The great healthcare reform debate in America

The healthcare reform debate has begun. Years too late.

One is struck by the acrimonious nature of the healthcare debate. At its heart must be the noble ideal to provide each and every American with medical treatment if they fall ill or if they are ill.

But the heart of this debate it seems is about money, the inability to fund a grand or less grand health scheme, “Where is all this money going to come from?” And it is this seemingly persuasive argument that has condemned Americans to the worst health care system in the civilized world during the past many decades. This is the argument from the right, from the Republicans, from conservative commentators; and they ask (possibly fairly) should the government be responsible for our health care?

Those on the left, the Democrats, clamor for a universal system, a national health system courtesy of the US government.

Those in the middle, most Americans, just simply want the assurance that healthcare is available to them or their loved ones if they need it no matter what their financial circumstance.

In order to appease both sides the president suggested in Congress that he would keep the best of the current system and build upon this to develop a system fit for all.

But is the best of the current system something to really keep and build upon? Is there truly anything good about it? The problems are well recognized. Hefty monthly insurance premiums barely affordable to most Americans. And they keep rising. People turned down by insurance companies because of past medical history (and therefore can’t get insured), people dropped by the insurance companies when they become chronically ill, and insurance companies unwilling to pay expected costs of hospitalization or costly surgical or investigative procedures.

This is the case simply because the sole aim of health insurance companies is profit. To make money. Providing health care is simply the medium to generate profit. Their responsibility is to shareholders and investors. It is not truly to the sick people they insure.

But neither has a universal government system elsewhere been shown to be supremely effective in providing quality health care to each and every citizen. Yet, in most European countries the system does work reasonably well. Anybody who is acutely ill will receive good health care; patients with conditions that are not acute (but not urgent) sometimes (commonly in some countries) have to wait longer periods than one would hope for a surgical procedure. But the system is costly.

Which brings us back to money again. One finds it incredible that the debate on the right (Republicans and conservatives) is so focused on the cost of providing health care, with commentator after commentator thrashing suggested initiatives and adding up the costly dollars to show the non-feasibility of providing universal health care. And yet one never hears such arithmetical acrobatics of cost calculations from these commentators when it comes to accounting for the defense of the nation, policing the nation, drug traffic control, America’s wars around the world etc. And when one sees the bucket loads of money used to bail out the banks ands failed auto companies recently surely an argument can be made to show some care for a sick human being?

A responsible government provides for the defense and policing of its people, the basic education of its people and the healthcare of its people. This is the case of every Western nation, certainly every country in Europe. The USA is alone in neglecting the healthcare needs of its people.

Any debater in healthcare is a function of his or her own personal life experiences. All those vigorously fighting change have surely either never been ill or have been in a position to afford the cost of their healthcare or their medical insurance. Such people had they ever been ‘on the other side’, unable to obtain appropriate treatment for their condition or the condition of a loved one, or rejected from an insurance company for chronic illness, or indeed, just had a family member with a chronic health condition, would long ago have changed sides. That’s why Ted Kennedy so strongly supported healthcare throughout his political career (two of his children had significant health problems). These debaters may have also felt the urge to switch sides when people they care for have lost their home or been made bankrupt simply to pay for medical bills they were unable to pay (which happens far too often).

There is a solution to America’s health care problem. And contrary to all current perceived thinking it is not complex.

This is the suggested the way forward. The bottom line is that every single American should have health cover and should never fear the financial implications of becoming ill.

  • For those that can afford it and for those employed there should be a mandatory insurance scheme (paid personally or by the employer). But participating insurance companies must be not for profit organizations, tightly regulated, far from any association with Wall Street. These would be newly established companies. Current insurance companies will initially compete and then fall by the wayside (or adapt). This will keep premiums under control and affordable.
  • And for those that cannot afford it, the uninsured, there is already a system in place which needs to be expanded and properly run. This is the current VA (Veterans Administration) Hospital and medical network. There is absolutely no reason why the current VA system should be reserved solely for American military veterans. Soldiers are unselfish heroes. Sure, they should continue to have free use of the system but why should it boil down to the fact that free health care in America is provided only to those who join the military? And while some may balk at treatment in the VA system, there are VA hospitals that are outstanding, with excellent medical personnel. And those VA hospitals that aren’t top notch can easily be upgraded. The time has come to open the gates of the VA medical system to all uninsured Americans. And just like the money was there for the unplanned Iraq war, for the war on drugs and to bail failed banks surely the federal government must show the necessary care for its own citizens. While currently the VA health care system is totally mismanaged (it costs more to run the VA health system then it does to run the entire national health care system in England yet it provides healthcare to less than a half the amount of people) there is no question that with efficient management this can be rectified.

Doctors too will have the play their part in the new medicine in America. The cost of receiving medical attention, the cost of surgical procedures, the cost of hospitalization, the cost of medical investigations is way way over the top. These costs are unreal and unreasonable, a simple reflection of the greed of American health corporations as well as so many health professionals allied and trusted with the provision of healthcare. With health insurance companies it is blatantly obvious. With the rest of health care it is not so obvious but ever so present. Congress must overhaul the greed in medicine as a matter of urgency. This is the root cause of the spiraling costs.

And of course, illegal migrants. They simply cannot and must not be offered free healthcare. The solution? If working (illegally) then he who pays his salary pays his health costs or must face the law; if an employer takes on an illegal worker the employer must be made fully responsible. If there is no responsible employer then emergency care will need to be rendered as a humanitarian gesture. But on recovery the illegal migrant must be deported. Care that is not considered urgent would not be offered.

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