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We rejected too many good and needed ideas in the haelthcare debate. We got Obamacare. We settled for too little.

It’s the perfect metaphor: an ailing system regarding health care.  In this case the patient is covered with bandaids, surrounded by splints, and on life support until we find the real cure for its sickness. For years we have seen our health care go down hill in most every way except one -- cost. And that continues to rise per capita above that of every developed country in the world. In fact, current prospective solutions to making things better are so muddled and so unrealistic that it demands we as a nation, revisit the issue again…and soon.

Despite the introduction of the Affordable Care Act (Obamacare), in relation to other countries’ health care results, those in America continue to decline to embarrassing lows.
The United Nations has long had criteria as to what constitutes an “industrialized, developed nation”. There are currently 33 on that list. And it must be noted of that number, 32 have Universal Health Care…all except the United States of America.

There are a number of ways to determine the “health” of a country, but perhaps the simplest one, and most easily defined is life expectancy. Notably, virtually every country (of the 32 countries referred to above) with universal health care, are in the top tier of longevity. The United States now ranks 34th, according to the World Health Organization. Another measure is infant mortality. According the 2009 CIA World Factbook which tracks such things, the United States is now 49th in the world in that statistic. But that is not the worst of it, because as far back as 1950, we ranked among the best in the world – now dozens of countries have passed us by.

Our moment of truth came a few years ago when we adopted Obamacare. Possibilities of true universal health care – in the form of a single payer plan or adoption of a public option -- was discussed but rejected out of hand by conservatives in Congress. Instead, we ended up with Obamacare, which does redress many of the ills of healthcare in America, but is unduly complicated, not well accepted by many, and still leaves large gaps in making health care in America truly effective, affordable and universal. What Obamacare has given us is the “best of bad choices”. As a great nation, we can and should do better.

There are three basic methods of collecting needed funds so that all citizens get full health care: both preventive and treatment. And all three methods have been long standing and successful. Some countries have what is called a “Two Tiered Plan”.  The government provides or mandates catastrophic or minimum insurance coverage for everyone.  Additional voluntary insurance or fee-for service care can be purchased if desired.  Thus, the government provides a core policy which can be supplemented with private insurance.

Then there is the Single Payer plan which about half the developed nations utilize. Again, rejected by conservatives, and badly mischaracterized as some sort of socialized medicine. The fact is the actual medical care (with the exception of a couple of countries) is carried out by private providers. In short…your doctor. This is not unlike our highly successful and well liked Medicare.  Also, already government run and widely accepted are the military Tricare and VA programs.

Finally, there is the Insurance Mandate. Among the nations that have such a plan, the most successful are several European countries (notably Germany with a highly regarded health care system). Very simply, the government mandates that all citizens purchase insurance, whether from private, public, or non-profit insurers; and if from private sources, no one can be rejected. This is essentially what Obamacare is attempting to do; but it is complicated and constrained by a variety of obstacles that are making it difficult to initiate, hard to understand, and resistant to acceptance.

In response to this opposition, some are fighting the advancement of Obamacare tooth and nail. Indeed, recently Representative Paul Ryan clearly stated the intention of the GOP to repeal Obamacare, dramatically change Medicare, and re-introduce the voucher system he suggested before and during the election.  Well, if Ryan can regurgitate a plan formerly introduced, and rejected, perhaps those who want true healthcare reform can again bring up the advantages of single payer…a public option…or even letting everyone, regardless of age,  enjoy the benefits of Medicare (which would help solve part of the growing Medicare costs too, with younger participants).

The bottom line is this. Virtually every developed industrialized nation has a universal health care program that is simple to operate, cost effective, and well accepted. In fact, virtually no other nation would trade their system for ours, despite apocryphal stories of unhappiness. Further, virtually every country has better healthcare results than we do. There should be no reason that a great nation such as our settles for “the best of bad choices”. We can do better, and our nation will be a healthier, stronger, and more robust when we do. It is time to again revisit changes for the better in healthcare for America.

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Poll

Regarding health care in America, we should:

22%2 votes
11%1 votes
66%6 votes

| 9 votes | Vote | Results

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Comment Preferences

  •  Your poll misses an option: (2+ / 0-)
    Recommended by:
    FloridaSNMOM, samddobermann

    Accept it for now.
    We all know it is a work in progress.

    •  No it is not. (0+ / 0-)

      It has yet to be implemented. So far, my state has been fighting over power of oversight much less come up with an exchange. It is proving too complex with competing interests gumming up the works.

  •  myles, you don't know what you are talking about. (0+ / 0-)

    Read the Time mag article
    on why costs are so high.

    We pay doctors based on piece work so they order lots of tests and procedures. The over treatment raises costs and reduces quality. It also makes care more dangerous. Furthermore when they make sloppy mistakes or you get a serious infection in hospitals they then can charge for all the care to try to fix it.

    Take for instance caesarian sections. Most industrialized countries have rates ranging between 10 and 15%. Here in America it's more like 35%. The more frequent caesarian rate leads to more babies winding up in NICU which is very expensive. Most countries have way more births delivered by midwives.

    It is NOT the system of financing care that is responsible for the low quality of the American system of care.

    You mix universal system of health care with single payer. They are not the same thing and few countries have single payer; they have mixed systems on the whole. For the most part they got there gradually. Take Canada which does have a single payer system. They got it in one province then is slowly spread.

    We didn't get a single payer system or the public option because we didn't have the votes. We didn't come out in droves and drown out the Teapots; we didn't have major marches in support of it. And most of all we didn't vote enough people into Congress who would vote for either one.

    What you call Obamacare is basically Title I of the ACA. Title II covers the governmental programs Medicare and Medicaid. the other 8 Titles are about improving quality, helping to get more care providers, the taxes, building staffing and equipping some 1200 more Community Health Centers, and other really important stuff.

    We have established the principle of health care for all. Now let's work on improving quality and driving down costs.

    Then we can re-look at the financing mechanism — which is all that insurance is whether private or Medicare or Medicaid is anyway.

    I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

    by samddobermann on Mon Mar 18, 2013 at 04:44:48 AM PDT

    •  I disagree with many of your points (0+ / 0-)

      Sure, our system is flawed with too many tests, doctor remuneration etc -- but the underlying factor is the COST we pay for insurance. The typical insurance admin cost (before capped, was over 20% of the premium. Medicare admin costs are 6% or less (depending on how calculated). this is the underlying factors in the cost of our sytem.

      I do not confuse single payer with unversal health care -- again it goes back to how we decide to "insure" that everyone is covered. You rightgully allude to Canada, I am ver coversant with their system -- EVERYONE IS COVERED WITH SINGLE PAYER THERE.  It is a simple, ealsily administered system, and would work well here.

      Finally, it is true Obamacare can improve things -- but there is no denying with 2000 pages of law, it is overly complicated, hard to get going, and may not be as effective as other solutions I suggest.

  •  PS silly poll. not all alternatives covered (0+ / 0-)

    We need to save and move forward to implement what we do have.

    We NEED to take back the House in 2014. Get to work.

    I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

    by samddobermann on Mon Mar 18, 2013 at 05:11:33 AM PDT

  •  "We rejected too many good and needed ideas. (0+ / 0-)

    We settled for too little."

    Who is this "we"?

    "We refuse to fight in a war started by men who refused to fight in a war." -freewayblogger

    by Bisbonian on Mon Mar 18, 2013 at 07:15:46 AM PDT

    •  We... (0+ / 0-)

      The American public. We did not fight hard enough, to get a system we can use and live with for the decades ahead. I am suggesting we go to battle again. We are not going to be able to have the health care we need with things as they are

      •  No, "we" are not. But "we" were ignored. (0+ / 0-)

        "We refuse to fight in a war started by men who refused to fight in a war." -freewayblogger

        by Bisbonian on Mon Mar 18, 2013 at 10:43:09 AM PDT

        [ Parent ]

        •  Often said... (0+ / 0-)

          and as recently as last month by Obama (paraphrased);
          "without public opinion nothing can get accomplished in Washington...with it, we do do most anything".

          This time we need to mobilize, and educate the public on the issues involved, and DEMAND a better system that costs less and gets us better care.

          Taking back the House as noted would help a lot.

Chi

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