A Christmas wish: Health care for all
By Bob Williams
The Record Searchlight
Monday, December 24, 2007
For too many Americans, loss of a job means loss of health care coverage. This has come home today among laid-off workers in the building trades as housing construction tanks. Too many Americans have no health care coverage even though they have a job. Other Americans, with health coverage, find themselves directed to emergency room care when their attack of chest pain occurs on the weekend. There they may sit from 7 p.m. to 11 p.m. until told to go home because the ER can handle only traumatic injury cases.
Health care can be better than this. It can be better if we install a nationwide system instead of the market we now have. Many small businesses cannot afford to offer health care to employees even though they would like to. The market is structured such that a business operator must cover 32 to 50 employees in their plan before getting a significant price break from insurers. This is why less than 50 percent of small-business owners in California offer health insurance while 99 percent of large businesses do.
The United States is the only country, out of 28 industrialized countries, that does not have a universal health care service in place. We have many of the best-trained medical professionals in the world, but of these 28 nations the U.S. ranks 23rd in infant mortality, 20th in female life expectancy, 21st in male life expectancy. Furthermore, among U.N. member states we rank 67th in health immunizations.
These numbers, as usual, are not as meaningful to people as are their own experiences. Many have experienced being unable to move their health insurance from one job to another. Many middle-income people have in the past seven years decided they can no longer afford health insurance.
Detractors like to call universal health care systems “socialized medicine.” Only a few systems worldwide are true socialized medicine in the sense of being totally government-financed through taxes and government-administered. Most universal health systems in the industrialized world are mixed public-private care systems but carefully regulated by a government or nonprofit agency.
We do have one socialized medicine program taking care of about 5 million people in the U.S.; this is the Veterans Affairs Healthcare System. Health experts on a recent ABC News report ranked VA Healthcare as one of the best systems in the country, having fewer medical errors and spending at least $1,500 less per year per patient than even Medicare. Fortunately for qualifying veterans and their families, the phrase “socialized medicine” has never gotten attached to this system in people’s minds. Just as our public education system — publicly financed with tax dollars, regulated, and governed by local boards — has not been labeled “socialized education.”
None of the health care proposals being put forward by presidential hopefuls today are socialized medicine. All involve a combination of government and private financing, uniform standards of record keeping, private providers and choice of provider by individuals. Many worry about government bureaucracy in health care while ignoring the problem of private insurance company bureaucracy. Individuals often have difficulty dealing with the obscure and involved paperwork of the private insurance companies. The private insurance bureaucracy costs the insured a great deal. The 14,000-member Physicians for a National Health Program have published data showing that, in California, only 66 percent of health care funds go for medical care. The remainder — a very large remainder — goes into administering the private insurance system. Approximately 20 percent goes into billing alone.
Just this month the American College of Physicians, the second largest medical association in the U.S., endorsed the idea of single-payer national health insurance to achieve universal coverage. Their statement in the Annals of Internal Medicine read: “Single-payer systems generally have the advantage of being more equitable, with lower administrative costs than systems using private health insurance, lower per capita health care expenditures, high levels of consumer and patient satisfaction, and high performance on measures of quality and access.”
A single-payer system can reduce administrative costs of health care to levels comparable to that of Medicare, currently estimated at approximately 3 percent. That is far different from the wasteful and inefficient health care delivery we have now. It is, in effect, Medicare for all.
Change is coming in our health care system because people demand it. It could be minor tinkering, which will require more tinkering year after year, or it could be significant change. It will not happen this Christmas and not next Christmas, but this could be a gift to all Americans in the Christmas after.
Bob Williams is a Millville rancher, a past president of the cattlemen’s association, and a retired UCLA professor of anthropology. His e-mail address is wmsranch@redding.net.