Penny Wise, Dollar Foolish, & Heartless: U.S. Health Care

How We Can Fix the Broken Health Care System?

Fewer Americans have health coverage and, those who do, pay more money for less care than any other industrialized nation in the world. According to the National Coalition on Health Care’s latest report, “Charting the Cost of Inaction,” 41,000,000 people in America are without healthcare. Furthermore, the cost of insurance is increasing 14%-16% per year, which is expected to bring the average family premium per year up to $14,545 by 2006, double what it was in 2001. The number of uninsured in America is expected to reach 54,000,000 by 2006. In the end, the taxpayers bear the burden of the uninsured. It is like the old mechanic’s warning: Pay me now, or pay me more later. Instead of relatively cost-effective preventative medicine, taxpayers pay far more for emergency procedures that could have been prevented. In keeping, over the past five years, emergency room use has doubled, and is expected to keep rising.

The problem of lack of insurance is especially serious among children. The U.S. rates a dismal 28th for international infant mortality. Nearly ten percent of American children aged 17 and under are without health insurance, according to the U.S. Department of Health and Human Services. Millions of children do not get the health care they need and many succumb to common childhood diseases, that left untreated, can cause unnecessary costs and permanent physical and mental damage.

A study completed in March 2003 by International Communications Media, found that 79% of people support federal and state efforts to provide health care to all children, even if it meant an increase in taxes!

According to the findings of The National Coalition on Health Care, a system that eliminates or controls costs would offset the increased expenditure needed to provide universal care. They agreed at a recent conference to support the following principles:

*Health insurance for all

*Improved quality of care

*Controlling system costs and stopping cost shifting

*Creating a more viable and equable mechanism of financing

*Simplified administration

An April 2003 study by the David and Lucille Packard Foundation shows that with a streamlining of the funding process, and by enrolling children in existing programs, like Medicaid and the State Children’s Health Insurance Program (SCHIP) we could largely eradicate the problem of uninsured children. Lack of awareness, language barriers, enrollment problems, and fear of repercussion for using public funds were stated as reasons for non-utilization of the available programs. Hispanic and other minority groups, children, and adolescents suffer the most from non-insurance.

Meanwhile states are facing immediate threats to funding for programs like Medicaid and SCHIP. These federal dollars, so greatly needed, require matching funds from states. Many states are simply unable to collect the needed funds due to budget shortfalls. These shortfalls are estimated at $30 billion for 2003; expected to rise to as much as $80 billion in 2004, according to the Packard report. Just last year, five million dollars in federal funds earmarked for children’s health programs went unused because states failed to come up with matching funds.

Business owners’ legitimate complaint is that the businesses that do provide health care are less competitive than those who do not. Those that do are asking for a ‘level playing field,’ in which all businesses bear the same cost of insurance. The only way to achieve that in a capitalist system is by passing a law requiring it.

Childhood immunizations, though controversial, are an effective method of preventing children from contracting many devastating illnesses and diseases. The increasing number of safe and effective vaccines for conditions such as measles, polio, and tetanus can allow many children to avoid major illness. The Center’s for Disease control and the American Academy of Pediatrics recommend ten different vaccines be given to children before kindergarten. However, children without health insurance often do not receive these vaccines.

The federal law currently mandates that children receive only measles and rubella vaccines. All other vaccinations are voluntary. Parents can research individual vaccines to make an informed decision through the National Vaccine Information Center, and other sources. It is important to consider the child’s age, and the quantity of vaccines injected at one time, as these factors can increase side-effects, or limit effectiveness of the vaccines. Although vaccines countless numbers people avoid illness, there are 12,000-14,000 injuries and deaths following vaccinations reported to the Federal Drug Administration, each year. Therefore, a one-size-fits-all approach to vaccinations is unrealistic. Each child’s history should be considered individually. However, it is important for each family to have access to the data and medical care to make informed choices.

Insurance, as well as supplemental programs like Medicaid, would not be needed because Walden Three considers health care, from cradle to grave for all conditions, a necessity. Instead of taxing businesses, the city provides and manages health care through its community service system. Unnecessary duplication of management, sales, accounting, collection, investing, and payout costs are saved by using a single provider system. Doctors will save valuable time and energy, currently wasted on insurance paperwork. The savings would cover those left uncovered today. Moreover, a large range of preventative care would be promoted and provided--proven to cost far less in the long run than the higher costs of repairing damage and providing emergency care.

Hospitals would be available for serious procedures like surgery, however, the emphasis would be on at-home care whenever possible. Using the city’s Cybernet, which would have the latest, reliable medical information and remote observation and data collection, nurses and physicians would make initial evaluations. Nursing stations are located in each building for more thorough initial examinations and scheduled exams by physicians. Thus, physicians, physician’s assistants, and nurses would effectively make “old fashioned” house calls, and follow a patient’s progress. Medical personnel would stay assigned to specific neighborhoods in the city, so that the families can get to know them. Hospitals would take care of more serious procedures like in-patient surgery, however, the emphasis would be on at-home care or the clinic care, whenever possible.

Thus, every citizen would have equal access to superior health care, free. Additionally, care would be more personal, holistic, and take into account a wide range of factors in the patient’s life. This concept merges state-of-the-art care with the kind of personal care that family doctors once gave.

In sum, Walden Three provides quality care to every citizen, not sub-standard care that views each person as a group of risk factors or ‘the best care money can buy.’