Class Warfare Blog

November 20, 2011

Health Care, What to Do? What to Do?

Filed under: Economics,Politics — Steve Ruis @ 10:31 am
Tags: ,

Since we are experiencing the years of electioneering prior to a presidential election (hardly seems reasonable) I expect we are going to hear Republican thunder about the repeal of “job killing Obama Care” the whole time. Apparently “baby killing Obama Care” didn’t pass the focus group sniff test.

As usual, many people will use a great many words but actually say quite little. What needs to be said is this: the American people clearly want affordable health care for themselves and compassionate care for those unable to pay. The problem here is nobody is defining “health care.” Currently, destitute folks turn up in county hospitals (government run) or emergency rooms of private hospitals and we all pay for their care through higher costs at those medical facilities from those of us who can and do pay. But nobody is talking about the level of care people are getting. People who cannot pay get no exotic treatments or fancy surgeries. They often get patched up and shown the door with the hope that they will darken the door of another facility next time. Even when they get the best advice and all the help they need, it doesn’t mean they will be served well.

One of the benefits that the Veterans Administration health system shows is that when a system adopts a patient for life, their care goes up significantly in quality. The attitude of the care givers is: if we don’t do a good job this time, this patient will be back on our examination table in short order. In other words, it pays to provide good care, just the reverse of what the pro bono care given to indigent people indicates. And the VA has demonstrated that, in more than a few cases, a more expensive treatment is the most cost effective (in that the patient returns for more care less often or not at all).

So, what kind of care should government provide? What are the interests of the general population? Obviously, people who cannot afford health care can spread infectious diseases and put us all in jeopardy. People who are sick and cannot work draw government assistance. People who can’t care for their children tax local systems of care giving.

I am going to argue that “the government” as the representative of all Americans interests should provide “basic health care” for all citizens. That’s right . . . everybody. But before you go “But, . . . but. . . .” let me explain. The key word here is “basic” in basic health care. I think everybody should be protected from infectious diseases as a matter of public health. That means immunizations, flu shots, treatments for colds and flu as well as tuberculosis, STDs, etc. are of these would be covered. This is good policy. As an example, when I was a member of Kaiser Permanente in California, I used to make it from the medical center parking lot in to get a flu shot and out in less than 10 minutes. They set up a quick process and charged not a penny extra for this service because it helped keep their costs down during cold and flu season. Just one bout of pneumonia saved would pay for a whole lot of flu shots. This is a form of preventive medicine.

Basic health coverage would cover all prenatal and post natal care for women as well as most childhood diseases for the children. And kids fall and break bones, so such are covered also.

What wouldn’t be covered are exotic surgeries, for example. Have the bad luck to have Siamese twins, you’ll have to pay out of pocket for surgeries to separate them because such would not be covered under basic health care provided by your neighbors. Have an exotic cancer that requires exotic drugs and treatments. It is sad and not covered under basic care.

Need a hip transplant surgery? Not covered. AIDS, not covered. Have really special needs? Not covered.

Now I may be starting to sound ogre-ish, even to my own ears. But this is the way of things. Sad things happen every day, but society as a whole doesn’t have any interest to protect individuals, only the population as a whole. We all have an interest in making sure that future generations grow up healthy and whole so they can take over our democracy, but no one particular individual, no matter how “special,” is needed. What? What if that kid needing a special operation is the next Gandhi? Well, what if he is the next Hitler? Society has no special interest in individuals, but does so in whole groups.

Now, with basic health care covered, the rest of the system can go to town providing “supplemental” care. Rich people have always had the best health care available to them. They should have all they can afford as far as I am concerned, but this would not be an income tax or corporate tax deductable expense as it is a luxury. People of even modest means may be able to procure supplemental insurance to cover health concerns not covered by government provided basic coverage.

So, have I stirred your health care pot? Do we all have enough of an interest to provide health care, basic health care, to all citizens? Can we do it without breaking the bank? I think we can if we focus on basic health care.


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