Sometimes I Feel Like a Piece of Bologna

Wednesday, May 23, 2007

Universal Health Insurance—Do We Really Want It?

Randy Bayne at California Notes asks, “Why can’t we all have health care like Mom’s?” I posted a response that I thought I’d cross post here.

Unfortunately, a single payer system isn't all it's cracked up to be. Neither is Medicare, and certainly not MediCal (Medicaid elsewhere). All you need to do is look at the nations that have it--the poor quality, cattle herding care, LONG waits for routine tests and procedures, and the complacence among providers.

When the government got involved in US health care in the '60s, costs skyrocketed and have continued going up, and quality went down. Ask a Medicaid person if they're happy with their care, and see if you would like that level of care.

There are negotiations going on now to limit--again--payments to Medicare providers, which will mean more leaving the system, just as providers no longer care for Medicaid patients.

As much as we wish it weren't true, there really is no free lunch and the free market system still works best--in health care and all else. Your mother is very fortunate to be getting the care she is. I have started attending my mom's medical appointments just so she will get the level of care I would expect for the price she's paying--which isn't cheap.

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2 comment(s):

A couple of points to add to the mix: If a person happens to have a talent or a job-liking in an area that is only small business, that person is likely to not have health insurance EVER through the employer. Given the cost of individual insurance, this is something that could be helped by single payer insurance.

There are many Veterans in this country that never bothered about the Vets medical care when they were working and had insurance. But in retirement, many turn to the Vets system, and/or many turn to it because their current insurance doesn't cover drugs, and/or because their employer drops insurance. This system has some advantages and several disadvantages, too much to go into here. But obviously with the retiring of the baby boomers and the fact that we are making new vets all the time, this system will swell. [My DH is a Vet doc.]

It is hard to get assigned to a Vet clinic "near you." You may be able to get a "check-up" near to home, but getting simple proceedures may entail a 200 mile trip. And one has to jump through hoops to stay in the system. The government is supposedly opening many more Vet clinics. Where are they going to get doctors for these clinics????

So the rhetorical question for me is should there be insurance systems for medical care that are so unequal because they are dependent on what one did for a living or did 40 years ago?

If we don't have some kind of single payor system, is it OK for a large corporation to not offer medical insurance?

There are lots of people who appear to be working for a large corporation, but in reality they are considered "independent contractors" so that the company doesn't have to pay benefits.

We need to differentiate between the government running health facilities / private clinics as well as between single payor / multiple health insurances.

The gov did get involved in health care in the 60's, but mostly as a "payor." ie medicare. And medicare is contracted out to private insurance companies to administer.

There is a ton of money going to administer health insurance, medicare, medicare D and the like that could go to actual "health care."

We also need to acknowledge that the increasing cost of health care includes proceedures and expensive machines that weren't available several years ago. How do costs compare when/if those aren't included in the comparison?

Ditto for computerized record keeping. This is an expensive transition. And the doctors do their own typing and charting. You pay doctor wages for him/her to be a typist. DH knows this from first hand experience. He used to dictate notes.

By Blogger P.S. an after-thought, at 5:38 AM  

Re the low level of care provided to Medicare patients: When a Medicare patient is NOT associated with poverty or the underclass, the level of care moves up dramatically. My evidence for this? The experiences, with eye care, dental care and medical care, of my foster daughter AFTER she became associated with my middle-class family.

Classism like this is rampant in our society. Healthcare providers are not immune to it.

By Blogger pete, at 7:18 AM  

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