Please Scroll Down to See Forums Below Socialized medicine should never happen.
Social Security should be disbanded.
Social Security should be disbanded.
Socialized Medicine........HELL NO! Look at Canada
- Thread starter rudedawg
- Start date
Newbie2building
New member
c-sharp minor said:
a heart bypass or transplant? if its a transplant then a year's wait is not uncommon based on the rules of the wait list. as for waiting in the halls, that happens here too. over crowding and old buildings lend to people even sleeping in beds in the hallways in the emergency rooms at times. all the complaints of the canadian article seem that they could apply here as well. socialized or not, there are problems on both sides of the spectrum.
smallmovesal
New member
The corporate threat to Canada’s health care system
Hospital closures, overburdened emergency wards, chronic waiting lists, premature discharges, inadequate home care, spiraling drug prices, reduced medicare coverage and increased user fees - Canadians are all too familiar with the signs indicating their cherished health care system is in crisis.
But according to some, there’s an easy remedy waiting in the wings – it’s called “privatization,” and it’s today’s version of the snake oil that shady hucksters used to promote on their way through town. Today, these hucksters come in the form of health care corporations eager to reap the profits that will come from the further privatization of our health care system.
Fortunately, the majority of Canadians are refusing to buy. And it’s not hard to see why.
Canadians want a public system
All the evidence suggests a publicly-run, single-payer system remains the most effective and efficient way for a country to deliver quality health services to its citizens.
Canadians know this. That’s why polls show a strong majority continues to support the five key principles of the Canada Health Act (CHA). The Act, passed in 1984, requires that Canada’s health care system be publicly-funded, publicly-administered, universal in its coverage, accessible by everyone across the country, and comprehensive in its scope.
In short, it must give equal and adequate coverage to all citizens, no matter where they live or what their economic circumstances. A truly Canadian way!
Public system more effective
Politicians claim they are cutting back on health care spending to save taxpayers money. But this claim fails to stand up to scrutiny.
Canadians will have to pay for their health care services one way or another. All the available evidence suggests that buying those services from the private sector will end up costing us more, and give a lot less in return. Here’s why:
a private system is more complex to administer. The more private insurance companies are involved in paying for medical services, the more duplication and red tape there is. In the US, health care administration cost $995 per capita in 1995, compared to $248 in Canada.1 Who says the private sector is more efficient!
a private system provides less coverage. Private insurance companies seek to minimize risk; they therefore refuse insurance to those with known medical conditions, or set rates so high that the average person can’t afford them. In the US, about 42 million citizens are unable to afford health insurance.2 A public system, like Canada’s, covers everyone – and costs less!
a private system is more prone to fraud. Some of the largest multinational firms now wanting to enter the Canadian health care “market” have already been convicted of fraud in the US, or are currently under investigation by the FBI. A national study produced by the Harvard Medical School in 1998 concluded that “large scale fraud has become routine”in the profit-driven health care sector. It also cited U.S. General Accounting Office estimates that “about 25 per cent of all home care agencies (most of which are for-profit) defraud Medicare.”3
a private system removes money from the system. In the private sector, some money is always used to pay back investors. The average Health-maintenance organization (HMO) in the US, for example, devotes 14 per cent of its premiums to overhead and profits (Canada’s public system uses a mere 0.9 per cent by comparison.4) And in an era of free trade, this means a proportion of our scarce health care dollars could actually leave the country - most likely to the US.
a private system raises costs. Private firms have a stake in costs going up, because higher costs mean higher profits. There are no internal checks and balances within the private sector to control costs. This, says University of British Columbia health economist Robert Evans, is the real agenda behind corporate pressure to reduce public health spending – its goal is not so much about cost control as cost shifting, i.e., transferring spending away from the current single-payer, public system where costs can be controlled and onto a more privatized system where costs are less able to be controlled.5 And according to Prof. Pat Armstrong of Carleton University, “it is mainly [this] increase in private expenditures that makes Canadian spending on health amongst the highest in the world.”6
Sell-off in progress
Despite its broad popular support, and the fact that it is more effective and efficient, our public health care system is being dismantled – bit by bit, year by year, budget by budget. And the pace is quickening, thanks to recent massive federal and provincial health care budget cuts.
The signs of increased privatization are everywhere, including:
the continual “de-listing” of services previously covered by medicare (i.e. specific medical procedures, support services, drugs)
the transferring of care out of areas covered by medicare (i.e. acute care in hospitals) to areas that are not (i.e. homecare)
the contracting out of “non-core” medical services (labs, ambulances and rehab services) to private companies. But who and what decides which are ‘core’ or ‘non-core’ services? Are blood tests not core services?
the contracting out of institutional support services (laundry, meal preparation, cleaning and maintenance, materials handling, information management, and disposal services) to private companies
the contracting in of management services, leading to the redesign of management practices in accordance with private sector criteria.
Taken together, these types of decisions have already led to a shift in where Canadians are spending their health care dollars (see chart).
Who will save medicare?
If Canada’s public system is better and cheaper than a privatized system, and is supported by the vast majority of the electorate, the question then is: why are our leaders allowing it to erode? Most politicans, it seems, are either actively helping the process, or passively allowing it to happen. As voters, we have a right to ask why.
While we wait for answers, one fact remains clear: we can no longer rely on our political leaders to save the system that means so much to us as Canadians, and which still has the potential to meet our needs more effectively and efficiently than any other approach.
It looks like the only people who can save Canada’s health care system are Canadians themselves. After all, it’s our system.
And we fought to get it. We’ll fight to keep it!
Notes
1 For Our Patients, Not for Profits: A Call to Action, Chartbook and Slideshow 1998 Edition, The Center for Health Program Studies, Harvard Medical School/The Cambridge Hospital, 1998, p. 118.
2 Ibid. p. 3.
3 Ibid. p 91.
4 Ibid. p. 63.
5 Robert G. Evans, “Health care reform: who’s selling the market, and why?”, Journal of Public Health Medicine, Vol. 19, No. 1, pp. 45-49.
6 Pat Armstrong, “Privatized Care,” in Medical Alert, Edited by Pat Armstrong et al., Garamond Press, 1997, pp. 21-22.
Further reading:
Michael Rachlis MD and Carol Kushner, Strong Medicine: How to Save Canada’s Health Care System, Harper–Collins Publishers Ltd., 1994.
Hospital closures, overburdened emergency wards, chronic waiting lists, premature discharges, inadequate home care, spiraling drug prices, reduced medicare coverage and increased user fees - Canadians are all too familiar with the signs indicating their cherished health care system is in crisis.
But according to some, there’s an easy remedy waiting in the wings – it’s called “privatization,” and it’s today’s version of the snake oil that shady hucksters used to promote on their way through town. Today, these hucksters come in the form of health care corporations eager to reap the profits that will come from the further privatization of our health care system.
Fortunately, the majority of Canadians are refusing to buy. And it’s not hard to see why.
Canadians want a public system
All the evidence suggests a publicly-run, single-payer system remains the most effective and efficient way for a country to deliver quality health services to its citizens.
Canadians know this. That’s why polls show a strong majority continues to support the five key principles of the Canada Health Act (CHA). The Act, passed in 1984, requires that Canada’s health care system be publicly-funded, publicly-administered, universal in its coverage, accessible by everyone across the country, and comprehensive in its scope.
In short, it must give equal and adequate coverage to all citizens, no matter where they live or what their economic circumstances. A truly Canadian way!
Public system more effective
Politicians claim they are cutting back on health care spending to save taxpayers money. But this claim fails to stand up to scrutiny.
Canadians will have to pay for their health care services one way or another. All the available evidence suggests that buying those services from the private sector will end up costing us more, and give a lot less in return. Here’s why:
a private system is more complex to administer. The more private insurance companies are involved in paying for medical services, the more duplication and red tape there is. In the US, health care administration cost $995 per capita in 1995, compared to $248 in Canada.1 Who says the private sector is more efficient!
a private system provides less coverage. Private insurance companies seek to minimize risk; they therefore refuse insurance to those with known medical conditions, or set rates so high that the average person can’t afford them. In the US, about 42 million citizens are unable to afford health insurance.2 A public system, like Canada’s, covers everyone – and costs less!
a private system is more prone to fraud. Some of the largest multinational firms now wanting to enter the Canadian health care “market” have already been convicted of fraud in the US, or are currently under investigation by the FBI. A national study produced by the Harvard Medical School in 1998 concluded that “large scale fraud has become routine”in the profit-driven health care sector. It also cited U.S. General Accounting Office estimates that “about 25 per cent of all home care agencies (most of which are for-profit) defraud Medicare.”3
a private system removes money from the system. In the private sector, some money is always used to pay back investors. The average Health-maintenance organization (HMO) in the US, for example, devotes 14 per cent of its premiums to overhead and profits (Canada’s public system uses a mere 0.9 per cent by comparison.4) And in an era of free trade, this means a proportion of our scarce health care dollars could actually leave the country - most likely to the US.
a private system raises costs. Private firms have a stake in costs going up, because higher costs mean higher profits. There are no internal checks and balances within the private sector to control costs. This, says University of British Columbia health economist Robert Evans, is the real agenda behind corporate pressure to reduce public health spending – its goal is not so much about cost control as cost shifting, i.e., transferring spending away from the current single-payer, public system where costs can be controlled and onto a more privatized system where costs are less able to be controlled.5 And according to Prof. Pat Armstrong of Carleton University, “it is mainly [this] increase in private expenditures that makes Canadian spending on health amongst the highest in the world.”6
Sell-off in progress
Despite its broad popular support, and the fact that it is more effective and efficient, our public health care system is being dismantled – bit by bit, year by year, budget by budget. And the pace is quickening, thanks to recent massive federal and provincial health care budget cuts.
The signs of increased privatization are everywhere, including:
the continual “de-listing” of services previously covered by medicare (i.e. specific medical procedures, support services, drugs)
the transferring of care out of areas covered by medicare (i.e. acute care in hospitals) to areas that are not (i.e. homecare)
the contracting out of “non-core” medical services (labs, ambulances and rehab services) to private companies. But who and what decides which are ‘core’ or ‘non-core’ services? Are blood tests not core services?
the contracting out of institutional support services (laundry, meal preparation, cleaning and maintenance, materials handling, information management, and disposal services) to private companies
the contracting in of management services, leading to the redesign of management practices in accordance with private sector criteria.
Taken together, these types of decisions have already led to a shift in where Canadians are spending their health care dollars (see chart).
Who will save medicare?
If Canada’s public system is better and cheaper than a privatized system, and is supported by the vast majority of the electorate, the question then is: why are our leaders allowing it to erode? Most politicans, it seems, are either actively helping the process, or passively allowing it to happen. As voters, we have a right to ask why.
While we wait for answers, one fact remains clear: we can no longer rely on our political leaders to save the system that means so much to us as Canadians, and which still has the potential to meet our needs more effectively and efficiently than any other approach.
It looks like the only people who can save Canada’s health care system are Canadians themselves. After all, it’s our system.
And we fought to get it. We’ll fight to keep it!
Notes
1 For Our Patients, Not for Profits: A Call to Action, Chartbook and Slideshow 1998 Edition, The Center for Health Program Studies, Harvard Medical School/The Cambridge Hospital, 1998, p. 118.
2 Ibid. p. 3.
3 Ibid. p 91.
4 Ibid. p. 63.
5 Robert G. Evans, “Health care reform: who’s selling the market, and why?”, Journal of Public Health Medicine, Vol. 19, No. 1, pp. 45-49.
6 Pat Armstrong, “Privatized Care,” in Medical Alert, Edited by Pat Armstrong et al., Garamond Press, 1997, pp. 21-22.
Further reading:
Michael Rachlis MD and Carol Kushner, Strong Medicine: How to Save Canada’s Health Care System, Harper–Collins Publishers Ltd., 1994.
rudedawg
New member
The cost is debunked right here:
"The Costs of Free Care
The first thing to realize is that free public medicine isn't really free. What the consumer doesn't pay, the taxpayer does, and with a vengeance. Public health expenditures in Quebec amount to 29 per cent of the provincial government budget. One-fifth of the revenues come from a wage tax of 3.22 per cent charged to employers and the rest comes from general taxes at the provincial and federal levels. It costs $1,200 per year in taxes for each Quebec citizen to have access to the public health system. This means that the average two-child family pays close to $5,000 per year in public health insurance. This is much more expensive than the most comprehensive private health insurance plan. "
QUOTE:
"a private system is more prone to fraud. Some of the largest multinational firms now wanting to enter the Canadian health care “market” have already been convicted of fraud in the US, or are currently under investigation by the FBI. A national study produced by the Harvard Medical School in 1998 concluded that “large scale fraud has become routine”in the profit-driven health care sector. It also cited U.S. General Accounting Office estimates that “about 25 per cent of all home care agencies (most of which are for-profit) defraud Medicare.”3 "
Key word in that is MEDICARE.
"The Costs of Free Care
The first thing to realize is that free public medicine isn't really free. What the consumer doesn't pay, the taxpayer does, and with a vengeance. Public health expenditures in Quebec amount to 29 per cent of the provincial government budget. One-fifth of the revenues come from a wage tax of 3.22 per cent charged to employers and the rest comes from general taxes at the provincial and federal levels. It costs $1,200 per year in taxes for each Quebec citizen to have access to the public health system. This means that the average two-child family pays close to $5,000 per year in public health insurance. This is much more expensive than the most comprehensive private health insurance plan. "
QUOTE:
"a private system is more prone to fraud. Some of the largest multinational firms now wanting to enter the Canadian health care “market” have already been convicted of fraud in the US, or are currently under investigation by the FBI. A national study produced by the Harvard Medical School in 1998 concluded that “large scale fraud has become routine”in the profit-driven health care sector. It also cited U.S. General Accounting Office estimates that “about 25 per cent of all home care agencies (most of which are for-profit) defraud Medicare.”3 "
Key word in that is MEDICARE.
smallmovesal
New member
well i don't think one can discount medicare from the equation... we are talking the various american systems vs the canadian, n'est-ce que pas?
i'm not sure i'm really comfortable talking about the quebec stats as a measure for all of canada.
i'm not sure i'm really comfortable talking about the quebec stats as a measure for all of canada.
smallmovesal
New member
rudedawg said:
I don't know French.
Do you have stats of Canada on a whole then?
"n'est-ce que pas" is the equivalent of saying "right?" or "no?"
i'm trying to work so this is all i've found so far... try stats canada
http://www.statcan.ca/english/Pgdb/People/Health/health17.htm
http://www.statcan.ca/english/Pgdb/People/Health/health13.htm
http://www.statcan.ca/english/Pgdb/People/Health/health60a.htm
rudedawg
New member
"Cancer Care Ontario couldn't ask for a better spokespatient than Marilyn Markou for its "Buffalo patients." That's the rubric for people the province pays to send to the US for treatments Canadian hospitals too backlogged to handle.
Canada's state-paid healthcare is often seen as fairer and more cost-effective than the American system. But Canada also needs to rely on America for medical services that it can't provide.
Ms. Markou, who spent seven weeks in Buffalo, N.Y., last summer receiving radiation treatments, has nothing but good things to say about the care she received. She even saw her summer sojourn as an opportunity to do some sightseeing. "I had never gotten to know Buffalo."
Still, she has some pretty stern criticism of Canadian Medicare, universal, government-paid medical care.
"The government has to pull its socks up.... I was sort of embarrassed that I had to go to another country because my own country couldn't look after me. That was not a good thing."
The existence of re-referral programs like Cancer Care Ontario's - and the waiting lists that produced them - are taken by many Canadians as sure signs that something is wrong with their beloved healthcare system. If this system - that to Canadians makes their country a kinder, gentler alternative to their neighbor to the south - is so great, then why does Canada have to send people to the US for treatment?"
------------------------------------------------------------------------------------
According to the Canadian Institute for Health Information's "National Health Expenditure Trends, 1975-1999," total healthcare expenditure per person in Canada was roughly $2,600 in 1997. The average annual increase was 9.8% from 1975 to 1991, and 1.4% from 1991 to 1996. Per capita expenditures were estimated to increase at annual rates of 3.9% in 1998 and 4.3% in 1999. Looking at the big picture, the average increase in health costs for the entire period of 1975 to 1999 is estimated to be 6.8%. During the same period (1975 to 1999), wages and salaries increased by 5.4% and general levels of inflation by 5.0%.
Although this ratio of taxpayers to dependent youths and elderly is currently manageable, by the year 2031, each active worker will have to produce or earn an additional 50% to provide for predominantly senior dependents. One option is to move from a pay-as-you-go system to a pre-funding mechanism. For example, it was estimated by the Canadian Institute of Actuaries (CIA) in 1996 that if all working people in Canada were putting aside sufficient funds to pay for their own healthcare in their retirement years that fund would contain more than $1 trillion (the present value of future benefits).
The CIA has also projected future healthcare costs for the first quarter of the 21st century. Just to maintain the current level of healthcare costs as a percentage of Gross Domestic Product (GDP), the rate of growth in healthcare costs in Canada must be between .5% to .75% below the rate of growth in earnings. If healthcare costs exceed earnings growth by 1%, the portion of GDP spent on healthcare will rise by more than 5% to 15%, representing a 50% increase in the share of GDP taken by healthcare by 2020.
Canada's state-paid healthcare is often seen as fairer and more cost-effective than the American system. But Canada also needs to rely on America for medical services that it can't provide.
Ms. Markou, who spent seven weeks in Buffalo, N.Y., last summer receiving radiation treatments, has nothing but good things to say about the care she received. She even saw her summer sojourn as an opportunity to do some sightseeing. "I had never gotten to know Buffalo."
Still, she has some pretty stern criticism of Canadian Medicare, universal, government-paid medical care.
"The government has to pull its socks up.... I was sort of embarrassed that I had to go to another country because my own country couldn't look after me. That was not a good thing."
The existence of re-referral programs like Cancer Care Ontario's - and the waiting lists that produced them - are taken by many Canadians as sure signs that something is wrong with their beloved healthcare system. If this system - that to Canadians makes their country a kinder, gentler alternative to their neighbor to the south - is so great, then why does Canada have to send people to the US for treatment?"
------------------------------------------------------------------------------------
According to the Canadian Institute for Health Information's "National Health Expenditure Trends, 1975-1999," total healthcare expenditure per person in Canada was roughly $2,600 in 1997. The average annual increase was 9.8% from 1975 to 1991, and 1.4% from 1991 to 1996. Per capita expenditures were estimated to increase at annual rates of 3.9% in 1998 and 4.3% in 1999. Looking at the big picture, the average increase in health costs for the entire period of 1975 to 1999 is estimated to be 6.8%. During the same period (1975 to 1999), wages and salaries increased by 5.4% and general levels of inflation by 5.0%.
Although this ratio of taxpayers to dependent youths and elderly is currently manageable, by the year 2031, each active worker will have to produce or earn an additional 50% to provide for predominantly senior dependents. One option is to move from a pay-as-you-go system to a pre-funding mechanism. For example, it was estimated by the Canadian Institute of Actuaries (CIA) in 1996 that if all working people in Canada were putting aside sufficient funds to pay for their own healthcare in their retirement years that fund would contain more than $1 trillion (the present value of future benefits).
The CIA has also projected future healthcare costs for the first quarter of the 21st century. Just to maintain the current level of healthcare costs as a percentage of Gross Domestic Product (GDP), the rate of growth in healthcare costs in Canada must be between .5% to .75% below the rate of growth in earnings. If healthcare costs exceed earnings growth by 1%, the portion of GDP spent on healthcare will rise by more than 5% to 15%, representing a 50% increase in the share of GDP taken by healthcare by 2020.
smallmovesal
New member
Those who have and those who have not:
A widening gap in American healthcare
By Joel R. Cooper, The Medical Reporter
©1995, Joel R. Cooper
All rights reserved
Comprehensive healthcare system reform failed in the USA. Yet many of the problems that made the Clinton Administration want to overhaul the nation's healthcare delivery system remain with us to this day. Some are getting worse.
Basic primary care services out of reach for many
Lack of access to basic primary care services for millions of Americans is a huge problem that continues to haunt us. Many people simply cannot afford visits to the doctor. Nor can they afford health insurance premiums.
The number of uninsured individuals in the U.S. is rising by 1.1 million annually, and this number reached a whopping 40.9 million in early 1994. (Source: the Employee Benefit Research Institute, Washington).
Contrary to popular belief, not all people without health insurance coverage are "lazy or unemployed." In fact, in turns out that the vast majority of people without health insurance --and therefore, in many cases, without access to appropriate medical services --are productive, working members of society. When they're caught in a pinch between paying the rent, buying groceries for their hungry children, or paying for a visit to the doctor, guess what is often neglected?
Donna E. Shalala, Secretary of Health and Human Services, addressing The Group Health Association of America in February 1995, put it this way:
"...there are growing discrepancies in access to health care for millions of people who get up every day and go to work but don't have the benefits of health care coverage.
Last year, more than three million Americans joined the ranks of the uninsured, bringing that total to more than 40 million. We know that more than 80 percent of people without health insurance are working or the dependents of workers. In fact, 10 million of them are children. And, if current trends continue, the number of uninsured will exceed 50 million by the beginning of the new century.
While the cost of coverage is declining for workers in firms with more than 500 employees, premiums for small employers rose an average of 6.5 Percent. As a result, the cost of insurance for the workers of such firms is increasingly out of reach and many small business owners are opting out of the insurance market, leaving their employees and their families without coverage.
Others are cutting back benefits and increasing cost-sharing, leaving millions of Americans with less insurance than they need."
Americans with less education get a "double whammy"
A report on the nation's health released in June 1995 by the U.S. Department of Health and Human Services reveals that people with less education are often at a distinct disadvantage with regard to the healthcare they receive. Blacks, Hispanics, high school dropouts, and children in poor families are often the ones hardest hit by the discrepancies in access to primary care.
Yet it is a lack of access to basic primary care services that often leads to the development of serious disease that could have been prevented. Preventable health conditions take a tremendous toll on our nation's human and financial resources.
Young women lacking education, familial/social support and/or access to basic primary care services often have unwanted pregnancies and sadly, in many cases, their babies are born with serious developmental disabilities or birth defects. This, too, takes a huge bite out of our country's healthcare budget, when you consider the cost of caring for a sick or developmentally disadvantaged child --or the sheer loss of productivity to society --over the course of a lifetime.
A vicious cycle develops. Lack of education can lead to poor or sub-optimal health, and poor or sub-optimal health makes it more difficult to receive appropriate education, thereby reinforcing a pattern of poverty, lack of access to primary care services, and increasingly poor health over time. Aggressive health promotion at the community and neighborhood level is absolutely critical to overcoming this vicious cycle. Time and time again, it has been shown that the message must be taken to the people where they live, in their homes and in their communities, and in a way that they can understand and is meaningful to them. Expecting people to come to you is wrong, because it won't happen, never has and never will.
In many cases, changing simple behaviors can pay huge dividends. For example, 5,600 American lives and $10.6 billion dollars could be saved each year if only Americans would use their car safety belts with the same frequency as drivers and passengers in other industrialized nations, according to The American Academy of Orthopaedic Surgeons. 33 percent of U.S. drivers and passengers reportedly do not wear safety belts.
Sure, this is a free country, but if you ask me, driving in a car and not wearing a seat belt is just plain asking for trouble --and highly irresponsible. If you don't wear your seat belt and get into a car wreck and are brain damaged, paralyzed for life, dependent on a respirator, or otherwise disabled, who will pay for it? The answer is that sooner or later, we all pay for it. As tax-paying Americans, and as Americans who have to bear the brunt of increasing insurance premiums, we all pay for it. So please buckle up and make sure others buckle up as well.
Are doctors to blame for people not getting the care they need?
Some people claim that doctors are to blame for the fact that many Americans don't receive the basic services they need. In my experience, this is absolutely untrue. Doctors, nurses, allied healthcare providers, and hospitals donate huge amounts of time and care each year in this country. Many physicians have taken the lead in developing programs to serve the uninsured and medically indigent in their communities.
In fact, more than two-thirds of U.S. physicians are providing over $21 billion in uncompensated care to patients in financial need, according to the American Medical Association (AMA). Since 1988, AMA survey data have shown a steady increase in the number of physicians providing charity care and the amount of time physicians spend per week rendering free or reduced-fee care to poor patients.
Healthcare professionals, such as doctors and nurses, can always give more, but so can the rest of us. If we can't help clinically, we can help financially. Or we can volunteer our time in community health clinics or local hospitals. You might start by asking your doctor what you can do to help. Many doctors don't make a point of telling their patients about their charitable activities -- about the time and clinical expertise they donate to their communities. Some prefer to be "quiet heroes and heroines." But chances are, they can use your help -- or they know of a charitable or educational organization that can.
What else can we do?
The choices looming before us in healthcare delivery are difficult, because our economic system simply will not support unlimited care to anyone, anytime, without question. Yet it most definitely behooves us as a society to find a way to ensure that all Americans can get, at minimum, basic primary care, prenatal care, and preventive care services. Mental health services are essential as well, since many of our nation's physical health problems have behavioral or emotional roots --substance abuse, violence, and driving without seat belts, for example.
Look at it this way: either we detect and deal with physical and emotional health problems on the front end in the primary care setting, or we wait until problems get serious, cost us more money and result in greater human pain, suffering, and loss overall.
Certainly, if even a small percentage of the huge profits that many U.S. corporations make were donated toward primary care, prenatal care, and preventive care services, that would be a wonderful start. I mean, let's face it: some companies and individuals in the USA are making far more money than they could possibly spend, or their children or even their grandchildren could possibly spend, in one or two lifetimes.
While the acquisition of profit has long been a powerful motivator in the American economic system, taking care of our brothers and sisters is part of being an American, too. It's better to give care to people at a time when it can do the most good --not simply for each individual but for the nation as a whole. If there is one criticism that can be safely leveled at our healthcare system, it's this: we have not been particularly effective, nor particularly efficient, at putting healthcare resources where they are needed most and where they can do the greatest good.
For example, we desperately need more primary care or "generalist" physicians in this country. And we need to deploy more of these generalist doctors, and sub-specialist physicians as well, in rural and under-served areas of our nation. We also need to channel more funds into primary care practice-based research that will help us develop better and more cost-effective ways to diagnose and treat maladies and diseases that affect most of the people most of the time. With all due respect to medical research, which is undeniably important, the U.S. government is sinking proportionately way too much money into rare and exotic bio-medical/high-tech research that, in actuality, stands to benefit very few people and has little to do with the day-to-day health problems seen by family doctors in primary care settings across America. My vote would be to allocate more financial resources to primary care practice-based research and research aimed at isolating, understanding, and preventing the spread of antibiotic-resistant diseases and other infectious illnesses, the new so-called "plagues" -- many of which haven't been unleashed on us yet.
By all means, doctors need to go where the people are...in communities, in neighborhoods. They need to get out of their hospital-based office buildings and take their knowledge, training, and expertise to the streets, farms, prairies, mountain towns, and Indian Reservations of America. And they need to be there not only as doctors...but also as teachers and role models. That's how they can touch the most lives...and make the greatest difference.
Pay now or pay later
Ultimately and unquestionably, all of us need to become more responsible for our own health. Health, or the absence thereof, is the sum total of all of our behaviors and actions --what we eat, how we live, whether or not we exercise, the extent to which we use or abuse drugs and alcohol, genetic factors, and more. About the best thing you can do for your health is to establish a continuing relationship with a good primary care physician and review your total health picture with this person. Take a look at areas where you are weak, areas that could stand improvement. Work on these areas daily. And be consistent. Remember: towering deeds and accomplishments begin with baby steps.
Truly, the health of America starts with you. But it doesn't end there. We are all interlinked participants in a giant societal eco-system of sorts. You may not think that the man infected with tuberculosis or Streptococcus pneumoniae in a far-away city or the woman who is using crack cocaine and smoking cigarettes while pregnant can have much impact on your life. After all, you don't have TB or "strep" and you aren't a pregnant drug addict. But just wait.
Either we pay now or we pay later. Doesn't it make sense to invest in a healthier America now?
Mr. Cooper, a professional medical/healthcare writer/reporter, is Editor-in-Chief of Your Health Information Resource.
He may be reached at
The Medical Reporter,
P.O. Box 370314,
Denver,
Colorado 80237,
Telephone: (303) 337-6299,
FAX: (303) 337-9201,
e-mail: [email protected]
A widening gap in American healthcare
By Joel R. Cooper, The Medical Reporter
©1995, Joel R. Cooper
All rights reserved
Comprehensive healthcare system reform failed in the USA. Yet many of the problems that made the Clinton Administration want to overhaul the nation's healthcare delivery system remain with us to this day. Some are getting worse.
Basic primary care services out of reach for many
Lack of access to basic primary care services for millions of Americans is a huge problem that continues to haunt us. Many people simply cannot afford visits to the doctor. Nor can they afford health insurance premiums.
The number of uninsured individuals in the U.S. is rising by 1.1 million annually, and this number reached a whopping 40.9 million in early 1994. (Source: the Employee Benefit Research Institute, Washington).
Contrary to popular belief, not all people without health insurance coverage are "lazy or unemployed." In fact, in turns out that the vast majority of people without health insurance --and therefore, in many cases, without access to appropriate medical services --are productive, working members of society. When they're caught in a pinch between paying the rent, buying groceries for their hungry children, or paying for a visit to the doctor, guess what is often neglected?
Donna E. Shalala, Secretary of Health and Human Services, addressing The Group Health Association of America in February 1995, put it this way:
"...there are growing discrepancies in access to health care for millions of people who get up every day and go to work but don't have the benefits of health care coverage.
Last year, more than three million Americans joined the ranks of the uninsured, bringing that total to more than 40 million. We know that more than 80 percent of people without health insurance are working or the dependents of workers. In fact, 10 million of them are children. And, if current trends continue, the number of uninsured will exceed 50 million by the beginning of the new century.
While the cost of coverage is declining for workers in firms with more than 500 employees, premiums for small employers rose an average of 6.5 Percent. As a result, the cost of insurance for the workers of such firms is increasingly out of reach and many small business owners are opting out of the insurance market, leaving their employees and their families without coverage.
Others are cutting back benefits and increasing cost-sharing, leaving millions of Americans with less insurance than they need."
Americans with less education get a "double whammy"
A report on the nation's health released in June 1995 by the U.S. Department of Health and Human Services reveals that people with less education are often at a distinct disadvantage with regard to the healthcare they receive. Blacks, Hispanics, high school dropouts, and children in poor families are often the ones hardest hit by the discrepancies in access to primary care.
Yet it is a lack of access to basic primary care services that often leads to the development of serious disease that could have been prevented. Preventable health conditions take a tremendous toll on our nation's human and financial resources.
Young women lacking education, familial/social support and/or access to basic primary care services often have unwanted pregnancies and sadly, in many cases, their babies are born with serious developmental disabilities or birth defects. This, too, takes a huge bite out of our country's healthcare budget, when you consider the cost of caring for a sick or developmentally disadvantaged child --or the sheer loss of productivity to society --over the course of a lifetime.
A vicious cycle develops. Lack of education can lead to poor or sub-optimal health, and poor or sub-optimal health makes it more difficult to receive appropriate education, thereby reinforcing a pattern of poverty, lack of access to primary care services, and increasingly poor health over time. Aggressive health promotion at the community and neighborhood level is absolutely critical to overcoming this vicious cycle. Time and time again, it has been shown that the message must be taken to the people where they live, in their homes and in their communities, and in a way that they can understand and is meaningful to them. Expecting people to come to you is wrong, because it won't happen, never has and never will.
In many cases, changing simple behaviors can pay huge dividends. For example, 5,600 American lives and $10.6 billion dollars could be saved each year if only Americans would use their car safety belts with the same frequency as drivers and passengers in other industrialized nations, according to The American Academy of Orthopaedic Surgeons. 33 percent of U.S. drivers and passengers reportedly do not wear safety belts.
Sure, this is a free country, but if you ask me, driving in a car and not wearing a seat belt is just plain asking for trouble --and highly irresponsible. If you don't wear your seat belt and get into a car wreck and are brain damaged, paralyzed for life, dependent on a respirator, or otherwise disabled, who will pay for it? The answer is that sooner or later, we all pay for it. As tax-paying Americans, and as Americans who have to bear the brunt of increasing insurance premiums, we all pay for it. So please buckle up and make sure others buckle up as well.
Are doctors to blame for people not getting the care they need?
Some people claim that doctors are to blame for the fact that many Americans don't receive the basic services they need. In my experience, this is absolutely untrue. Doctors, nurses, allied healthcare providers, and hospitals donate huge amounts of time and care each year in this country. Many physicians have taken the lead in developing programs to serve the uninsured and medically indigent in their communities.
In fact, more than two-thirds of U.S. physicians are providing over $21 billion in uncompensated care to patients in financial need, according to the American Medical Association (AMA). Since 1988, AMA survey data have shown a steady increase in the number of physicians providing charity care and the amount of time physicians spend per week rendering free or reduced-fee care to poor patients.
Healthcare professionals, such as doctors and nurses, can always give more, but so can the rest of us. If we can't help clinically, we can help financially. Or we can volunteer our time in community health clinics or local hospitals. You might start by asking your doctor what you can do to help. Many doctors don't make a point of telling their patients about their charitable activities -- about the time and clinical expertise they donate to their communities. Some prefer to be "quiet heroes and heroines." But chances are, they can use your help -- or they know of a charitable or educational organization that can.
What else can we do?
The choices looming before us in healthcare delivery are difficult, because our economic system simply will not support unlimited care to anyone, anytime, without question. Yet it most definitely behooves us as a society to find a way to ensure that all Americans can get, at minimum, basic primary care, prenatal care, and preventive care services. Mental health services are essential as well, since many of our nation's physical health problems have behavioral or emotional roots --substance abuse, violence, and driving without seat belts, for example.
Look at it this way: either we detect and deal with physical and emotional health problems on the front end in the primary care setting, or we wait until problems get serious, cost us more money and result in greater human pain, suffering, and loss overall.
Certainly, if even a small percentage of the huge profits that many U.S. corporations make were donated toward primary care, prenatal care, and preventive care services, that would be a wonderful start. I mean, let's face it: some companies and individuals in the USA are making far more money than they could possibly spend, or their children or even their grandchildren could possibly spend, in one or two lifetimes.
While the acquisition of profit has long been a powerful motivator in the American economic system, taking care of our brothers and sisters is part of being an American, too. It's better to give care to people at a time when it can do the most good --not simply for each individual but for the nation as a whole. If there is one criticism that can be safely leveled at our healthcare system, it's this: we have not been particularly effective, nor particularly efficient, at putting healthcare resources where they are needed most and where they can do the greatest good.
For example, we desperately need more primary care or "generalist" physicians in this country. And we need to deploy more of these generalist doctors, and sub-specialist physicians as well, in rural and under-served areas of our nation. We also need to channel more funds into primary care practice-based research that will help us develop better and more cost-effective ways to diagnose and treat maladies and diseases that affect most of the people most of the time. With all due respect to medical research, which is undeniably important, the U.S. government is sinking proportionately way too much money into rare and exotic bio-medical/high-tech research that, in actuality, stands to benefit very few people and has little to do with the day-to-day health problems seen by family doctors in primary care settings across America. My vote would be to allocate more financial resources to primary care practice-based research and research aimed at isolating, understanding, and preventing the spread of antibiotic-resistant diseases and other infectious illnesses, the new so-called "plagues" -- many of which haven't been unleashed on us yet.
By all means, doctors need to go where the people are...in communities, in neighborhoods. They need to get out of their hospital-based office buildings and take their knowledge, training, and expertise to the streets, farms, prairies, mountain towns, and Indian Reservations of America. And they need to be there not only as doctors...but also as teachers and role models. That's how they can touch the most lives...and make the greatest difference.
Pay now or pay later
Ultimately and unquestionably, all of us need to become more responsible for our own health. Health, or the absence thereof, is the sum total of all of our behaviors and actions --what we eat, how we live, whether or not we exercise, the extent to which we use or abuse drugs and alcohol, genetic factors, and more. About the best thing you can do for your health is to establish a continuing relationship with a good primary care physician and review your total health picture with this person. Take a look at areas where you are weak, areas that could stand improvement. Work on these areas daily. And be consistent. Remember: towering deeds and accomplishments begin with baby steps.
Truly, the health of America starts with you. But it doesn't end there. We are all interlinked participants in a giant societal eco-system of sorts. You may not think that the man infected with tuberculosis or Streptococcus pneumoniae in a far-away city or the woman who is using crack cocaine and smoking cigarettes while pregnant can have much impact on your life. After all, you don't have TB or "strep" and you aren't a pregnant drug addict. But just wait.
Either we pay now or we pay later. Doesn't it make sense to invest in a healthier America now?
Mr. Cooper, a professional medical/healthcare writer/reporter, is Editor-in-Chief of Your Health Information Resource.
He may be reached at
The Medical Reporter,
P.O. Box 370314,
Denver,
Colorado 80237,
Telephone: (303) 337-6299,
FAX: (303) 337-9201,
e-mail: [email protected]
