Health Care Reform

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1scope_chemo_withtextIt is currently estimated there are nearly 46 million uninsured Americans. Over the course of 2007 and 2008, 87 million Americans were uninsured. Hardest hit are “low-income Americans and racial and ethnic minorities.” In recent years, more than 12 million Americans were discriminated against because of pre-existing conditions. Even people with insurance are not receiving the care they need. Dwindling reimbursements from third-party payers force physicians and hospitals to close their doors, further diminishing access.  These are the reasons health care reform, including implementation of a US National Health Care System, is imperative now.
 
What is the cost of providing health care for all compared to the cost of not providing health care for a growing proportion of Americans? To provide context for this question, perhaps we must ask alast chart more fundamental question: In our society, is health care a right or a privilege? If it is a privilege, then our current laissez faire health care system—where patients and physicians must battle third-party payers—is fitting. And health care shall continue to evolve into a luxury limited to the privileged fewer and fewer. And the fittest, perhaps only, survivor will be the third-party payer. However, if health care is a right, we have an obligation to provide health care for all and ensure the public health.

The health care crisis, perhaps the most compelling and urgent facing our nation today, upturns our existing paradigm of health care as a privilege. It shows us the cost of not providing health care. To resolve it, we must examine the basic components: those who are impacted, the money trail, and those at greatest risk. We must understand the relationships among patients (uninsured, underserved, and insured), physicians, medical goods suppliers (hospitals/pharmacies and pharmaceutical/medical equipment manufacturers), and third-party payers (health and liability insurance companies). The money trail reveals the ways to control expenditure. For example, we must stop healthcare plans from discriminating on the the basis of pre-existing conditions, gender, race, or ethnicity. We must forbid coverage cancellation when patients are diagnosed with expensive conditions. We must cap premiums, deductibles, and copays. We must create a standard for required covered services. Providers must be compensated adequately and equitably. Patients and physicians must take measures to optimize health and diminish the demands for defensive medicine. Finally, we must implement a US National Health Care System to serve those at greatest risk—the uninsured.

The US spent approximately $2.2 trillion on health care in 2007 ($7,421 per person)—this constitutes 16.2% of the Gross Domestic Product (GDP). US vs OthersThis is nearly twice the average of other developed nations, and projected to reach 49% by 2082.  Unfortunately, spending more dollars results in getting less health care. This demands action.  Support a US National Health Care System now.

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One Response to “Health Care Reform”

  1. cdionne Says:

    With so many thoughts on Healthcare Reform, it’s simply hard to dissect it all and know WHAT to support! Check out what Don Berwick from the Institute for Healthcare Improvement has been up to:

    http://www.marktrahant.com/MarkTrahant.com/Blog/Entries/2009/7/8_Dr._Donald_Berwick,_MD,_MPP,_FCRPCEO_Institute_for_Healthcare_Improvement.html

    I attended the Indian Health Summit in Denver this year and have copies of his slides from that presentation. The most notable slide was the last one:

    “The Indian Health system can become a leading prototype for the redesign of health care in America.”

    His presentation was met with both interest and a whole lot of raised eyebrows (in incredulity) over this issue of modeling the U.S. public health system after the IHS system. I’ve seen YouTube videos where people at town halls are angry about this possibility — as they know the kind of care IHS is able to offer to tribes in their own backyards. But, those people are always shouted down or told to leave because they are just being “trouble makers” or are “plants.” But, they speak the truth. The IHS IS being looked at as a model.

    I don’t think the IHS is necessarily a bad model — I’m just not certain many of the principles that underlie a tribe’s collective participation in their own healthcare would apply much to the melting pot of middle america. Furthermore, there is a great deal of health services simply not covered by IHS at all AND a horrific shortage of doctors, nurses, radiologists, etc. with an inability to hire due to the low wages allocated for medical professionals within IHS. Maybe it’s a good model for implementing rural health programs — but even then there are social factors that play a huge role in tribal care that may not be present in outside communities.

    More info on Berwick and his ongoing interests in Evidence-Based Care and Healthcare Reform:
    http://www.hsph.harvard.edu/faculty/donald-berwick/

    It is important that this country move to a US National Health Care System but I don’t think it’s so easy as to simply “Just Do It.” It certainly doesn’t help any when transparency over what is being considered is shrouded in non-public meetings with key stakeholders in the insurance and pharmaceutical industries, etc.

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