Lunch time, so I’m going to take advantage of WiFi and post.
Hillary Clinton Promises Universal Healthcare
This is an issue I’ve thought a lot about over the years. As a “fringe person” (the bizarre fringes, but who’s labelling?), I’ve had very few encounters with healthcare in America.
Cut for TMI and rantiness
My first encounter was pregnancy, and the baby was born 4 1/2 months premature (she survived and is doing well). Her twin was an invasive cancer. (as an aside – all pregnancies are a form of cancer, it’s just that some of them develop into viable beings) The doctor for the pregnancy was outstanding (he’s now in research because he can’t afford malpractice insurance as an OB-GYN), the insurance company was not. We were left, after insurance paid their share, with more than $1,000,000.00 in medical bills.
Yep, that’s right – after insurance paid their share.
The doctor thought he’d gotten all the cancer from the twin out, but it metastasized to several other places, cropping up virulently a year later. A year and a half of intensive chemo, radiation therapy, and chemotherapy later, it was in remission, leaving us with half a million in debt, added to the previous million.
The gods weren’t through with us yet, though, and I became pregnant agin – startling the medical community. He was also born 4 1/2 months early, another million dollar baby (he’s doing well and serving in the military).
In each instance, the insurance company refused to pay for many procedures and necessary tests – lack of which delayed needed treatments which contributed to the prematurity of the babies. The insurance refused to pay for much of the necessary support for the babies because they were so premature. Their attitude was that these babies were “unsalvageable” and therefore not to be treated. After 2 weeks in intensive care, I took each baby home and cared for them myself. Both babies are now adults, with college educations. One works in IT for the Health Department and the other is a soldier on deployment.
The insurance company thought these two people were not worth saving.
And therein lies my concern for a universal health care system. How many more babies like these two will be deemed “not worth saving” – and not have the advantage of a fringey mother who knows a lot of phytotherapy and magic to keep them alive and well without any professional medical support at all?
I’ve only used the traditional healthcare system to get tests run that I felt were needed. Occasionally, I’ve used them for diagnostic purposes. But I have never again used the medical system for treatment of anything for me and mine – precisely because insurance doesn’t allow us to do what is in our best interests health-wise.
I fear, very much, that auniversal health care system, at least all the ones that have been promoted so far, will be as detrimental to our overall health, or worse, than health insurance has proven to be.
I wrote an article almost 10 years ago (might have been a bit longer than that, time flies when you’re having fun) about how the average uninsured Pagan and itinerant Rennie merchant could have good health care with little or no health insurance – and I didn’t recommend learning herbal therapies or reiki or anything else of that nature.
I’ve somewhat modified my views since then with new information that has become available but the bulk of whatI wrote then holds true still.
I’ll share with you the type of healthcare system I think might be a viable on in American culture.
One is to take the taxes we currently pay for Medicaid and Medicare and use it for “level one” health care: primarily preventive care in the form of routine vision screening, basic dental care, immunizations, common ailment care provided at out-patient clinics that can be easily handled by RNs and interns (colds, flu, minor injuries like simple fractures, cuts, and other small emergencies that are not life-threatening but still require medical attention), birth control, chronic illnes care that is not in crises (like hypertension, diabetes, seizure disorders, thyroid disorders, allergies, and such needing monitoring and refill of medication), pain mangement of chronic illnesses, screenings for illnesses of various sorts (based on family history and need), basic pregnancy and childbirth, and preventive health education which includes free classes on nutrition, CPR, dental care, vision care, cold and flu prevention, exercise programs, health cost management, etc. All of this would be routine, handled by trained personnel but not necessarily MDs and specialist MDs. All would be paid for by our tax dollars and it would be available to everyone in America – including tourists and visitors from other countries.
It would also pay for “level two” care – crises situations, immediate, life-threatening injuries and illnesses until the patient is stable.
Level one and level two care are funded by tax dollars, but that still leaves a vast portion of health care uncovered – the high risk pregnancy, the lengthy illnesses that are not chronic, like cancer care, surgeries for conditions that are not immediately life-threatening, physical therapy and supportive after care for critical care patients – all of the healthcare that insurance companies term “major medical”. This level of care is where something resembling health insurance steps in. That nasty “pre-existing condition” clause has to go because most of these conditions would be found during the “level one” care, or would be the wind up of “level two” care – every condition treated here would fall under “pre-existing”. Because not everyone will need this type of care, I see no reason why it should be entirely tax-supported. It can be paid for through private insurance, as the bulk of our healthcare currently is, or we can seek viable alternatives.
Our tax dollars should provide major medical care for all children up until they leave school (whether that’s high school or college), for all senior citizens over the age of 70 (may treat younger if the adult in question is incapacitated by age-related conditions, such as Alzheimer’s – and older if the senior opts out of the care, but the senior can choose to take advantage of it at anytime after age 70), and for the disabled.
One such alternative I propose is the Health Trust Accounts. It’s sort of like the Health Savings accounts – vaguely, anyway.
Let me tell you how I envision a Health Trust Account working: Each person receives a Health Trust Account at birth, with our tax dollars providing the seed money for it and a nominal sum paid into it each year ($100, $200, something like that). The parents can put as much or as little money into it as they want or can afford, and their employers will put in an amount to match the tax dollar amount. Because children have all of their healthcare (except elective cosmetic surgery like rhinoplasty with no underlying medical condition or breast enlargement) paid for by tax dollars, they won’t be touching the money in these accounts until they are full adults and will have a large fund to pay for major medical costs. As adults, they can continue to deposit money into these Health Trust funds, and their employers, instead of paying for health insurance, can deposit that amount in the Health Trust Fund of their employees. Basic and life-threatening health care is still tax-dollar funded, but now the adults are in control of how and where their health dollars are spent for major medical care and they can work in pertnership with their doctor for their medical care. The doctor can charge reasonable and fair fees instead of the grossly inflated fees they must charge in order to recoup a fair amount.
Did you know that a doctor charges $120.00 for a typical 15 minute office visit for an established uninsured patient but only receives between $25 and $50 from the insurance company of an insured patient – the rest is “written off” and the doctor doesn’t see a penny of it – this is why doctors now charge office visit co-pays, so they can double the amount of money they get. Wouldn’t it just be easier if they charged – and received $50 – $75 for that visit? As it’s set up now, the uninsured patient pays far too much just for being uninsured. There are some doctors who will negotiate fees with uninsured patients, and others who offer sometimes large discounts if the patient pays cash up front.
The insurance companies starve the doctors of their rightful fees, force them to cut corners at the patient’s expense, deny necessary procedures because they are expensive or “unnecessary”, and charge a hefty premium with lots of deductibles and in-covered charges to the patient. Everybody loses except the insurance companies.
anyway, back to the Health Trust Account. Employers who previously couldn’t afford to provide health insurance to their employees because of the premiums could afford to contribute to a Health Trust Account. Perhaps they could do a “matching funds” – whatever amount the employee designates be withheld from their paycheck could be matched by the employer so the employee gets a double deposit. Most employers even of quite small businesses could afford to contribute $50 or $100 per employee per month.
That money adds up very fast for healthy adults. If they never need to touch their Health Trust Account, they could enter their senior years able to opt out of the tax-dollar paid health care. After age 70, they could choose to use the Health Trust Account money as a secondary retirement fund for daily living expenses or use it to pay for their medical care.
Obviously, they get out of it whatever they put into it, and there should be no limit to the amount they can contribute to their Health Trust Fund.
To use it, they would present a debit card to the doctor, hospital, pharmacist, clinic, masseuse, chiropractor, nurse, or other health care provider and the amount would be debited from their Health Trust Account. The patient controls the funds, and decides what health care is needed and what isn’t.
Medical care would go back to being between the patient and their health care givers without the insurance companies controlling both sides of hte health equation.
For surgeries purely for cosmetic reasons (breast enlargements, penile enlargements, liposuction for those not seriously or morbidly obese, nose reshaping with no medical need, ear shaping, etc.), the patient would not be able to use the Health Trust Account funds and would have to find another way to fund these things, just as they do now. Of course, they may just have more money free to save for such things.
So tax dollars would pay for basic, preventive, and educational health care, supplemented by major medical care funded through private dollares – either via a tax-free Health Trust Account or through traditional major medical insurance programs.
The emergency rooms would return to being for life-threatening injuries and health crises and not be clogged with the uninsured and Medicaid people who can’t get the health care they need otherwise. We wouldn’t have children dying of an abcessed tooth because the parent couldn’t afford a $70 dental visit and a $20.00 antibiotic.
People who abuse the medical system now by going to the ER or the doctor for every little twinge would be more aware of the actual cost because it would be coming out of their Health Trust Fund. And yanno, if they’re paying for it, why shouldn’t they get the attention of a health care provider? It won’t be my tax dollars paying for that, nor will I be paying higher insurance premiums to cover the cost. The people who need it – children, the elderly, the disabled – will get it, and the able-bodied adults will have a system whereby they can get quality medical care at reasonable prices – and only the healthcare they need.
I would hope there would be no more gouging like when I was charged $30.00 for a box of preemie Pampers – and charged for 4 boxes a day (there were 90 diapers in a box of Preemie Pampers back then)- when my babies were in NICU and the retail value of that same box of Pampers was $3.75 and I used a box a week instead of 4 boxes a day. I would hope there would be no more “routine x-rays” if one is admitted to the hospital, and no more “routine pregnancy tests” when you enter the hospital if you’re female even if you’ve had a tubal ligation, a hysterectomy, or passed menopause.
Each time I went to the hospital for radiation or chemotherapy, I had to also pay for a regular pregnancy test even though I was taking a hormone assay that was more sensitive and definitive than a regular pregnancy test to chart the progress of the cancer, and I had to have a chest x-ray – upping the amount of rads I was receiving to unsafe levels with the radiation therapy. Had I been able to opt out of those (and other) unecessary tests, I certainly would have, but opting out of a few tests meant I was “refusing treatment” and I would have gotten no care at all.
That seriously needs to be revamped even if we don’t get a tiered universal health care system.
If we keep insurance as an option, we need to lose the “pre-existing condition” clause, and we need to allow the patient and doctor decide which tests and procedures are essential. There should never be a “routine chest x-ray” or a “routine pregnancy test”.
So, that’s what it boils down to: tax-subsidized basic health care, health education, and preventive care for everybody; tax-subsidized major medical care for children, disabled, and elderly; private subsidized major medical for able-bodied adults.
I’d like to see insurance dropped entirely, but the industry has enough political clout I doubt it will happen.
Still, I can hold out hope that we can be allowed non-insurance alternatives that won’t cost us the fortune being uninsured does.
Ebonypearl 