Monday, June 18, 2007

Universal Health Care

Society, and the government thereof, has an overriding interest in the health, welfare and continued productivity of it's citizens.

That is the reasoning used to justify things like seatbelt laws, helmet laws, right-to-life laws as well as child and elder abuse laws. The State should ensure the saftey of it's citizens so that they can continue to pay taxes and contribute to society.

By that same reasoning, every single citizen of this country should be entitled to the very best medical care that modern science can provide, free of charge.

Just as any student willing to go into medical practice (or education, or any other civic responsibility) should be entitled to an education, free of charge.

No one should be allowed to make a profit off of human suffering.

I envision a system where every six months, each citizen takes a week off work to go to a Medical/Dental/Pyschological spa. At that spa, they perform every single diagnostic test known to the bleeding edge of medical science. DNA profiling, MRI scans, Genetic mapping, EVERYTHING! Between medical tests, you get the full battery of massage, manicures, pedicures, mudbaths and pampering you can imagine.

While you are there, you get double your normal pay.

If they find anything wrong, they fix it. No charge.

Average, healthy, productive life expectancy is about 130.

CURRENT FOR PROFIT PARASITIC MODEL:
Passive Health Care System
Do Nothing Unless Someone Complains
If Someone Complains, Do As Little As Possible For Least Cost
Charge Sick Person As Much As Legally Allowed For Illness And Treatment
Build Wealth For Providers From Suffering Of Sick
Rich People Stay Healthy
Poor People Die
Repeat As Necessary

PROPOSED TAXPAYER PARENTAL MODEL:
Proactive Health Care System
Regular Diagnostic Checks
Free, Proactive Treatment Programs
No Charge To Victim Of Illness
Patient Brought Back To Health In Comfort And Dignity

NATIONALIZE MEDICINAL AND PHARMACEUTICAL CARE:
Pharmaceutical R&D Performed By Not For Profit Groups
Health Care Students Recieve Free Education And Training
Health Care Providers Paid Flat Salary

I would much rather my government keep me healthy and productive than protect me from some foreign enemy that they created with their own assholish policies.

15 comments:

satyavati said...

Unfortunately, one of the biggest groups AGAINST socialized medicine are doctors.

I used to fight with one of the doctors I used to work with all the time over this. He said, "If I get paid the same regardless of how many patients I see, what incentive is there for me to work?"

I replied: "So much for medicine being a mission instead of a business."

Don't get me started on the conditions that I work under (RN in non-union state) or that caregivers lower on the food chain (LPN/CNA/HHA) work under. The people who provide the hands-on care are the ones who are simultaneously the most important and the lowest compensated.

I'm in a position that I see this from both sides; as a nurse and also as a patient. In 2000/2001 I postponed seeing a doctor for three months after I fell, because I knew I'd broken my ankle, and I had no insurance at the time. Needless to say, working, walking, and driving on it all that time did a ton of additional damage, and I ended up having surgery and being out of work for 12 weeks. I've also taken care of people who've ended up in the hospital because they couldn't afford their medicines or see a doctor for their minor ailment, which became a major ailment due to nonintervention.

The whole situation is pitiful. I've said it before: we are virtually the only civilized nation in the world that does not provide healthcare for our citizens. The reason is simple: as with all things genuinely and uniquely American, it boils down to the money.

The same doctor I mentioned also said to me in the course of the same conversation: "Let me get this straight. You actually believe people are entitled to healthcare?"

Yeah. I do. And until we can manage it, we'll never be really civilized around here.

Xavier Onassis said...

satyavati - "He said, "If I get paid the same regardless of how many patients I see, what incentive is there for me to work?"

The beauty of my plan is that it would drive greedy, money-hungry, social-climbing bastards (I don't actually know him, but I'm on a broad-brush, generalizing roll here) like the proverbial "him" out of the profession and encourage those who are in it for a heartfelt desire to help people.

That's what we want in a doctor, right? Someone who's highest priority is MY best interest, rather than HIS/HER bottom line.

My health should trump my doctor's bank account.

Why is that such a foreign concept?

Xavier Onassis said...

"Let me get this straight. You actually believe people are entitled to healthcare?"

Absofuckinglutely.

And legal representation.

I have a problem with any profession who makes their money when their customer's lives and livelyhood's are up against the wall and they have no choice but to pay what some opportunistic blood-sucker chooses to charge.

emawkc said...

"...every single citizen of this country should be entitled to the very best medical care that modern science can provide, free of charge."

Great idea. Now you just need to find about a million more healthcare workers like Satyavati who are willing to work for no monetary compensation and drug companies that can afford to develop new drugs to give away at no charge. Maybe they can all ride to work on sparkly winged unicornes over the Sweetplumb Bridge in the land of the Magic Sugar Sprites.

Or, we could try to find a realistic way to address the problems.

Xavier Onassis said...

"Maybe they can all ride to work on sparkly winged unicornes over the Sweetplumb Bridge in the land of the Magic Sugar Sprites."

LOL!

I figured you would be the first to respond to this one!

I pay an ASSLOAD in taxes every year.

I would much rather those taxes (and even additional taxes...yes...INCREASE TAXES) go to taking care of the citizens that pay the taxes instead of fighting and creating new enemies all over the world.

I don't want to be cared for by a doctor or a nurse motivated by money! I want trained professionals caring for me who are motivated by a desire to help people. Specifically, ME!

Do you prefer a profit motive? Would you prefer a doctor looking at emaw and thinking, "I know he's sick. REALLY sick. But I have a boat payment to make, he has mediocre insurance and I really don't see how he can contribute to my bottom line. My accountant says I should just let him die. So, fuck him. I'll give him some drugs. His insurance will cover some of that. I'm off to the lake!"

satyavati said...

Here's a perspective. I don't do my job because I'm motivated by money. I don't believe any amount of compensation is actually adequate for some of the things I've got to do. But I'm not willing to work for free, either.

A first place to start would be to subsidize healthcare education. Then you've removed the burden of paying back school loans and all that. Next, totally cap the whole malpractice awards thing. Malpractice insurance can cost incredible amounts of money.

Drug companies? Can afford it. We've already discussed here the amount of money big pharma spends on advertising trinkets. What they pay out in promotional sticky pads alone in the course of one year could probably fund research quite nicely.

I think maybe some kind of middle of the road system might be best for us, with all the basic care being taken care of and only things like major medical and hospitalization requiring insurance coverage.

And yes, you're damn straight. I'd be willing to pay a whole lot more in taxes if we had universal healthcare and free education. Imagine actually getting something in return for all that tax money!

travelingal said...

First of all, I believe in making health insurance available and affordable for every citizen of this country. But, of course, nothing is free and shouldn't be except under extreme circumstances. Some people are under the mistaken impression that healthcare is free in other countries with universal health care. Ten years ago I was visiting with friends of mine who live in Germany, both professionals. They each (husband and wife) paid $300/month for their health insurance. At that time, the costs were based on individual income. Not sure what it is today. And, of course, the taxes in Germany are substantially more than they are here...so even though Germany has a good universal health care program, it's not free.

I would never want a program like Canada has. The reason the people have to wait exhorbitant times for operations, etc. is that there is an extreme shortage of doctors. Why is that? It's because their salaries are limited to the point that it's not an attractive profession. In the end, people end up paying very high taxes to the government for providing universal health care that they may die waiting for!

I just hope whatever program this country comes up with is a smart one.

emawkc said...

"I would much rather those taxes (and even additional taxes...yes...INCREASE TAXES) go to taking care of the citizens that pay the taxes instead of fighting and creating new enemies all over the world."

What surprises me is your faith in our government to use the additional taxes (let alone the current assloads of taxes we all pay) effeciently.

What a preview of what a national health system would look like in the US?

Look, I don't mean to dismiss the idea out of hand. I just have a feeling that Satyavati is right. We can do a lot to improve our current system with insurance reforms, prescription drug marketing reforms and tort reforms.

satyavati said...

oh my God...
someone agrees with me?

This is the seventh sign of the Apocalypse.

Xavier Onassis said...

satyavati - "I think maybe some kind of middle of the road system might be best for us, with all the basic care being taken care of and only things like major medical and hospitalization requiring insurance coverage."

See, I disagree with that. I think EVERYTHING should be covered. ESPECIALLY the major illnesses. If you are diagnosed with a major illness, you should not have to decide "do I want to keep my house? Or do I want to live? Do I want to buy groceries and keep the utilities turned on? Or do I want to buy the medication that MIGHT just keep me alive?"

I think it is inexcusable for a civilized society to force that decision on a sick person and their families. It is unspeakably cruel.

emaw and satyavati - emaw said "Now you just need to find about a million more healthcare workers like Satyavati who are willing to work for no monetary compensation and drug companies that can afford to develop new drugs to give away at no charge."

I never meant that anyone should work for free. They should be reasonably compensated for the services they provide. But the gap between nurses pay and doctors pay should be a LOT narrower.

That should be taken into account with the single-payer system.

emaw - "We can do a lot to improve our current system with insurance reforms, prescription drug marketing reforms and tort reforms"

Okay. As long as the patient doesn't have to pay for treatment and the best medical care known to man is available for free, I'll vote for it.

crse said...

I dont think there are easy answers here although the differences in spending between social and human services and the money spent on "fighting and creating new enemies all over the world" are obscene.

Personally, I am in the rare position of providing what could be construed as "socialized medicine". I specialize in a diagnosis that is costly to treat in terms of both time and money. What is significant about this treatment is that most programs in our area do not accept private pay insurance. The department of welfare accepts this particular diagnosis as a medical necessity thus qualifying all our patients for a medical card regardless of income.

I've been in the field for eight years and the system is implemented statewide in terms of the diagnosis. Managed care companies often get involved but instead of clients being pieces of paper, the managed care company sends a representative to periodical review meetings that involve the entire team including the client. The acceptance or denial of service occurs on the spot at the end of the meeting. In my eight years working with this system, Ive seldom experienced clinical disagreement with decisions made on behalf of my clients. There seem to be enough checks and balances in place to regulate treatment.

I know that one state and one diagnosis cannot be compared with universal health care provision in general, but I see the concept working every day. (I think the system is currently implemented in a total of three states at this point) And no I am definitely not getting rich off the process and neither are my supervisors, but we are proud of our clinical reputations and are grateful for the system that allows us to do our jobs. So yeah I think it could work.

Then again, i also like the sparkly unicorn idea...

satyavati said...

I'm not saying I disagree with the whole top of the line care for zero cost thing... I just don't necessarily see it as something we can attain in my lifetime. I'm thinking even if we could start with preventative care it would make a huge difference.

If basic, preventative medicine was paid for, a lot of more involved, more serious, more expensive problems could be headed off at the pass. This is such an obvious fact that even insurance companies push the whole 'wellness' thing nowadays.

And here's something else. I would not/could not/will not ever say that I deserve to be paid as much as a doctor does. I'm a nurse; we have our place in the chain, and although I'm a better doctor than a few doctors I know, I'd never be presuming to know what they know or be thinking I deserve what they do. Twelve years is a long damn time to be in school, and they do it.

If I'm going to approach this problem reasonably with a solution that it might be feasible to try to implement in less than two generations' time without entirely dismantling the whole healthcare delivery system as it stands in one fell swoop, I'm still going to go back to the basics: subsidize the education, cap malpractice awards, seriously regulate the whole pharma industry. Invest in patient education and wellness.

Unfortunately, that's when you get into politics. There's special interest groups in this country that push their own agendae (is that a word?) even to the point of misleading the public about health risks, and once again, I come back to the conclusion that when you're in America, in the end, it's all going to be about making the buck.

Xavier Onassis said...

satyavati - don't sell yourself short.

Yeah the doctors are the ones with the 12 years of education and training blah, blah, blah.

They are also the ones who breeze in, spend 10 minutes with a patient, scribble a few notes and then drop them in your laps for the next 36-72 hours.

It is the nurse who exhibits actual care and concern. It is the nurse who feeds you ice chips, wipes the sweat from your brow and holds your hand. It is the nurse who notice mistakes and conflicting orders from the doctors. It is the nurse who acts as the patient's advocate when the doctors get things wrong. It is the nurse who helps you get well enough to go home. The doctor is long gone and has a couple of rounds of golf under his belt when the nurse wheels you out the door to your ride.

I say cut the doctor's pay in half, and double the nurse's pay. That would be a good start.

satyavati said...

Geez, XO, next time you're sick, I wanna be your nurse.

Most women think we're like the nurses they see in soap operas, and most men think we're like the nurses they see in porno movies. It'd be nice to take care of a person who realizes we're neither.

But getting back to this issue: at this point in my life and career, I'd be happy if the NC legislature would just let us have a union.

travelingal said...

And, one more comment about pharmaceutical companies. Since I worked for one nearly my whole career, I can attest to the fact they pay very well, but, nearly everybody who works for them is a skilled worker. The technology is complex and the regulations are unbelievable so I think the pay is well deserved. Yah, the advertising is a good size of the budget, but R&D is by far the biggest expenditure. If you all want your drugs from China and the third world, strapping down the major pharmaceutical companies is the way to do it.