I am devoting this, my first Diary on Daily Kos, to talk about something that has been concerning me in the Health Care debate. Specifically, that we are being sold the idea of Universal Health Care, when what we are getting is actually Universal Health Insurance, and that there is a huge difference between the two.
Follow the fold for more.
The Universal Health Care plans currently promoted by our leading candidates at the outset sound great. They want everyone to be able to afford Health Insurance -- you can buy a private plan, get help paying for it if you need it, or you can sign up for the government run program.
I am for Universal Heath Care, I think everyone should have access to the knowledge, technology, and practices that will not only serve them when they are sick, but keep them healthy. The problem is that neither the guarantee of private insurance, nor the promise of government run insurance will assure that you get the health care you need to stay alive and healthy.
Lets look first at private insurance. It seems clear to anyone with a brain that for profit health insurance is fatally flawed because it is for profit. It exists to make money, the fact that it pays for some of your health needs also, is incidental. It is always in their interest to deny your claim and to make it difficult for you to file claims at all.
This is an obvious point to most people here, and I wont belabor it.
Lets look then at government health care, because under the plans put forth by Clinton and Edwards, if you don't want private health insurance (ie: to allow your health decisions to be made by someone who does not care if you live or die), you can use government program.
Now, I know it sounds really great to think that we will all get the same wonderful care that our Senators do, but you cannot really expect that when you expand a health care program to the population of an entire country that the program will maintain the same quality of care. There is no way to create a functioning system to effectively administer so large a program without spending more money then might be feasible to allocate to such a program.
Let me give an example:
I currently use a federally funded program, I have tried many times to call them and I have never gotten anything besides an answering machine asking me to leave a message and promising to call me back -- a promise yet to be kept. My program will only pay for Doctor visits, medications, and lab test but will not pay for any specialized care or dental work.
Furthermore, I had to fight just to get my Doctor to accept me as a patient. I still feel when he sees me like he is doing his 15 minutes of pro-bono work, and the office nurse still complains that I need to get on a different plan, as their office has trouble getting paid at all by my insurance.
I imagine when Americans dream of a Universal Health Care system run by the federal government that they would like a little bit better customer service and reliable coverage. I think it is naive to expect that this will be the case when trying to provide health care to the entire population on a shoe string budget.
Another problem with a federal plan is that the benefits will no doubt be negotiated in congress, meaning that, for example, those annoying Republicans from the South will go to Hell and Highwater to make sure that birth control is not paid for by the Universal Health Care program. Thus eliminating an effective deterrent to unwanted pregnancies for ALL OF US. Beyond birth control, we know that Congress is too entrenched with the lobbyist of big pharma to believe that our interests as citizens will win out.
The Federal Government also has a bad habit of attaching ridiculous conditions to money. For example, they give lots of money for HIV prevention, under the requirement that it only teaches Abstinence. This money is not only useless, but creates a generation of sexually uneducated citizens who have never been taught how to make real decisions about their health. There was also, thanks to Jesse Helms, a condition on all Federal HIV prevention money that none of it could be used to make or distribute materials that condoned the practice of homosexuality or drug use. You can imagine the handicaps this puts on prevention work -- I know because I used to do this work, and if we wanted to print a sex-positive poster or ad, we had to get the money from the state, not the feds. Ridiculous, right? But do you think we can expect any better? What if Universal Health Care won't pay for condoms? Don't expect that it will.
Even with an Edwards on the bully pulpit there is every reason to believe the benefits package of government health care will be watered down to the point where it becomes nothing more than a means to funnel government money into the bank accounts of pharmaceutical companies, via your "health needs" which will be reduced to what antibiotic or drug you need prescribed. Edwards will be forced to choose to veto a program that is watered down, or choose to pass the legislation despite its problems, citing something along the lines of "incremental change is better than none." You can imagine that after campaigning on this promise, he will be hard pressed to veto any bill that survives congress.
My thoughts on this, as a citizen not an expert, are that Universal Health Care should not be run by the federal government. We must not give congress the chance to water down and destroy the government program or we will be left with a mandate to buy private health insurance, which would probably suck.
Rather, Unversal Health Care, should be achieved from the ground up, through community based initiatives, and other programs created and managed by local governments, perhaps congressional districts, so that programs can be customized and tailored to the specific needs of populations. The goal of these should not be to foremost get everyone on health insurance, but to evaluate the health needs and barriers to care within their populations. Then to take this information and come up with solutions focused on what really matters: getting you access to the knowledge, technology, and providers necessary to keep you healthy.
The smaller pools of people will allow for more specialized solutions -- especially given that different populations and communities have vastly different health care needs based on demographics, economy, and environmental conditions. Each population will be able to address the health care needs specific to the problems faced by their residents. This does not have to mean health insurance, but could mean sliding scale walk in clinics and community health centers. There are lots of ways health care works.
We can create a healthier America, but we must not confused this with getting everyone on Health Insurance. This is a dangerous misunderstanding.
There's my two cents: think Universally, act locally. We are currently being sold by our candidates the idea NOT of Universal Health Care, but Universal Health Insurance. We must think if this is really what we want.