Conclusion

In closing, I would like to quote a man who dedicated a good portion of his life to solving the ethical dilemma of helping those in need at a personal cost. The late American philosopher John Rawls said, "I have a moral obligation to aid those who are worse off than myself" and "Each person is to have an equal right to the most extensive total system of equal basic liberties compatible with a similar system of liberty for all" I am not going to try to determine the confines of these statements, rather I will let you decide. In order to maintain a government "of the people, by the people and for the people" we the people must decide what is best and effectively communicate that to our representatives. No one person can draw up a perfect bill to solve all of our problems, this country has been a joint effort since day one and to stray from that would cause utter failure and the collapse of our great nation. So stay true to your beliefs, protect your liberties and the liberties of your neighbor and we cannot help but succeed. Whatever our country decides on this issue of health care, lets stand behind them and make it work life is about perseverance and if we persevere together we will succeed together. Abraham Lincoln said in one of his most stirring speeches that "a house divided cannot stand" but I believe that the conclusion of that same speech is often overlooked. Lincoln's final words on the evening of June 15th 1858 were, "Our cause, then, must be entrusted to, and conducted by, its own undoubted friends-those whose hands are free, whose hearts are in the work-who do care for the result. Two years ago the Republicans of the nation mustered over thirteen hundred thousand strong. We did this under the single impulse of resistance to a common danger, with every external circumstance against us. Of strange, discordant, and even hostile elements, we gathered from the four winds, and formed and fought the battle through, under the constant hot fire of a disciplined, proud, and pampered enemy. Did we brave all them to falter now?-now, when that same enemy is wavering, dissevered, and belligerent? The result is not doubtful. We shall not fail-if we stand firm, we shall not fail. Wise counsels may accelerate, or mistakes delay it, but, sooner or later, the victory is sure to come." This should still inspire every American to stand firm, a united front and prevail though all adversity, I can't say it any better than the former president and cornerstone of our nation.

The number of people that are uninsured in America is a serious problem 47 million uninsured means that nearly 16% of all Americans do not receive the care that they need. The health care professionals and America's taxpayers need to take this very seriously and ask themselves if it is worth a few extra dollars to help insure these people. One of the scariest statistics I found at aflcio.org was that 8.7 million children are uninsured which contributes to America's relatively high infant mortality rate. These children have no choice and no say in whether or not the receive care and can do nothing themselves to gain that privilege. Is it not our responsibility to help the helpless when we can? If the government comes out with a bill that requires employers to at least pay for children to be covered without driving down the middle class with high taxes and creating more poverty then I think we should strongly consider it. The problem comes with where the money comes from, until we find a just and efficient way to fund an inflated health care system then we must restrain ourselves and make the best long-term decision.

A few days ago former U.S. Comptroller Dave Walker was on CNN talking about the current healthcare system and reform possibilities, specifically medicare. As it stands now medicare costs somewhere around $38 trillion per year, Walker suggests a budget for this service that would require a reform in the way that we pay our medical bills. Currently there is no budget on medicare in the U.S. unlike most other industrialized nations. The reform in payment that Walker suggests is a shift from payment simply for treatment to payment for the effect of treatment. While this economically makes sense and would certainly lower the cost of care I do not believe that it would function well in the medical field for a couple of reasons. First labor is used for all treatments whether they work or not is out of their control, and they should be payed for their labor. Secondly, with the constantly changing and variability in effectiveness of treatment based on all kinds of individual variables presented by each patient this system would not be just to the medical professionals or the patients. Finally this shift would hinder experimental treeatment and the overall progression of healthcare because new treatments inherently have a low level of effectiveness initially and take time to get better.

As the labyrinth of healthcare gets more and more complex more and more opinions are formed, 'we pay too much for care' 'we pay a good amount for the quality of care that we get' 'our care is the best in the world' 'our quality of care is sub par in even the poorest of countries' etc. With so many diametrically opposed viewpoints with seemingly legitimate backing it is nearly impossible to really understand what is going on. Don't feel overwhelmed, just take in as much information as you can and use reliable sources with viable solutions to increase your understanding. That being said, I would like to bring up an article that i found at the Baltimore Chronicle's webpage that covers the most common accusations of Americas healthcare system. This article is based on the extremely high prices of American healthcare, we are 1.5 times more expensive than the second most expensive country, Norway. According to this article our cost is so high because of many taxes that we pay our doctors and surgeons as well as the inflation of healthcare costs in general, they started high and are only getting higher. This is definitely a problem with American health care if you want everyone to receive quality care and must be fixed in order to treat our growing population. Most people assume that there is a relationship between price and quality (as price goes up so does quality and vice versa). However, Dr. Holtzman disagrees claiming that there is a way to decrease costas and increase quality of care by eliminating pecuniary taxes paid to doctors and increasing primary care. Once again, it is up to you, the reader, to determine if this is a valid claim. The catch-22 is that not doing anything with our healthcare system could cause it to break down, but doing something to completely reform it may have the same effect. While Dr. Holtzman may be on to something and I believe that if there is any way to do what he claims is possible then it should be done post haste, I am highly skeptical of this claim because it goes against one of the most basic economic relationships, that of cost and quality.

Health care for low income families in the U.S. is a scarcity with 53% of low income citizens reporting to be uninsured according to medhealthinsurance.com. This causes a myriad of problems and difficult decisions for low income people and puts them at a much higher risk of serious illness. Uninsured familes are four times more likely to avoid going to the doctor than in insure families because of the cost and many of those families clame that the emergency room is their primary care center at which the mean cost per visit is $3000. Low income families are much more likely to be diagnosed in the advanced stages of a major disease because they do not get regular check ups. All in all the information that I gathered from medhealthinsurance.com showed me that something should be done to provide regular care to low income families. It could be argued that medical professionals have a moral obligation to help all who are in need because they can and are trained to do so. Money should not be the determining factor of whether a person can receive quality care just like no amount of money is worth a person's life.

Up until now I have been extensively covering the conservative point of view on socialized medicine which is adamantly opposed to it. Now I would like to switch gears so that you have an idea of what the pro-reform arguments are. According to an article that I read recently from the Los Vegas Sun by Cynthi Shiroky all of the problems that the right wing associates with government run health care (rationing care, costing more, coming between patient and doctor, limiting access and treatments, denying or delaying care, and being socialistic) are all problems with the current system, excluding the socialist part. Additionally, the aforementioned problems are false pretenses about the proposed reform which claims to be non-profit, cheap, and efficient. I believe that the biggest pro to this reform is that it would not allow people to have their coverage dropped because of a preexisting or a recently contracted illness. If all these things can be promised and work out as its supporters claim then maybe socialized medicine is the way to go. Sure we would have an increase in taxes but in my opinion there is no exchange rate between dollars and lives.

In an article I recently read by David Gratz on the U.S. News website a very grave prediction is made. Gratzer claims that within ten years of the adoption of a public health care option almost all of the private insurance companies will be run out of business because they will be unable to compete with or pay the taxes in this bill. This is a very dangerous possibility that is at this moment killing thousands of people across the globe because they cannot get competent, if any, care. This possibility must be considered and provisions must be made to ensure that the private option will stay around, otherwise the government will be taking away something near to every American's heart, liberty, and not to mention forcing them into a third world level of health care.

I was reading in the Battalion today and I came across an article titled "Health care bill passes in House" this article was released by the Associated Press and contained an update on the proposed health care bill. As the title suggests the bill was passed by the House of Representatives, but it does not appear that it will make it beyond the Senate. In order to be ratified the bill must gain 60 votes to even be discussed and 120 votes to bypass debate and be put into action. The chances of this bill receiving even 60 votes in the senate are not good. As of now it does not appear that the currently proposed bill will be America's new health care plan and the legislators will be forced to start again to reform health care.

According to newswire.com there is an impending shortage of medical professionals in the next few years due to the increase in age of current physicians and the decrease in students training to go into the medical field. We can also expect a dramatic increase in the number of patients treated in the next few years as the baby boomers turn 65 and older. Something must be done immediately to fix this problem before our health care system collapses because there is no one to treat patients. This is a matter of priorities for the American people and legislators, no matter where you stand on government run health care , before we do anything else we must attract and train many bright young people into the medical field. Otherwise, no matter what system is in effect, the health care of the United States will be unable to treat its citizens. This must be done before we make any changes to the current system because an influx of patients will require more medical professionals so it is only wise to have those professionals available before we absolutely need them for survival.

If you go to the CRNA website you will find that the majority of specialized nurses believe that switching to universal healthcare will cause salary cuts in the medical field. The question then is not if the existing medical professionals are okay with a salary cut. Rather, we should be concerned with the way that this effects medical students. The health industry, more than any other, needs to attract the best and brightest talent so that optimum care and research may be provided. Counting on the goodwill of people who must endure twelve years of education to become specialized in medicine will not provide the talent necessary to fill current shortages (some of which are outlined on the CRNA website as well). Therefore, I believe that any healthcare reform should at least maintain, if not increase, the salary of medical professionals because they will be required to treat more patients, be more knowledgeable, and there will be a desperate need for more people in medicine after the influx of millions of patients with no medical history. If this is not supplied by the proposed bill I don't see how it will keep from tanking along with the health and care of millions of U.S. citizens.

What About the Babies?

Despite being at the top of healthcare expenses (over $6,000 per capita) the U.S. is ranked in the lower portion of the world's nations when it comes to infant mortality rate. How can this be? Many people say that our IMR is so low because we have decentralized healthcare and don't take long term care of infants born into a low socioeconomic status. While this may be so there are at least two perspectives on any problem; an article in the NY Times approaches this particular issue well. Some researchers agree that IMR is high in the U.S. because of our private healthcare while another significant portion claim that the United States is so far behind in terms of IMR because of unnecessary preterm births. Many American women choose to have labor induced early because the last month of pregnancy is so difficult; high number of preterm births means a high IMR no matter how advanced your healthcare is. Yet another aspect of health that is split into two diametrically opposed groups in which no absolute solution can be found proving that a massive healthcare reform may or may not drastically improve the overall health of Americans. Reform is a risky business because if you change something that is working for millions of people based on some disputable statistics and you're wrong then many people will suffer unnecessarily.

Dollars and Sense?

The newest proposed heathcare reform would cost $871 billion dollars, but before we get blown away by this number understand that our current system is not cheap comparatively. According to the Washington Post website the main controversy is that the government would be determining the amount of government aid universally rather than taking into account individual circumstances. So while $871 billion is an enormous amount of money if it is used improperly it will do the people of America no good. The plan that attempts to compensate for this general distribution of funds states that the amount of money should be negotiate with the providers rather than the government so that everyone could benefit from the governmental aid instead of just those with high premiums.

Obama's Latest

Early last month President Obama gave a speech outlining some specifics of his administration's plan to reform America's health care plan, you can find the transcript and video of this speech covered by CNN here. As all presidential address this speech is quite wordy and dances around a lot of the controversial debates. Obama does this, I believe, with partially good intentions, rather than addressing all the issues people are fighting over he tries to get to the point of his plan. However without addressing things like how illegal immigrants will be kept from taking advantage of this plan is extremely important to the southwestern states. All that aside this speech claims that there are three focus points of this reformation. These three points, according to Obama, are to, "provide more security and stability to those who have health insurance. It will provide insurance for those who don't. And it will slow the growth of health care costs for our families, our businesses and our government." We can all agree that keeping insurance companies from dropping people because they develop an expensive disease/disorder should be prevented and that the price of health care should be kept affordable without giving up our cutting edge research and care. The only question remains is how to we provide health care to 45 million more Americans without sacrificing the foremost quality and timeliness of care as discussed in my last post. The answer to this question is not shortcoming and may or may not have a definite solution.

International Physician's Perspective

Before I did any research on international health care systems I decided to limit my search to medical professionals since the would have the most direct contact with the implementation of a socialized system. I came across an article written by David Gratzer whose credentials and past work can be found here; the article claimed to describe socialized health care around the world as patients see it. Gratzer was trained in Ontario, Canada which has a government run health care system. One thing you should know is that private insurance is outlawed in Canada and that has never been a proposed portion of the American bill and will never be considered. However, you can deduce that many people who now barely afford health insurance will be forced to drop it because of the increased payments for government run care thereby leaving only the upper-class with private insurance on top of the national coverage. Gatzer relates numerous stories about insanely long waiting lists for any form of care, people packed into waiting ER waiting rooms for days at a time, and people requiring specialized care, such as radiation therapy, having to wait four months to receive their first treatment. All in all this article, click here to access, reveals some pretty interesting things about socialized medicine that must be considered when proposing a government run system. One final thing to consider; Gatzer brings to attention the argument that America's system is flawed because our life expectancy is lower than other nations. This statistic is justified by excluding the number of people that are killed as a result of accident or homicide. Once this change is made America has a higher life expectancy than most other nations.

While I was back in Fort worth last weekend I picked up the local paper (The Star Telegram) and saw an article titled, "Some Playing the Odds On Healthcare" by Beth Fouhy. In this article Mrs. Fouhy argues that a lot of the people who are uninsured are because they do not want to pay for something that they may not need and take the risk that if something does happen they will pay cash and risk their fiscal stability. Fouhy claims that the high insurance premiums and doubt about what insurers will cove contributes to people choosing not to have insurance. Obviously income is the number one reason for people to not have health insurance, but these other factors seem to be pushed aside. If sanctions were placed on insurance companies that force them to truly insure their clients rather than see them as a money-making venture then the reform in heathcare may not need to be as drastic. Another thing that may make health insurance more enticing to those who choose not to pay for it is to make it clear what the companies will cover and to broaden this list based solely on what the doctor recommends. As it stands now insurance companies make more decisions about the treatment that patients get than the doctors. Something should be done to reverse this relationship, doctors know what is best for the patient and insurance companies should do everything in their power to make sure their clients get the prescribed treatment without tremendous cost on top of their monthly premiums. Changes like these would surely make our healthcare system better for a lot of people.

I was reading the Battalion the other day and I saw that President Obama is coming to the George Bush Library on October the 16th. The article hinted to a possibility of him briefly discussing the health care reform so I would encourage anyone to go and listen to gain information. A good decision is a well informed decision so we will not be able to vote smart if we do not make the effort to gain the information to make a wise decision. Recently health care has become a hostile topic and I would like to encourage people to remember that we are all Americans and we must stay united if we want to remain a powerful nation. Debate is constructive but only if it is sound, logical, and free from emotional swing. As Abraham Lincoln said, "a house divided will not stand" so lets keep a united front and remember that we are all brothers and sisters of the same nation.

A Second Opinion

I was thinking the other day about a good way to determine what is best for the future of American healthcare. One thing that came to mind was; why not let the medical professionals vote on how they think they can provide the best care for the most people? Or allow them to give an estimate of the maximum number of patients they could effectively treat in a shift. This information would prove to be extremely helpful to lawmakers while they are trying to hammer out the specifics of this plan. Knowing the number of patients that could be treated in a day may lead to a slow dispersion of healthcare based on severity of injury until everyone’s needs have been met, if indeed socialized medicine is the best plan for the country. I believe that going to the people who must work with whatever system is implemented would be best because no one knows the application of the present plan and ideas proposed in future plans better than the people who work with it every day.

What do we do?

Although my last post seemed to have a lot of detail in it there is still a lot of uncertainty as to how this reformation will be implemented. Similar bills contain over a thousand pages of logistics and policies. The United States has not yet defined many specifics so it is difficult to exactly analyze the plan. However, we have several examples worldwide that can give us some direction as to the achievements and downfalls of socialized medicine. The simplest analogy that I have heard describing social medicine is that of a military nurse, “under socialized healthcare, even with private insurance, the quality of care will go down. Think of it this way, right now, those who can afford a sandwich can get any type of sandwich they want with a number of meats and cheese and all the condiments you could want; under socialized medicine everyone will get a sandwich, but it will be ham and bread”. There are not many ways to avoid this drop in quality because there are not enough medical professionals to properly treat an influx of 45 million new patients. As Americans prepare to propose the specifics of healthcare reform we should look very hard into ways to avoid this consequence without dropping quality of care or the standards of training for medical professionals. I’ll try to share some ideas later.

Reform Summary

In this post I will be summarizing the proposed health care reformation based on information I found at: http://www.kff.org/uninsured/upload/Obama_Health_Care_Reform_Proposal.pdf and in later posts I will explain how these things will be enacted and the limitations and possible problems the plan will run into. One of the big selling points of this bill is the “Overall approach to expanding access to coverage” which means that the government will make various laws that will give everyone a universal health insurance policy. A couple such requirements are that all children to have government funded health insurance and employers must either offer health insurance to its employees or aid the government funded insurance. The creation of the National Health Insurance Exchange (NHE) will make it possible for private business owners and individuals to have access to the new public plan or a series of approved private plans. This bill plans to meet these new requirements by expanding organizations like Medicaid and State Children's Health Insurance Program (SCHIP) to be able to provide care similar to what the Federal Employees Health Benefits Program (FEHBP) offers. The Obama administration plans to subsidize these requirements by making federal income tax related funds available to those who cannot afford the required coverage. The state of Texas has roundly denied previous offers by the federal government to assist (using national and state tax money) in funding the health insurance of children and people in poverty. Texas is an independent state and does not like the federal government interfering in our affairs, which is why Texas has very low state spending and taxes. Health insurance companies would no longer be able to consider current or previous health conditions in their acceptance of an individual or the formation of an individual’s premium and would form plans that meet minimal quality and efficiency determined by the NHE. A few other changes to private insurance to help control monopoly formation and price gouging are proposed. There is no state flexibility on these matters; all states must meet these requirements. Thanks for reading! I will be expanding on these concepts and giving some opinions in later posts.

Introduction

My name is Alex, I am from Fort Worth Texas, and I am currently a student at Texas A&M University. Over the next few months I will be researching and sharing current information on the proposed health care reform in the United States. As a future Physical Therapist this topic is very important to me so I will try my best to keep the information as up-to-date as possible and provide you with the pros and cons of this reform. The reform in a nutshell would require individuals to pay a certain tax for universal health care, leveling the playing field so that the rich are not always the ones to get the best treatment, supposedly everyone would get the same treatment. In theory this plan sounds very good, but when you get down into the nuts and bolts of it there are many points of controversy and if you look at other countries that have instituted a similar system then many questions are raised about our ability to implement this plan with favorable results for all.