Ken ~
After viewing the previous responses to your initial post and noting that they are avoiding the divisive political aspects of this issue and after reading David's salient post (that reflects my views) I'll venture to add a few comments of my own.
I concur with Steve that we don't really have a 'health care' problem in the U.S. as much as we have a health care cost problem. A lot of folks want 2009-level health care at 1980 prices - and that's not feasible. Medicare and Medicaid (simultaneously enacted in 1965) have contributed to the problem due to their low reimbursement policies that force private insurers to pay the difference to doctors and hospitals (their operating costs and subsequent fees don't go down) which raises medical insurance premiums because no company can operate for long without a profit, which, these days, is around 3% for HMO's. Hardly a windfall. These government-run entities (Medicare, Medicaid) are the best example of why 'nationalized', 'universal' or 'socialized' health care - under any name - would be a disaster. In 1966, Medicare cost 3 billion and was projected to cost 12 billion by 1990. Medicare actually cost 107 billion in 1990. Medicare now has 34 trillion dollars in unfunded liabilities. To cover that, the Medicare tax rate will have to rise from it's current rate of 2.9% to almost 14%. When Medicare began in 1966, the monthly premium due from Medicare recipients was $3.00. Today, it's almost $100. - and Medicare is still grossly underfunded. For every dollar paid in premiums, the government pays $3. Thus, the 'unfunded liabilities' that assume future demands on Medicare that are not funded with higher taxes.
We often read or hear about the '47 million uninsured' in America, meaning that at any given time, 47 million people don't have medical insurance protection. Unfortunately, that is a half-truth. Yes, some 47 million people in the U.S. may not carry medical insurance on a given day but 27%, some 12.6 million — aren't even citizens. Another 20% of the uninsured are only uninsured for an average of 4 months at any given time. They are usually between jobs. Some 38% of all the uninsured have incomes well over the national average of $48,000. They simply chose not to buy medical insurance coverage. When you look into the reality behind the '47 million uninsured' headline used to make those of us with insurance feel guilty, the real dynamics of this alleged 'crisis' become a bit clearer. In addition, Medicaid was enacted to cover the indigent so the cry that '47 million don't have access to health care' is a fallacy. Anyone can receive medical attention at almost any ER in America, with or without prior insurance coverage. Hospitals have people especially hired to help those receiving medical care and without insurance apply for federal, state and local benefits that help pay hospital and doctor costs. However, some states have a problem with undocumented people (illegal aliens) that do not qualify for any benefits due to their illegal status yet receive necessary medical attention. The hospitals 'absorb' the unpaid expense and because most are not charities, have to raise their prices to cover it. Eventually, insurance companies pay the higher rates - and raise our premiums. Many of these hospitals that treated large numbers of illegal (undocumented) aliens (foreigners) have gone out of business because they could not charge enough to insured patients to offset the huge cost of treating so many uninsured illegal aliens without any medical insurance and unqualified to obtain any government assistance, in most cases. That is a tragedy. However, 'universal' health care insurance would not cover illegal aliens, nor should it. I'm well aware that we all need some form of 'catastrophic' medical insurance. My AN surgery cost about $100,000. Who has that kind of money? Still, while we may all need some form of medical insurance, if we could control what we pay for it by the prudent use of doctors and medical facilities, it would empower the consumer, instead of empowering government.
The current 'nationalized health care' package is still being shaped and debated in Washington so I cannot make assumptions at this point. However, with the history of how government programs constantly expand (I don't object - but as an example: Medicare began covering disabled people in 1972) and how costs are usually wildly underestimated makes me highly skeptical of any health insurance 'reform' instituted by government, under any political party. The U.S. simply cannot afford another multi-trillion-dollar 'program' to 'reform' health care, which is excellent, thank you. It's how we pay for our health care that is the real issue. I concur with Steve's assessment that taking better care of ourselves is crucial, as well as being more responsible for how our health care money is spent. Whether that is with Medical Savings Accounts or some other scheme, it would beat another government monstrosity that would inevitably reduce the quality and access to health care while costing even more than we pay, now. Most of us like our medical care and want everyone to have something similar. However, expanding the government's role in medical care would only injure the current high quality of that care, introduce care rationing and waiting lists while limiting our options and costing far more than we pay now, while still not 'covering' every person in America. I prefer the free enterprise system approach that holds the consumer (us) responsible for seeking and finding the most cost-effective approach to their health care while paying for much of it, themselves, when possible. When the patient has the option of going elsewhere with his money, doctors and hospitals will compete for the 'business'. As long as third parties (insurance companies) pay most of the bills, that doesn't happen. A huge, hideously expensive, option-closing 'single-payer' government-run system doesn't hold any appeal for me, but then, it may for others. I'm forced to be on Medicare (Blue Cross dropped me when I turned 65) but I'm not happy about it. My private medical insurance costs the same as I'm paying for the government insurance and I feel I have fewer options as many doctors are dropping Medicare and don't accept it as payment. 'Socialized medicine' hasn't worked well in other countries with much smaller, less diverse populations than the U.S. The rush to enact a so-called 'reform' measure that, in effect, will have the government running the health care insurance business (pushing out private insurers in no time) is unnecessary and makes me suspicious of the necessity for a gigantic bill that no elected official actually reads being hurried through the congressional labyrinth based on false claims of a 'health care crisis'.
I don't chose to debate this issue, I'm just adding my thoughts to others and hoping they won't be misunderstood or misrepresented. As AN patients, the future of health care is a fair issue for discussion, assuming we can keep the politics, parties and personalities out of it. I believe I've succeeded in doing that. My objections are beyond party or ideology. I thank those who've previously contributed to the discussion. What actually happens will be another topic of interest in the near future, I'm certain.
Jim
