Friday, August 24, 2018

medicare for all

Not just current medicare, but a no deductible, minimal copay, everyone gets meds and everyone can schedule an appointment at a Drs. office. No more EMTALA as the only human safety net.  No more of Dr.s and pharmacy's, etc., trying to find ways to get more from the people with good coverage while trying to avoid taking patients with poor payor sources like Medicaid and the local jails.

Medicare-for-all has become a battle cry for many of us.

I don't care what we call it, as long as it takes all the profit out of healthcare and makes sure every single person has the ability to receive the same healthcare as a person with excellent insurance.

The arguments against it include:

"My taxes should not pay for other peoples health issues" (who, exactly, do you think is paying for the care provided in emergency rooms, hospitals, ambulances, nursing homes, etc, for those patient's without insurance/jobs/money?)

"My taxes should not pay for the poor life choices of crackheads and junkies and lazy bums"
 1. I'm pretty sure my taxes have paid for some poor life choices of rich people, bank bailouts, failing automobile manufacturers, infrastructure prettiness in the expensive zipcodes of my city, and
2. my taxes are paying for their incarceration, and for the increased policing where they are hanging out, why not invest that in drug treatment, mental health care, affordable housing, life choices and coping education when young, especially in areas hit by poverty and job retraining programs that are easy to access as opposed to the current federal goldmining system in which career colleges get loans for people in fields in which there are no opportunities , that will never pay well, and then we ruin their credit for life since there is no loan forgiveness for education loans--not even bankruptcy.

"If your job doesn't provide good insurance, get a better job"  (ok, so either require every employer of even one person,no matter how part time, to provide insurance, with those making too little to live (less than 15$ an hour) having no part of the payment, or what?  Do we quit having cosmetologists, and wait staff, and dishwashers, taxi drivers and carnies?  They have jobs.  They just don't get insurance with them. )
This side of the argument is all from the idea that anyone with worse insurance or no insurance can only blame themselves and therefore need to die. (apparently in an ER)

The truth is, they do die, but not quickly or cheaply.

They may not be able to get any mental health treatment or chemical dependency treatment or chronic illness treatment or other basic preventative medicine screenings, but the law is, when it is bad enough, they can go to the Emergency room and get full service---if what they have wrong can cause death, dismemberment, if it isn't treated.
Many (not all, there are good, conservative ER Docs that do the mandatory medical exam and tell them they need to see a doctor but that they are not in danger of death or permanent disability from their complaint.--they can't see any other doctor which is why they went to the ER in the first place) but many of the ER doctors take their Hippocratic oath seriously enough and get that the people really can't go anywhere else, thus send them out with a prescription and suggestions for future good health.  Most of them can't fill the prescription, though.  Pharmacies have no requirement to give drugs to people without money.

The flip side (sides) of the "no universal healthcare" argument is:
"Without competition, no one will do new research" (that is the reason that there are so few drugs and treatments for orphan diseases, no big money so, no! money isn't the motivator.  But what if we had researchers that were trying to find cures, trying to make scientific breakthroughs, trying to save the world and NOT DEPENDENT on the money the drug companies give them.  There is a reason we have many treatments for erectile dysfunction, baldness, short eyelashes, and wrinkles but few treatments for neurofibromatosis, progressive supranuclear palsy, leukodystropies.  We also need to do more research into causes and preventions for chronic illnesses instead of just making more "bread and butter" treatments that patients take their whole lives till they die.  Soooo, as long as competition in this country is measured by dollars, only money items get researched.  More people want it, more research.  More rich people want it, Big Research.
"rich people from other countries come here for healthcare so they won't have to wait or risk being turned down for their treatment"  (I guess that is also why rich people here go to other countries for treatment they can't get here, rich people all over do whatever they want, and after we all have healthcare available without having to fear dying of a simple infection or a treatable chronic illness, the rich people will still be able to find doctors--US doctors, doctors in other nations, that will do whatever they want.  John Doe the homeless guy can get his insulin and his foot care and it won't hurt the Forbes 400's healthcare one bit.  They can go where ever they want, or hire their own, private, fulltime physician that only cares for them.  (reminds me of the old royal poop examiner)
"But we won't have the best healthcare system after we have universal healthcare, medicare-for-all, call it what you will"
https://www.numbeo.com/health-care/rankings_by_country.jsp
There are bunches of sources regarding quality of healthcare by country.  The USA is at about the 30th position every time, EXCEPT by COST of healthcare.  WE pay more than any other country.
Apparently paying multiple insurance CEO's millions and insurance marketers commissions and multiple Pharmacy CEO's millions and drug rep's commissions and Dr.'s educational cruises and ski trips and expensive dinners to use those drugs on their patients, really increases money in healthcare.
We have Medicaid being applied like an HMO, with physicians getting paid monthly for providing care for a certain number of patients (capitation) and then, since it pays less than other insurance, they arrange for a set number of available appointments for those Medicaid patient's and when that number has been reached, they tell the patient to go to the Emergency room.  Poor people going to a Doctors office by appointment instead of waiting till it's nearly too late and going to the ER and on to the ICU then dying is much more economical.  IF you consider that healthcare providers are physicians, nurses, therapists, pharmacists and technicians, then the huge numbers of people making a living off those people's work is basically padding the bill.

So, in truth, those that sing the chorus against universal healthcare, are just being gullible.

If the used car salesman told them that blacksmoke coming out the tailpipe was because it was so new the paint was still burning off, you wouldn't believe them (I hope).
If your child's teacher told you that it has been proven that children shouldn't be taught to read before age 16, when you asked why your 7 year old couldn't read, you WOULD seek other information.
So why, when those people making craploads of money off our nations healthcare problems tell you universal healthcare is bad, do you not even question their motivation.

The insurance companies do not want universal healthcare, it will likely put most of them out of business.
The pharmaceutical companies do not want universal healthcare, it will make them have to charge prices competitive with what other nations, those with universal healthcare, already pay for drugs.

The Physicians are split on it, some are fine with it, it fits their view of caring for people, others don't want it, it will decrease some of those insurance and pharmaceutical perks used in marketing.  It will make them follow the evidence based practice guidelines so they can't do more invasive tests than are frankly good for a patient or required for diagnosis and treatment.

But employers should want it, it is good for employees to have access to healthcare that is not tied to their own ability to make some high-volume purchase.  (that is why small businesses have problems, they don't get the high volume lowered price)

It will be great for emergency rooms and ambulances, they will be back to treating emergencies.
It will be great for poor people and addicted people and chronically ill people and people under 65 that want to retire but couldn't get affordable care till 65.
And, it will eliminate the need for states to provide Medicaid for their poor and disabled.

There is a reason that access to healthcare is a human right.  It is as necessary to life, liberty and the pursuit of happiness as all of our rights are per the Bill of Rights.  It's our ability to choose life over death, life over disease, life over dysfunction.

Why are we even having this discussion.

To your health!



No comments:

Post a Comment

2024 begins

 It's a new year, and like the reality of most new years, it looks remarkably like the previous year. The world has rising fascism, risi...