A Universal Health Care Initiative has gained some momentum this week after a survey suggests doctor's opinions have changed substantially since the last survey in 2002. Reuters reports that of more than 2,000 doctors surveyed, 59% said they support a national health insurance program. The report appears in the Annals of Internal Medicine (sub req'd, scroll to page 566).
In 2002 the same survey found that 49% of doctors supported national health insurance. This marks the first time a peer-reviewed study has found that a majority of physicians approve of a switch from our patchwork insurance network to a unified national policy.
Even though this is the first study to definitively survey doctor's opinions, for years now there has been a push for universal coverage. The American Medical Association (AMA) began their "Voice For The Uninsured" program a few years ago to expand health care coverage to all citizens. On their website, the AMA outlines specific details and plans to reach their goal of coverage. The AMA is a large organization with members from the nursing and medical community, as well as students in the medical field.
The American College of Physicians, the nation's largest medical specialty group, last year endorsed single-payer healthcare as a national reform agenda. With 124,000 members, the organization said it is ready to stand behind a single-payer national healthcare system as the "one pathway" to universal coverage.
Groups of physicians and students have even started their own organizations, such as "Physicians for a National Health Program", which holds 15,000 physicians, medical students, and health professionals as members.
The American Medical Student Association also endorses a single-payer system, and these guys are going to be the future of health care in America. I think its time we start listening to the providers because they do have an inside knowledge of the machinery that effects the economics of our health care system. Many of them go abroad and observe the different systems in place around the world to truly grasp where our system stands compared to the world's best systems.
Unfortunately the answer that continues to be found is that we pay far too much for how little care we receive. Most of this goes to cover insurers costs and rising profits and gets passed on to the consumer as higher prices. At some point the public will have to demand access to more fair and affordable care or the prices will continue to rise on the backs of a fractioned patchwork insurance net we employ.
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For what its worth, in about 2-3 months the Presidential race is going to heat up and hopefully some real issues will cross the table. Healthcare will definitely be one of these issues and the big debate will be on whether to keep our current system or switch to a publicly managed insurance system.
I make no secret that Universal healthcare should be a pillar of modern society and public health. With the amount of travel and personal exposure due to rising population density it is important that we value the health of our neighbors and fellow citizens.
So my question is why is there such an upwelling of support against a universally accepted insurance program? Currently in the US we have 2 different publicly managed insurance programs. One is Medicare/Medicaid and the other is the for national children's health insurance. Currently most Americans are happy with this system and believe that it is right to help insure those with fixed incomes and those too young to care for themselves.
In 2001, the median income for Medicare receiving families was $20,000. The cost of Medicare is 15% of the cost for private coverage which means many of these families could never afford private insurance. It is estimated that 43 million individuals who are not on a fixed income receive Medicare benefits, that is over 10% of the nation (most in the working population) that would not be covered if not for the public system now in place.
Another concern is exactly how we're going to pay for this. And that is a good question that policy makers will have to address going forward. One fallacy of universal healthcare is that we will have to pay to insure those who aren't contributing to the healthcare fund. While this may be true and another roadblock to universal coverage, the truth is that many people today are receiving treatment at our public hospitals and not paying for it. Many of these people contribute very little to no tax revenue and are still receiving services at no charge. These services and time logged by physicians and nurses still have to be paid, they are not a pro-bono service, and will receive payments whether the patient can pay or not. This payment comes in the form of increased insurance premiums and elevated cost of service.
If a hospital can expect 60% of people receiving CT scans to be able to pay, the cost of each CT scan is going to rise as the cost of unpaid service has to be ameliorated through a concurrent price increase in each individual procedure. Now that a CT scan price has increased any insurance company with a client receiving a CT scan will now have to pay more for the procedure than previously. The rise in price is not absorbed by anyone other than the patient themselves as their premiums and most likely deductible will continue to rise as the insurance company is responsible for higher procedural payments. To compound the problem, the insurance company is not seeking good faith and word of mouth advertising, they are looking at their profits.
Here is another reason why healthcare here is so expensive. If a procedure costs $100 and the insurance company is responsible for $80 your copay is $20. That doesn't sound too bad, but why do you have to pay $300 a month to maintain your coverage? The answer is profits. In order for the insurance company to make money the consumer must pay above and beyond the cost of care received. Its really a simple equation, if the insurance company has to pay X you can be sure that you will be contributing X + Y to the insurance company in order to feed its profits. So you are paying both for your coverage and services received and the profit margin for the company. This is ridiculous, and add to it the cost of the doctor's profits and you are looking at a steep price with hidden profits behind every procedure you have done. If these companies are allowed to reap in huge profits it is not coming from the hospitals, physicians, or government, its coming from our pockets!
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FactCheck.org just busted the Hillary campaign running a false ad in Texas. In the ad the narrator says Barack's plan won't cover 15 million Americans while Hillary's would cover every American. The source for the stat is a 2/14/2008 article on FactCheck.org about the two candidates health plans. FactCheck.org have said, "we quoted independent experts who predict that Obama's plan would leave out 15 million or more who would choose to go without coverage, but we also said that even Clinton's mandate "would leave out a million people or perhaps more, depending on how severe the penalties would be for those who don't comply.""
Small stuff, but you think these guys would be careful enough not to stir up bad press like misquoting a fact based resource.
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On scienceblogs.com, revere has posted another article busting a myth about Canadian Healthcare. This time he tackles the Emergency Room.
Here's my take on the health care debate over managed vs. universal care.
I think there's three big points that should be considered when deciding which would be a more appropriate system.
1. What are countries who are changing or updating their system their system doing? Europe, Asia, Australia, and Canada. These places all practice some form of socialized healthcare. Whether its a mixed system or purely national most countries have consistently moved away from privately managed care. And when these countries update their systems they all turn to the Nordic countries, who have developed the most progressive healthcare policies.
2. What is the cost per annum? In 2005 the US spent the most of any country per person according to John's Hopkins University. This is obviously not a good reflection on our current system.
3. How do we fare against other countries on benchmark health stats? Well on infant mortality we rank just a little below Cuba, meaning for every 1 of our little red blooded baseball playin' boys who dies young there's an extra Cuban commie waving that red flag around cause his healthcare system is better, chew on that math. In life expectancy we're not too bad, in this study by the WHO we're 24th, others say lower. We're also the fattest, most plastic surgery having, second most aborting nation.
So I think its pretty obvious there is a problem and there are a few aspects of a new health care system should address to improve the system.
I'm ok with a mixed or two-tiered system as long as the national enrollment had to be accepted by all doctors, covers all preventative, normal treatments, and emergency care. This is very important because doctors make a lot of money right now because they deserve it. Go to any hospital in the US and follow a doctor around for 14 hours. Then go home and eat and go back to the hospital when he gets called two hours later and hang out with him there for another 6 hours until he gets to leave. And then do it again the next day, 6 days a week, all year.
The point is they do work hard because our large treatment facilities are absolutely loaded with people who could be seen by a family doctor with a thermometer and prescription pad. But instead the guys that know how to cut open chests and sew up blood vessels are filling out paperwork for the 30 prescriptions they give out to see children with the flu! The flu people, something no emergency room can do anything to help you with. But the problem is these families can't afford to walk into a private doctors office. ER care will improve and the system will be far less burdened with clogged institutions.
This in turn offers better overall community health because people don't have to pay to go to the doctor yearly, or don't have to show up to the ER 15 times in a year for a newborn. Consistent screening and preventative care will do a lot to stop late stage diseases, like cancer.
This country is one of the few that has serious doubts about evolution and believes in a great creator that gives everyone the same love but when it comes to healthcare has a pay or die attitude, that doesn't add up.
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