plan in a country where insurance companies are pulling in hundreds of millions of dollars in profits a year. However, the insurance man remains the "middle man." And we see - especially as a result of the internet - many businesses eliminating the middle man today. It is working, and people are saving money on items that were once marked up for the manufacturer's profit, and then marked up again for the middle man's profit. If we eliminate the middle man, then we eliminate waste. and, if we go by the current profit margins of the insurance companies, we will save hundreds of millions dollars - perhaps even billions of dollars a year and the government could then well afford to subsidize the physicians and healthcare providers as opposed to the insurance companies - which is what the plans proposed by President Elect Barak Obama does, as did Senator Hillary Clinton's, and as did Senator John McCain's plan do.

When we take out the middle man who is incentivized against allowing access to healthcare, we take the worry out of healthcare on all fronts. A healthcare system without the insurance companies is a win-win situation for the government, and the medical service providers. People will, once again, be able to choose their own healthcare providers, and there will be an incentive for hospitals to deal with the increasingly rising rates of staph infection, and other conditions that make going to them for care worrisome.

We might see health insurance companies go out of business, but those jobs will be absorbed by a hospital and medical practice industry that will begin to rebuild itself. Managed care is like a landlord that never makes repairs to its rental units. Right now, we have dilapidated and slum housing, and managed care is the slum landlord who keeps raising rents without making improvements.

Managed care, in theory, is contrary to what is the American dream and perspective. Managed care puts a price on diagnoses, saying that a certain diagnosis, because of its outcome, is worth a certain amount of reimbursement. Managed care does not take into account the quality of life that keeps a person's very life on earth a meaningful experience and passing. We need to put the emphasis back on the meaning of quality of life, and this can only be done by putting the authority over the delivery of healthcare into the hands of the experts - the physicians, nurses, and community of service providers that have all been devastated by the current healthcare system.