Wednesday, May 13, 2009

Healthcare Inequality and Inequity

The question of healthcare inequality and inequitiy raises an important question: Should consideration of money or the issue of socialism, which many conservatives forecast will lead to Marxism or Communism, even be an issue in relationship to profit when it comes to the care and well-being of anyone.

This basic moral question needs answering before any healthcare system reform plan is considered.

Ability to pay, when life, liberty, and freedom are concerned, is an ugly factor that rises from a money-based economic system. It becomes a very suitable argument in opposition to our current system of capitalism and free market, where pursuit of profit supersedes pursuit of decency and morality. Do we let a human being suffer from an incurable disease or let them die because they do not have the ability to pay for treatment? To say yes, money does count, would lead to an important question about America, and its regard for the quality and depth of its proclaimed humanity. In my view, our current healthcare system is in violation of the principles Americans have held sacred since its founding.

The incentive for unreasonable profit by healthcare insurance companies, physicians, hospitals, other health care providers, and associated research and development is high because of the nature of the industry – people need healthcare. It’s very seldom a personal choice, very different than the decision to purchase of a new car or new home of which the cost of healthcare exponentially exceeds. Most of the time there is no choice, it’s simply necessary. Let’s face it, for health care providers, pharmaceutical companies, or R & D it is not in their best interest to keep people well and free from run-of-the-mill illnesses. There have been cures discovered for diseases such as polio, and there are great efforts to resolve the problems of other diseases such as cancer, but to cure many of the nondisabling or otherwise debilitating afflictions … well, I just wonder.

Healthcare in America, for the most part, is provided by institutions or corporations who negotiate a group policy on the behalf of their employees and who each pay, employer and employee, an employer-assessed portion of the premiums. Suppressed wages are a result of this picked-up cost by the employer, and are even more so as insurance premiums rise. Employees who lose their jobs may lose health insurance coverage, and as a result, in order to continue their previous coverage, will pay COBRA payments that are 110% of their original healthcare group insurance cost, while at the same time, for many, losing their source of income. From personal experience, and from CNN reports of others, COBRA payments can equal and in some cases exceed ones rent or home mortgage payment.

As of 2006, medical expenses have annually caused at least 425,000 bankruptcies, and one in six or more working-age adults are burdened with medical debt. Health insurance for individuals and small firms have become prohibitively expensive with many organizations reducing coverage and/or contracting for higher deductibles.

Healthcare professionals, insurance providers, and politicians, claim America has the best healthcare system in the world. I ask, Oh really? Why is it that no other national health care system allows their citizens to file for bankruptcy under a claim of excessive medical debt? Why is it that so many Americans leave our country to receive healthcare in another? Why are our emergency rooms flooded with patients who need non-emergency care? Why is America’s infant mortality rate so high compared with other developed countries? Why do politicians and others opine that in other countries with national healthcare one must wait months for treatment, and fail to understand the fact, or are ignorant of the fact, that in America the average Jack and Jill who try to make an urgent doctor’s appointment that is not a life or death emergency is in many cases impossible.

“Additionally, among developed nations, waiting lists are not a major factor in explaining lower costs. Examining Organization for Economic Cooperation and Development (OECD) nations, one study identified twelve countries that had waiting lists for elective surgeries and seven countries besides the U.S. that did not have these waiting lists. Per capita health spending averaged $2,366 in the countries with waiting lists, $2,696 in the non-U.S. countries without waiting lists, and $5,267 in the U.S. (See Exhibit 3). Thus, waiting lists are neither inevitable nor necessary in systems that cover all of their people.” A report by: Tom Daschle

“It is hard to believe that, in the wealthiest nation on the planet, 77 million people – 37 percent of all adults – report having difficulty paying medical bills or medical debt. In this regard, we do stand out among the world’s leading nations; we are the only one that fails to ensure that health care is affordable for all.” A report by: Tom Daschle

In the view of republicans/conservatives/libertarians, we need to restore and revive a free market health care system.

“We recognize the freedom of individuals to determine the level of health insurance they want, the level of health care they want, the care providers they want, the medicines and treatments they will use and all other aspects of their medical care, including end-of-life decisions.” National platform adopted at Denver Libertarian Party convention May 30, 2008. This is the same position taken by the Republican Party, as well.

Because of this capitalist, free market, free enterprise healthcare insurance ideology, which is substantially our current system of providing healthcare, this system, like our economy, is essentially a failed system. It is broken.

At least the Obama Administration, unlike republicans, acknowledges that it is a broken system, and they are listening to recommendations for Health Reform in order to address the crushing cost of health care. President Obama has received from the House of Representatives their commitment to pass a comprehensive health care reform bill by July 31, 2009..

Our healthcare is dependant on insurance programs that avoid the sick, but will insure the healthy, and in doing so only if you have the ability to pay; it is analogous to providing an umbrella on a sunny day.

If we can afford, have unyielding support for the most undemocratic, socialistic, and sophisticated killing machine entity the world has ever known – the U.S. Military -- then America should be able to afford to provide for its citizens an affordable, accessible, high quality healthcare for all.

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