Health Care Charity... and Then What?

By: Teddy
Published On: 11/9/2008 5:38:14 PM

I finally got to read the article recommended by teacherken, The Healing Fields: Hidden Hurt by Mary Otto in "The Washington Post Magazine" for 9 November 2008. Since I, along with half a dozen other constituents of Delegate David Bulova, and Mr. Bulova himself had had a wide-ranging conversation about health care and health insurance just this past Saturday, I'd been thinking about the very same problems over the weekend.  No, not problem, that's not a strong enough word; more like Growing Disaster. To be sure, President Elect Obama presented a modest health care improvement suggestion during his campaign---- one that, predictably, was denigrated by Republicans as "socialized medicine" which would bankrupt the United States, cause millions to lose insurance coverage, and not work anyway. What we do have is not working, either, of course. A society, especially one based on democratic principles, should measure its success from how well the folks on the bottom are doing, rather than how comfortable are the folks at the glittering top.  Clearly, we have an almighty big gap: there is room for improvement, especially as compared to other industrialized democracies. The 3-day annual field hospital on the Wise County Fair Grounds is one attempt to fill that gap; a touching and gallant effort, to be sure, but only a feudalist could consider it a solution. So?
Half of the United States' population, I've been told, is suburban-urban. What is the other half? Some people are small town or comfortably country, I'd guess, but most of the rest are pretty much like the Appalachians described in the article, whether they live in the mountains and coal country, or in half-empty by-passed former-factory towns, or on dusty plains where family farms have failed and Agribusiness' factory farms do not provide a living for the remaining populace. This is the detritus of an unsustainable life style and culture that, in full tide, washed up the mountains and out across the water-poor plains, and now the tide has drawn back, stranding human beings in place. Sure, we can ameliorate the heart-wrenching health care disasters touched on in the article with annual charity clinics, much as in the Middle Ages the occasional noble lady and her confessor priest established comfort and care "hospitals" for the poor, thus racking up brownie points for themselves in Heaven.  Charity=Good.

We can tinker around the edges of our high-cost but broken private health insurance system, hoping employers can somehow continue to provide minimal care for those who do have real jobs, while trying to improve the efficiency and control the galloping costs of Medicare and Medicaid---- despite mushrooming federal deficits. Broad Coverage Health Insurance=Better.

Or, we can get real, and go for Real Change.   Yes we can:

1) Improve the economies of these depressed areas by creating sustainable new local industries which will pay living wages with adequate benefits (either that, or help the jobless and the sick or retired to move to better areas, and repair the wounded lands they leave behind); this would not be the first time America has done this sort of thing---- consider the vast land grants the federal government gave to entrepreneurs to induce them to build the transcontinental railroads, for example.  PLUS

2) Create single-payer universal health care based on an infrastructure which would include such things as:

a) government-sponsored medical education (a medical ROTC) whose graduates would owe a suitable number of years' post-graduate work in Public Health Service, who would be sent  wherever the Service designated a need, which could be inner cities or rural and remote areas, or anywhere for that matter and for which they would be paid a stipend, of course (remember, these medics will have no expensive student loans to pay off, they won't need astronomical incomes);

b) clinics established in under-served areas, a few specially constructed just as the Postal Service constructs post offices, but most in already-existing but now-unused factories or warehouses, staffed by the Public Health Service (see item a) above);

c) federal prescription drug and equipment service wherein there are government grants (mostly to private enterprise and universities) to develop new drugs, medical procedures and equipment; this includes the requirement that the feds can bargain for how much the drugs will cost the feds and the patients; moreover, a surprising number of drugs and equipment are in fact already developed not by Big Pharma but by small businesses and universities, many times with the help of government grants, that later are bought out by major companies (or, sometimes are suppressed to protect the profits of big companies);

d) referral specialists (including mental health), laboratories, and major hospitals networked with these Public Health Service local clinics.
Universal Health Care=Best.

Does it sound expensive? I admit to start-up costs, and I've made no spread sheet or analysis. I suspect that, long run, it will not be as expensive as what we have today, may save money in fact... particularly if you consider the cost of lost labor of the current sick and jobless people in their stagnant local economies, the cost of emergency room care for uninsured, drug and equipment costs from a for-profit health care system, the incredible cost of getting any kind of medical training or advanced education.

Be honest with ourselves: Our society has used up and thrown away as disposable vast numbers of exactly the people described in The Healing Fields, not to mention how we and President Bush (we are ultimately responsible for Bush, y'know) have treated our returning Veterans, many of whom come from exactly these classes. The rest of society has not paid the true costs of our comforts, and the bill for a lot of it is coming due: environment, health care, veterans, education--- are all coming due. Suck it up, America. We're all in this together, it's never been You're On Your Own. WITT, not YOYO.  

Comments



Rest on Laurels, or Stand and Deliver (Teddy - 11/9/2008 6:38:27 PM)
Big Pharma owns the Republican Party, IMHO, as much as does Big Oil. Hillary Clinton's health care effort was turned into a disaster, and gave national health insurance such a bad name (once the agitprop finished its misrepresentations and attacks) that all an opponent of health care reform has to do is shout "socialized medicine" or "Hillarycare," and the reform is SOL. During the discussion with Delegate Bulova, when I hinted, in an aside to a retired gentleman that perhaps a single payer system might be cheaper, he dismissed the idea as "socialized medicine, and that hasn't worked anywhere in the world." I rather expected that reaction.

Okay, I put this on the table to see if even some part of it might actually be able to be included in an effort to accomplish something a bit better than the "bandaid" mentioned by teacherken, and in the Post article.  



Health Care (Mary I - 11/9/2008 9:06:51 PM)
Under COBRA, I was able to continue with Blue Cross/Blue Shield. I pay the entire premium in excess of $500.00 per month. This is for Standard rather than basic coverage and is the same coverage offered those on the Hll. I select my own doctors and have perscription coverage as well.
I have no interest in any change in this. I was very happy with Obama's thought that if you have healthcare coverage and want to keep it, under his plan that would be the case.

What I really don't understand is why as a Blue Cross requirement,when I became of "age",I had to enroll in Medicare.  Medicare is primary and then Blue Cross picks up the balance...Good deal for Blue Cross as there was no reduction in my premium and they end up paying less.
This really makes no sense to me.  



Yes, that's part of problem (Teddy - 11/9/2008 10:46:11 PM)
I refer to the confusing mishmash of coverage and policies, which insurers yank back and forth almost at will, raising fees each time as they "serve you better." I have AARP Medigap, which I think performs the "gap" coverage like your Blue Shield.

What bugs me is the insistence in  our current market economy that I must be an expert on absolutely everything, or I'm subject to "Gotchas," which, if I complain I've been had, is always followed by, "You should have known better, didn't you read the fine print?" So I have to be an educated consumer about vehicles, transportation, drugs and side-effects, insurance of every variety, stocks and bonds, quarterly stock reports and government statistics, banks and derivitives and the FDIC "Watch List," elder law, construction, mortgage loans, consumer credit, the food I eat and any additives and their additives and clones, blah, blah, blah.

And when, I ask you, does one then have time and energy to get a life? Does it really have to be this way, or is it just me?
***
PS: in the real world, I liked Obama's plan, too. But if we had a blank slate, how would we design from scratch a cost-effective, socially effective universal health care system?