This is the fourth in a series that has thus far included Why the Left is Right on... Gay Rights, Why the Left is Right on... The Death Penalty, and Why the Left is Right on... Abortion. In it I will briefly explore some of the problems with the current American health care system, and why I believe that these problems would best be solved by Democratic proposals for universal health care coverage.
For full disclosure, I note that I recently filed bankruptcy because of medical bills accrued when I did not have insurance - and my brother and my mother both still have no health insurance at all, so it is a personal issue for me.
According to Media Matters for America:
69 percent of Americans think it is the responsibility of the federal government to make sure all Americans have access to health coverage; 76 percent find access to health care more important than maintaining the Bush tax cuts; three in five would be willing to have their own taxes increased to achieve universal coverage.
I am not going to base my arguments around public opinion, as I think it is morally imperative that we solve our nation's health care crisis regardless of popularity - but I provide that statement simply because so many people are perfectly willing to make assumptions about the suppposedly 'conservative' nature of our country's electorate. On this issue, we beat the Republicans three-to-one, so it is safe to say that we have a real mandate for change in January regardless of John McCain's attempts to scare people by shouting 'Big Government!' while lurking in a shadowy alleyway.
Over 15% of Americans go without medical coverage completely.
We are not talking about the under-insured, or those that forgo regular doctor visits because of the cost (even with a copay). Over /forty million/ Americans do not have access to health insurance at all - and eight million of these are children. African Americans (20% of whom went uninsured) and Latinos (32% of whom had no coverage) are much more likely to do without health benefits than Caucasians (who still had 11% of their own without insurance).
So what does this mean? Why should we care if someone has no health insurance - if they get really sick they can still get treated at the hospital, right? Well, hospitals specialize in emergency care - if you have a chronic or serious health condition that does not keep you at death's door, you aren't likely to find much treatment or sympathy from the local hospital - and to make matters worse, it is an open secret that hospitals are quite willing to charge people without insurance up to four times more than someone in a similar situation who had coverage. You can't go into the hospital to get a prescription for a mental illness, or for your regular checkup related to diabetes, or for your inflamed gums, and even if it is something sudden and life-threatening like an injury or a heart attack, an uninsured American is very likely to pay out the nose for even the most basic of treatment.
Universal health care would improve efficiency
Yes, I am truly arguing that the establishment of a no-doubt gargantuan government bureaucracy will in fact reduce wasteful inefficiencies, because the current medical system is awash with duplication and red-tape. The process of getting a simple procedure covered under even high-quality insurance can be daunting, especially for a less educated head of household. You go to the doctor, the doctor decides what treatment would benefit you best, you must submit a claim for the treatment to the insurance company to see if they are willing to cover it, an approval department has to go over the claim and investigate it according to policies and loopholes, checks have to be written and mailed, patients are sent co-pay bills from several agencies for a single operation, and none of this is done in a universal or streamlined way.
If we had a centralized bureaucracy we could easily do away with a lot of these problems - and we could unify patient records and health tracking information. In the current system, each office, clinic, urgent care facility, or hospital keeps its own separate records, often according to its own proprietary design. This bureaucracy consumes 31 percent of all health care spending. Almost a third of your health care costs goes to paying for red-tape.
Doctors should focus on healing, not on dealing with slippery insurance companies
Doctors literally have to take classes in order to understand the vast array of insurance plans that exist in the wide world, and their staff has to waste valuable time and energy examining patients' plans to see which procedures they are allowed to recommend. Amazingly, doctors are limited by the insurance companies as to which tests they are permitted to order, and they are constantly being forced to find new ways to help their patients despite extreme efforts by the insurance industry to minimize expenditures no matter the consequence.
In fact, insurance companies have been known to deny people coverage completely if they feel they are not in adequate health. If the 'risk' is too high for the insurance company (because of poor health previously, or because of a pre-existing medical condition), they will refuse an individual coverage even if he has the means to pay for it, simply because of the bottom line. Even if you yourself do not have a history of health problems, if the insurance companies feel that your /family/ demonstrates a tendency toward a serious health condition, they can deny you access to care under their plan.
Universal medical coverage would encourage preventive medicine.
The uninsured, under-insured, and the poor-with-insurance do not go to the doctor as much as they should - not because they are too lazy or too busy, but because the cost is prohibitive. Now, if someone has a heart attack they are going to go to a medical professional no matter the price (and they will not be turned away no matter the salary), but with a national health insurance system we could prevent the heart attack altogether.
Studies have shown that, compared to the insured, elderly patients without insurance are 50% less likely to receive preventive care such as pap smears, mammograms, blood pressure checks, sigmoidoscopies, cholesterol screening, and prostate exams. Many times this only leads to more serious health conditions that could have been prevented - conditions that are more costly both to the patient and to society.