Universal Health Care Doesn't Mean We're Entitled to All the Health Care in the Universe

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The AFL-CIO and its community arm, Working America, just released their 2008 Health Care for America Survey. Most of the 26,419 online respondents are insured, employed, and college graduates -- those, the report explains, most likely to react positively to America's health care system.

But with its pie charts and tables, enhanced by 489 "heart-wrenching stories about the effects of this broken health care system on them and their families," the report is like a PDF version of Michael Moore's movie Sicko. Of course, it's to be expected that many of those who took part were prompted by the chance to air their grievances.

One of the premises on which Senators Clinton and Obama are running is the extent to which they feel our pain. In fact, Hillary consented to an in-depth interview on her plans for universal health care with Kevin Sack of the New York Times.

When taking either of their plans into consideration, one must first disabuse him or herself of the notion that, if implemented, you're going to walk into a doctor's office like in England and out again with nary an exchange of cash nor any paperwork. Both Obama and Clinton's versions of "universal" coverage call for a bill that would require Americans to buy health insurance.

Require? Who doesn't want health insurance? A few twenty-somethings too blinded by their partying to picture the illnesses they're courting? For many others, the heart is willing, but the pocketbook is weak.

Then Sack writes, "Mrs. Clinton said she would like to cap health insurance premiums at 5 percent to 10 percent of income." We're not trying to pick on Hillary -- she's catching enough grief as it is -- but that doesn't sound like much in the way of relief.

Sacks adds: "She has previously said that garnishing wages would be one option" to guarantee participation. Garnishing wages?

Already you can feel yourself hyperventilating. It's like finding out after an emergency room visit that the attending physician wasn't on your plan. Or when doctors shoot bills -- which by all rights should be sent to your insurance company -- out to you like baseballs from a pitching machine.

It's not quite as bad as all that. "Refundable tax credits would help make the newly mandatory policies affordable for low- and middle-income workers," Sack writes. Also, "Government insurance similar to Medicare would be available to all consumers." And, of course, Hillary "would require insurers to cover every applicant regardless of age or health status."

Meanwhile, Obama at least understands that concerns about premiums is paramount. Mandating coverage only for children, he opposes requiring us to buy insurance until it's affordable.

To achieve that end, Hillary suggests rolling back President Bush's income tax cuts for those who earn more than $250,000 a year. Not to mention taxing everybody's favorite whipping boy, the smoker.

But there's one cost-cutting measure that Hillary, Obama, or, for that matter, anyone championing universal health care won't touch. As one of the respondents to the Health Care for America Survey said, "Everybody deserves high quality, affordable health care."

That's an easy sentiment to sign on to to. But don't "high quality" and "affordable" operate at cross-purposes to each other? In other words, measures such as increasing taxes and reducing administrative costs -- such as dismantling the apparatus devoted to denying claims -- may not be enough to shore it up.

In fact, it's time to ask ourselves: Does universal health care really mean that we're entitled to all the health care in the universe?

A critical factor sending health-care costs rocketing into the stratosphere is medical technology. For example doctors prescribe tests, MRI's and CT scans like they're handing out candy at Halloween. While reassured, the patient can't help but suspect that the doctor's underlying motive is either the promise of kickbacks from the medical technology industry or bullet-proofing the doctor from malpractice suits.

Is there a way to intercept this knee-jerk response on the part of doctors in hopes of keeping costs down? Yes, but it requires a leap of faith from a public conditioned to believe that the technological assigns a precision and accuracy to our random existences which we can no longer do without. Besides, to many of us, prosecuting a successful malpractice suit is the equivalent to winning a state lottery.

What if we freed doctors from concern about medical malpractice except in the face of criminal negligence? In other words, to keep costs down why not enable them to diagnose the old-fashioned way -- by using their know-how and experience?

But the faith of doctors in technology rivals that of their patients. Like pilots who are instrument-rated, the last thing they want to do is turn the clock back to the days when they flew by the seat of their pants no matter what the visibility. Their diagnostic muscles, if ever developed, may have have long-since atrophied.

In full hyperventilation mode by now, we ask, "What? Trust doctors?"

That's a barometer of how far health care in America has fallen in our eyes. Doesn't anybody remember those halcyon days when we trusted no one more than our doctor?

Comments

[AnAussieSlummingIt]

Universal Health Care Doesn't Mean We're Entitled to All the Health Care in the Universe - why doesn't it? It does here in Aus. When I was seventeen I had a car accident which left me in intensive care requiring a neurosurgeon. The Neurosurgeon who attended me was one of the best in the country, the care I received was first rate and six months later I was released from hospital only slightly worse for wear. Two major operations plus six months worth of primary care cost me exactly nothing (aside from the taxes that I pay as a matter of course). This is the way that we Aussies believe it should be. We aren't the richest country on the earth but we have some understanding of the things that are important. Health care is important so we have a universal system called Medicare. Social cohesion is important so we have a universal social security safety net via our social security system. Democracy is important so we make voting compulsory. Why is it that the richest country on the face of the earth can't (or won't) provide the very minimum that is considered required by virtually every other first world country?
Perhaps it is because you don't have a real democracy but rather a plutocracy in which any gov entering office is unlikely to have been voted for by any more than one in five people.

[texpine]

Very interesting comment Aussie. I'll have to think about it some. Right now it seems to be all about the Money (who, where, when , how) and not the actual Healthcare but I'll reserve final judgment on it 'till I've given it more thought.

[texpine]

Healthcare Insurance (like any Insurance) is Leagalized Betting! You put your money up betting you will get sick and the Insurance Company makes Book that you won't! The bet is worded so you only get a payoff if you actually get sick. Most of the time whether sick or well, they make another monthly bet with you. The House (Insurance Company) wins a large majority of the time.
Where the Money comes from to place the bet and who will finacially back the Insurance Company seems to be what is causing this controversy.

[JacobSinger]

This article is nothing more than semi-apologist posturing; it muddies the waters with incidentals that make the problem seem more complex than can possibly be solved by ANY UHC system, and it does so by propping up the potential strawman argument that the plans offered by Clinton & Obama aren't true Universal Healthcare, and by extension asserting that no options other than the ones offfered by Clinton & Obama are available or feasible--and that is a LIE.

Look here to understand why this article is essentially defeatist misinformation:

http://www.huffingtonpost.com/miles-mogulescu/why-not-single-payer-par_b_94239.html

Conyers' H.R. 676 is the best offer on the table, and with that system the thrust of this article is basically meaningless.

[BusGreg]

I had to go to the ER the other night, to remove a small sliver of metal from my eye. For the ER Doc to numb my eye, find the piece and remove it took all but 10 minutes. Besides the triage nurse and the doctor I had to see 5 other people, 3 prior and 2 after the procedure, all paper shufflers! To cap it off I was handed Oxycontin just in case there might be pain later. I informed the doctor that I don't take narcotics and that it wasn't painful enough to warrant even an aspirin with the metalsliver in my eye. Guess what?! They gave me the damn things anyway: We have billed Medicare already, was the answer.
It is evident how much money is wasted on unnecessary drugs and bureaucrats by today's healthcare system. Add to that the profit taken off the top by HMO's (Hand Money Over) which never sees the doctor. America could easily afford government healthinsurance for all even if we had to pay slightly higher taxes IF we had:
1) a trustworthy government that works for the PEOPLE.
2) healthcare for all.
3) quality education for all.
4) our troops at home and not wasting trillions in Iraq.
5) tradepolicies that benefit US rather than every other country on earth.
6) an energy policy that benefits US and the environment and not exxon-mobile.
7) and yes, a trustworthy government that works for the PEOPLE.

[FreedomLoverX]

We don't need health insurance. The whole idea is deceptive and stupid. NO ONE wants health insurance. What we want, plain and simple, is health CARE. And yes, it should be available to all, unconditionally - that means all the health care in the universe.

[GoreyFantod]

Yes, it almost seems as though Mr. Wellen didn't actually watch Sicko, just the trailer and the snippets shown on CNN. I grew up in Canada, so believe me, I know the difference between health insurance and health care; between a society where teeth and glasses are considered a luxury & one where they're seen as a necessity & a right.

I'm so tired of a lack of affordable health care & dentistry being transformed into a discussion about insurance. I live in Massachusetts and I'm required by law (thanks Mittens Romney, you prick), to buy insurance that I can't afford, with rates based on gross income. Yes, you read that right - there's no accounting for one's actual expenses like rent, food, utilities or other outstanding debts & liabilities. Insurers were all for the new law, they just don't like the part where they have to make it affordable, so they're lying all the way to the bank about their rates.

Insurance is not health care & malpractice suits are not the problem. A health care system run by greedy, selfish fools & scrooges and programmed thinkers who buy the lie that one's level of health should be commensurate with one's ability to pay - that's the problem.

[Herrington]

HuffPost's Pick

Of all the mounting costs of healthcare, malpractice, technology, insurance profit and overhead, doctors administrative cost, one of the most insidious and undisclosed, unreported and unevaluated costs is the non-profit hospital. Your non-profit hospital will mark up every procedure anywhere from 150%-400% over cost. Ok, $200 to see your doctor is one thing, but $20,000 for a procedure that costs $5,000 is another. Non-profit is a hoax.

Where do the "non-profits" go? Only speculation is possible because only the IRS is entitled to look at the books. If you want tot see them, you have to bring a subpoena. Hospitals have been quietly forming regional monopolies for years and the result has been to raise prices of care everywhere due to reduced competition and price fixing. But look at the non-profit model. All that is required is spend what you take in. And spend they do, on facilities, on equipment, on mergers and aquisitions and they can dole out bonuses to their baords of directors with complete impunity. It is the perfect model to encourage corruption and inefficeincy.

[Mormondude]

HuffPost's Pick

We don't need doctors to get dumber and more old-fashioned. The medical training they get today is practically pre-historic given the quantum leaps we're achieving in biomedical science. We need a whole new type of doctor that can embrace the next generation of medicine, not get stuck in the mindset of last century.

The topic of your post is entirely correct. We can't expect to get all the health care in the universe unless we want to take over the entire system, top to bottom. In Cuba a hotel attendant makes more money than a surgeon. If we bring doctor's salaries crashing down, and bring the prescription drug system crashing down, and bring the technological standard of care crashing down, then maybe we can afford to treat everyone for everything they could want.

What bothers me is that the absolute best insurance now seems to be Medicaid. It covers everything. Emergency rooms, prescriptions, doctor visits, outpatient, etc, etc, etc. It's gold plated coverage. I know a family that would go to the ER every time their kids got a fever, or every time they got diarrhea, just because it was "free", and they had a tinge of hypochondria. When you divorce financial consequences from making medical decisions, the costs naturally spiral out of control. So when someone says "Medicaid for everyone", I always cringe.

[JacobSinger]

I am continuing to marvel at the misinformation in your post.

"When you divorce financial consequences from making medical decisions, the costs naturally spiral out of control."

That assertion is absolute nonsense, as you have it exactly backwards; financial costs have been put ABOVE medical decisions, and so the absurd healthcare "system" we have in the US functions like exactly what it is: a corporation that puts the goal of making the highest possible profits above the quality of care--it happens at the doctor's office, at the pharmacy, and especially with the medical insurance providers.

By embracing and enacting H.R. 676, the "Medicare for All" bill, overhead costs would be reduced, the quality of care would go up and the insidious PROFIT FIRST approach to healthcare would be a thing of the past.

Please try to get better information to work with; anyone with any knowledge on the subject knows better, and you simply come off as being status quo shill who is biased towards corporate profits over quality care.

[Mormondude]

Under our current system and insurance adjuster decides what to pay for and how much to pay for it. Under a single payer system a government bureaucrat would decide what to pay for and how much to pay for it. I don't see the huge benefit there.

If you're talking about administration costs, that can be reformed without implementing a single payer system. The government itself can't even decide on a single insurance form today, so why would you expect that to change under a new system?

[GoreyFantod]

Am I the only one who wonders how "HuffPost's Picks" are chosen? I haven't checked out the picks in the sections that don't interest me, like Living, Entertainment or Business, but it seems the majority express markedly conservative opinions. Both of these "Editor's Picks" express a view of health insurance that's well to the right of America, let alone the average HuffPost reader, but they're remarkably close in reactionary tone to the original post.

Are they chosen by the actual editors, by the post's author or by volunteer moderators? I'm guessing it's the latter, but I don't recall seeing an explanation of this anywhere. Anyway, I probably wouldn't care, but when these "Picks" lean so right it makes me wonder whether there's a connection to the way comments are moderated...

[JacobSinger]

"In Cuba a hotel attendant makes more money than a surgeon."

Really? And you have what source of information to back that up? Care to provide a link?

[Mormondude]

Here's one for ya'.

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/02/13/wcuba13.xml

"Castro introduced the dual currency in the 1990s as a means of the boosting the economy after the collapse of the Soviet Union when Cuba threw open its doors to foreign tourists. Last year almost 2.5 million foreign travellers, mainly from Canada, Britain, Italy, Spain and Mexico, visited the Caribbean island.

The changes are credited with keeping the economy afloat but also created a vast and troublesome gap between the population of 11 million dividing those who have the convertible currency and those who don't.

"You can't buy anything with Cuban pesos," said Mr Espinosa. "Anything worth buying " soap, cooking oil, shoes " must all be purchased in convertibles.

"We are in a situation where a bell hop or a chambermaid can earn many times the salary of a doctor or civil engineer. What incentive is there now to train to be such a thing?"