Universal Healthcare and the 2008 Election

I started writing this while riding on an Amtrak train heading north along the Hudson River to see my parents. I just spent four wonderfully intense days in New York City, one of my favorite places on the planet. Home for me these days is Los Angeles, a location that I will always agree with Dorothy Parker on -- it is twelve suburbs in search of a city. One of the many pleasures I get from New York is an actual functioning mass transit system. I am a huge fan of the subway system -- and since Los Angeles doesn't have one that reaches the greater part of the city, I don't get too many opportunities to take subways, so I indulge myself in New York. The beauty of riding the subway, for me, is the in your face interaction with all segments of the population. You see young, old, rich, poor, black, white, brown, yellow -- everyone takes the subway because owning a car in New York is a complete nightmare and way too much expense. The subway system is like the healthcare system I dream of -- everyone gets a chance for a fair price to equal access to their destination.

As of recent, I have a new reason to frequently travel to New York -- my HIV specialist is based there. A few years ago, my gut told me to at least develop a relationship with a doctor in New York. I am in the City at least six times a year on business so it seemed to make sense on many levels. I didn't want to take a risk of needing one and having a huge learning curve. I also really became quite frustrated with the many factors of healthcare in Los Angeles. Many of the highly recommended doctors were leaving their practices after becoming burnt out so I was constantly having to doctor search. I also found that many of the doctors at the larger universities were too busy with research and missed important factors in my treatment. I liked having a doctor on the cutting edge, but didn't want to pay for it with my life. Also, as a publicist myself, I felt it was a bit out of the norm when doctors wanted to either become celebrities or discuss my antics with celebrities instead of my healthcare needs. I also had a doctor who took it personally that I was on the Today show and he was not.

Cost, however, become the most important factor. I constantly felt like I was being over tested or over treated just so they could pay the rent. As a person living with AIDS, I am constantly going to the doctor -- be it the HIV specialist, neurologist, dermatologist, podiatrist, optometrist or even the sometimes needed therapist appointment - and I pay close attention to the details of each and every visit. I am self-employed and my healthcare comes right out of my own pocket. My co-payments, as with all individual policies, are higher than those with group policies, and I find that many doctors don't really pay attention to that fact. As long as they get paid it doesn't really matter where the money comes from. Now that I have my virus under control, the next item on my list is to control my medical bills. A few weeks after I write this I will be paying off a doctor that I have owed money to for two years -- a situation I never thought I would be in -- but one that I am very grateful I have overcome. I will have paid all outstanding medical debt - but of course we know the future for a person with AIDS will only bring more. However, for now, I have won a battle, and plan to celebrate the moment.

In our current presidential election, health care has finally become one of those deal-breaking issues for voters. For each individual, it usually comes down to one issue that will earn the candidate your vote. We rarely take the time to learn about the entire picture, instead we rely on sound bites and information given us, whether correct or not, through the media. For some the issue is abortion, for others it's gay and lesbian rights, still some it's the environment. For me, it's obviously healthcare. Without quality healthcare that is affordable and accessible, I have no future. Without the possibility of a future, I don't have a reason to dream -- and I have a lot to dream about.

One of the dreams I had, in order to give myself reason to fight this disease, goes back a few years to when I was spending more time than I wanted to at a Los Angeles hospital. I made this bargain with God. I said, "God, just keep me alive long enough to see my nephew's high school graduation and that will be enough." Well, now that I have four nephews, it is apparently not going to be enough, so I need to have a renegotiation of sorts very soon. What will help me achieve better results in these negotiations is a healthcare system that actually works for me.

The candidate I endorsed with all of my heart and soul recently suspended her campaign. I supported Senator Clinton because of her desire and long history to offer all Americans the same healthcare without qualifications. So I am forced to examine the remaining two candidates. As a person living with AIDS, there is no choice. Senator Obama supports a universal, affordable, and portable healthcare system for all Americans. Senator McCain falls far short of universal healthcare coverage. Individuals with pre-existing conditions (read -- people with AIDS) would be forced to join with a state created non-profit that would provide these individuals a chance to purchase insurance. Senator McCain's plan sounds very much like the current Medicare system, although with a bigger price for the consumer. It appears to be virtually the same system we have right now, allowing the market place to make necessary adjustments and assuming all will be fine. As a person living with AIDS, I can tell you first hand the market place makes adjustments in my life daily -- like do I pay for blood work this month, or do I get new tires for the car? These are the choices I am forced to make with the current healthcare system. Senator Obama's plan more closely resembles Senator Clinton's ideals and therefore there isn't even a discussion for me about who I will be voting for.

The Preamble of the Constitution states very, very clearly the following: "promote the general welfare, promote the blessings of liberty for us and our posterity", which, obviously, can be interpreted in a variety of ways. I, of course, have my own invention on the phrase. Our founding fathers could have had no idea that healthcare would become the industry it has become and would be disabled by its evil stepsibling -- the insurance industry. However, they did want to guarantee one thing - that their generation, and following generations would have every possibility to achieve their fullest potential. For that is why they fought - they fought for the ability to live their lives to the fullest without restrictions placed on them by a monarchy that was out of touch with the common man. We must remember that without access to even the most basic of healthcare, we are not giving individuals that could make substantial contributions to society a chance at a life that, apparently, our founding fathers wanted us to have, and in the end we all loose.

We need to get back to basics and take care of the needs of people living with HIV/AIDS right here in this country first. We need to increase funding for the Ryan White Act and insure that it is not a fight to reapprove it but rather a given that it continues until there is a cure. We need to persevere with funding research and must allow all Americans access to the same drugs and not let the States decide which drugs are on their ADAP lists. Giving all Americans this access to all drugs available helps give them a chance for that full life discussed at that Constitutional Convention in Philadelphia so very many years ago.

Getting back to that bargain I made with God, I want to live to be able to have the chance to make a renegotiation. For you see, I have four of the most wonderful nephews that are on this planet, and I want to live to see them become men and watch them make their contributions to this world. I want to have a healthcare system that actually does what it says right there in the name -- provide care. I want a health care system that I feel a part of -- not just another person standing at the velvet ropes trying to figure out how to bribe the doorman so I can get in.

We need to take care of our own. Not just a few. Not just those with money and connections. We need to have a healthcare system just like that subway system in New York. It needs to be open to all, at a price we can all pay, and provides us with what we need. This way, we can take care of ourselves, our neighbors and fellow countrymen, and then, and only then, let's reach out to help the world. We can do it. We have everything in place -- we just need to let people have access to it.

So this November, vote as if your life depends on it, because it truly does.

Follow Thomas DeLorenzo on Twitter: www.twitter.com/TDeLorenzo

Comments

[Thomas DeLorenzo - Huffpost Blogger]

Health care is one of the single most important issues facing Americans today -- lets all work together to make it happen.

[fourpim]

HealthCare in America? From what I experienced today....I think NOT. I had made a call from my surgeons office last week to the PCP to make an appt in order to obtain medical clearance for the surgery. Get to the PCP today and he is ballastic about the surgeon....why did he not contact him directly, then yelled at me for the ER not contacting him last week when I was taken in there via ambulance. I explained to the PCP that when I asked the ER if they had contacted the PCP...was told "no reason to". PCP told me pointblank there is a MAJOR communication problem at the surgeons office. I reminded the PCP that when I called to his office and explained pointblank I needed a "surgical pre-authorization" appointment...they book me for a BP check. Hmmmm...where is there a communication issue? And here I am right smack in the middle, in a great deal of pain, work wont let me back because of the pain and I am now at 60% pay due to my short time with the company. Life looking very bleak. This is NOT HEALTHCARE when 2 grown men act like kindergartener's and put the patient right in the middle.

I have been to some Universal Health Care meetings here in the Denver area.....I will certainly increase my support for this issue!

[charlesclarknovels]

Most comments above reflect the same attitude: our healthcare system needs to be reformed. A continuation of the same reimbursement program now in place will continue to escalate cost and concomitantly premiums, deductibles, and co-pay. The cost can be reduced and brought under control if a few simple changes are put in place: Deny reimbursement for medically unnecessary procedures, medically unnecessary diagnostics such as laboratory and imaging procedures, and for services performed in facilities in which the physician provider has a financial interest. Examples: Day Surgery Units, Laboratories, Radiology Imaging Facilities, Home Nursing entities, Hospice Care, and others.

CMS is already focusing on quality issues in hospitals with the Core Measures program and with the access to information through Hospital Compare. If this is expanded to include physician providers, quality will improve. Improved quality equates to more efficient utilization of services and fewer complications of care such as postoperative infections and medication errors.

But, the question is this: are our lawmakers courageous enough to stand up to the powerful lobbyists of the healthcare industry? Probably not.

charlesclarknovels

www.charlesclarknovels.com

[SpiralForward]

whether you believe that Universal Healthcare is the right answer now or not, to me this article well establishes the point that the system does need to change and attempting a system-wide solution is the first step. In my opinion a system-wide option is likely the best route to start. Inspirational piece!

[la-story]

It's a matter for all people-- those with chronic diseases particularly -- to have a better safety net. This has been an issue that's been presented multiple times during multiple presidencies. and no one -- NO ONE -- has stepped up to the plate to seriously address this since Hilary Clinton was first lady.
And no one took that presentation seriously.
The health care system in Calif is in dire need of some change and it affects everyone -- particularly those who don't have insurance because they are at the mercy of the county health care system and you know who pays that bill? You and me.
Nice job on the piece

[1stThron]

Universal health care could be affordable today if the Centers for Medicare and Medicaid Services (CMS) had not implemented decades ago reimbursement policies that paid for operational inefficiencies and preventable medical errors. Together, these perverted policies have inflated health care cost 42% to 60%. To compound the problem, CMS controls its budget through a Congressional mandate that discounts payments to health care providers who then transfer the discounts to patient charges paid by commercial insurance artificially inflating premiums. When you underpay health care providers for excellence so the saving can pay for operational inefficiencies and preventable medical errors, expect more of what is rewarded not what is underpaid. If the U.S. Congress had the courage to pay health care providers for excellence and never preventable medical errors or operational inefficiencies, then you would see the gates open to the "most efficient delivery of quality, universal, integrated care" (MEDQUIC).

[RoloTomassi]

If you find the blatant drivel posted so far here by the GOPers & Blue Dog degenerates, then follow the link below to read the truth about WHY we don't have a UHC system in the US:

http://www.chomsky.info/interviews/20080718.htm

WE CAN HAVE A UNIVERSAL HEALTHCARE SYSTEM IN THE U.S., BUT WE MUST ORGANIZE AND PUSH THE ISSUE BEYOND THE NAYSAYERS WHO ARE NOTHING BUT CORPORATIST CRONIES AND THE SIMPLY MISGUIDED.

[BrighterStar]

Dreaming is a good thing, but you must also accept reality, especially when implementing policy for the nation. All of the reforms you seek have serious negative consequences. A long history with social reform has taught us that the reality of the world is that when the marketplace is used to deliver goods and services people are much better off and when the government is depended on to deliver goods and services bad things happen.

[RoloTomassi]

What a load of corporatist-driven drivel; it works EVERYWHERE in the developed world BUT HERE IN THE USA, and that is simply because:

1) Corporatists tell us you're repeating, and

2) We buy as though it is actually the truth.

And it's just that simple.

[egal]

Actually, history has taught us that what you describe benefits the top 1% and no others. The market and the government both have their differences, but it would require gouging out one's own eyes and ears to believe that going the way of the market alone is not betraying 99% of our populace and lining up the bottom 35% for early, painful, and largely preventable deaths.

[BrighterStar]

If you want to talk preventable deaths look at the cancer survival rate in England where there is a wait list to begin treatment. Thousands of people die every year because of an incompetent government run health system.

[Laurag4321]

Universal health care will result in a lower overall expenditure, plus insuring the 45 million plus people who are uninsured, many of who currently have no access to health care except in an emergency. Profit should not be a motive in denying health care to those who need it.

Look at Medicare and TriCare. Both are government-funded (but not DELIVERED -- big difference) health care programs, both require financial contributions from those who can pay, and both afford among the best health care available in the US today. Why shouldn't all Americans have that kind of access to high quality health care at an affordable rate?

The big myth of a universal health insurance program and/or single-payer program is that it would be government-run health care. No, the government would run the insurance program, not the providers.

[BrighterStar]

A government controlled monopoly is going to deliver more goods and services at a lower cost? Your not fighting conservatives your fighting reality.

[schatsie]

are you talking about ENRON and how when they got deregulated they partied over the bodies of grandmothers???

Our healthcare system is a free market system and it does NOT work.....that is why Medicare was established....

[tegrat]

"universal health care" is a meaningless term unless you define how you are going to accomplish it. Neither McCain, nor, unfortunately, Obama have defined viable plans to achieve comprehensive, affordable care. McCain's is much further from reality, as he is enamored of the notion that privatization is key to good health care (what could you expect from someone who feels he can just waltz into the dermatologist's office when he pleases). But the saddest part is the refusal of the Obama campaign to acknowledge what the rest of the industrialized world already knows, which is that single payer is the only viable and fair system for accomplishing the goal of universal access to health care. You of all people, with a chronic condition, and having dealt with the insurance industry as an individual subscriber, must know how ridiculous and counterproductive keeping the multiple insurers in the game is. Single payer has the numbers on its side, and is garnering the grassroots support which will be required for it's implementation (I invite you to join, a good starting place is Physicians for a National Health Plan). Groups like "Health Care for America Now" claim to support single payer in principle, but undermine it is practice as they further their goal of including the insurance industry (which supports them) at the table. Voting for Obama should definitely not be based on the issue of health care. Neither candidate will be able to construct legislation to implement the systems they propose.

[UnbiasView]

Are you saying "promote the general welfare" means providing the money for them?

Promoting would be AIDs education like stop sleeping around or stop using other people's needles . . . providing them with treatment for free when they screw up is another story.

[Laurag4321]

Who said provide it for free? Who said not to provide education, as well? How about making insurance affordable to all, and keeping value judgments out of it?

[schatsie]

How about providing treatment when they get infected with EColi from the meat industry???
or drug resistant TB so that when you stand next to them in the grocery store that they are no longer contagious. and how about clean water so we don't spread cholera.

I guess you could then argue that cancer treatment is not needed or transplants or blood pressure medicine... Are you living in a fantasy????

[hopeless277]

Whoever becomes president(McCain by all accounts) will find that congress is neither willing nor able to agree on healthcare reform much less universal healthcare. The insurance corporations have a lock on the representatives you elected. They will send BILLIONS to Pakistan and Georgia while letting the USA and it's people rot. Literally. There will be no universal healthcare in this country ever. There will only be war. Endless, perpetual war. My advise is to invest heavily in weapons manufacturing. That will be where all your tax dollars will be spent.

[schatsie]

I am inclined to agree with you. We would rather send trillions of dollars to China and the oil countries instead of developing alternatives (like the Germans are doing) and pay for health care of children in our own country....