IT'S TIME FOR UNIVERSAL HEALTH CARE

Hi Miller, You are correct; the emergency room must provide services, and make every effort to stabilize the patient before they can ask for insurance or financial information. Sometimes, those procedures to stabilize the patient run into thousands of dollars.

Thanks for the head's up on the Florsheim Shoe article. I'm pleased that the family is again involved in the rebirth of the company.

They gave me my first break after graduation from college, and they will always have a special place in my heart.

I made a hard copy for my archives.

It is not better than my Blue Cross Plan.

Any universal health care plan will inevitably incorporate some restrictions on both citizens and care providers concerning what care can be obtained and what can or will be provided. As a result issues like hospital waiting lists became a primary political issue in the UK, and earlier in Canada. The defects described above in Medicare will also infect any government-run universal care or single payer system. We have a fairly perfect knowledge of the defects of our present system, but can only imagine those associated with others.

I prefer freedom and a market system.

NHS rationing is 'necessary evil', say doctors

And from the 'comments' section:

I believe in a sliding fee scale (based on income and assets) for a universal health care system.

I don't. I believe in a fee for service based on the patient's health and conformity to maintaining good health practices.

Good health practices is an oxymoron for most people. The next best thing is the hospital providing information on healthy living to all who request it; other people will continue to smoke and eat unhealthy food. The co-pay would discourage people to use the medical services for simple injuries and pain where a faucet wash and bandage would do.

A universal healthcare system would not pay for elective surgery, and would only pay for basics. If one wants, say, a private room, he or she would pay extra.

This way there would, at least, be basic care for all. At present, about 100 M people either have no health insurance or inadequate health insurance (exclusions, high deductibles, etc.). We can't continue to say that if you can't afford coverage, you can drop dead.

As this health debate on insurance is waged, more and more of the responsibilites of an MD are being taken over by mid-level
"health care practioners".

The optometrist is taking on responsibilites once performed only the opthalmologist.

The optometric tech is taking on the responsibilites once performed only by the optometrist.

The pharmacist is now giving vaccinations, a job once performed only internists ( MD ).

Nurse anesthetists are now performing many of the responsibilites of the anesthesiologists ( MD ).


And all of the above is being done to cut cost, and having great potential harm when it comes to patient care and well being.

Also, with the advent of new schools of osteopathy, we see more and more DOs performing functions once restricted to MDs.

Another complaint seen more and more frequently is the growing role of the "family practioner", in areas once restricted to internal medicine, with the bottom line being that patients on the receiving end of this "care" are actually getting inferior treatment, all in the name of cost cutting and increased patient
flow.

The pracice of medicine is starting to sound more and more like a job in the stockyards,these days , all because of attempted cost cutting by MBA managers, who know nothing and care little about patient care.

But insurance isn't really affordable for most people. Too many people pay health insurance premiums by doing without other things, like a car, a private school for their kids, a house with a mortgage, etc.

And no attempt is made to regulate the insurance company.

The big thrust today is restrict fat intake by individuals and a major push for the FDA to regulate the tobacco industry.

Do you think that most of those without health insurance are smokers and are over weight? I do.

Define "good health practices".
I am a volunteer firefighter,is that a "good health practice"?
What about those that fly hang gliders,or free climb rocks?
What about those that eat red meat?
Is that a "good health practice"?

Also,who is going to determine what those "good health practices" are?
Are you going to want to create some new govt agency to determine that?

In general, for the average adult one could say that '"good health practices" consist of:

Good nutrition

Good hygiene

Good sleep patterns

Required vaccinations

Prostate examinations for the adult male ( 40+ years_

Occult rectal blood exams yearly

Physical exams yearly

Routine dental care

Mammography for women age 40+ years

Regular pelvic exams for adult women

Routine blood analysis yearly basis

Detection and Tx of type I and II diabetes

Annual flu shots where indicated

Regular excercise routines appropriate to age

Weight control according to established guidelines

Bone density evaluation in women postmenopausal

Rx meds for control of bone loss in mid-life and latter, prevention of osteoporosis

Control of BP and Tx of hypertension with meds and alternative medicine.

Control of HDL and LDL cholesterol levels

Control of triglyceride levels

Annual eye exam and Rx where needed

Blood glucose levels within normal range otherwise, evaluate and Tx with diet and meds.

These are some of an ongoing list of what "good health practices are". Feel free to add to this list, according to your own protocol for maintaining good health.

There is a causal relationship between red meat consumption and cholesterol levels and also colon cancer.

Moderation in eating habits is suggested to be healthy.

Firefighting is a profession, that may have serious health consequences. As a result, annual PE are recommended for the firefighter. Special attention needs to be paid to : pulmonary health, skin health
( skin cancer ), etc.

Fly hang gliders or free climb rocks: these are physical activities, that have a certain amount of risk associated with them. They are not recommended for the infirmed individual.

When an adult has an annual PE, the internist will cover most if not all of these items, as they relate specifically to you as his/her patient.

Evaulation is usually part of the standard adult PE exam ( physical, blood, urine etc. ).

Miller, I think there are so many uninsured because their employers don't offer insurance, they are out of work and can't afford private policies (which are prohibitive), etc., and not because they have bad habits.

As you well know, you can take perfect care of yourself and still come down with a terrible disease. Virtually everyone is faced with this sometime or the other.

It is interesting to observe that, in the internal political debates in both the UK and Canadam, a continuing major political issue is the quality and responsiveness of the care provided under their single (government) payer systems of health care. The facts before us strongly suggest that these systems not the panacea its advocates would have us believe them to be.

It remains a fact that the partly capitalistic medical care system in this country is still (despite the best efforts of the DEA) the world's chief source of innovation and new drug development.

Be careful what you wish for.

georgeob, Irregardless of the fact that it's not the panacea some may believe universal health care to be, I still want to see our country provide health care for all of our citizens. I don't believe that the richest country in the world should be the last developed country to provide universal health care.

I'll accept all the "failings" of Canada and England, but at least all their citizens know they will have health care when they need it, and it won't bankrupt families who must have a member of their family taken care of by the health care system. I still believe in a sliding fee scale.

We have big problems in our health system too! Many die in our hospitals from many different causes besides natural ones. Many of the emergency rooms are filled with people who must wait untold hours to see a doctor. Prevention will make our emergency rooms more efficient.

As for the cost, I think most of us understand that the balance between profit, high pay of executives, and some clerk sitting in an office to make medical decisions are not the best way to handle the health care system of today. Some studies have shown that the one-payer system will reduce cost, and cover everybody with health insurance.

I have no problem with people having to wait (months) for non-life threatening elective surgery.

A most telling fact is that the life expectancy in the USA is near the bottom of that in countries with universal healthcare.

The same arguments we hear about the supposed "efficiencies" of a single payer, government-managed health care system, were offered a couple of generations ago concerning the superiority of government-managed economies and government central economic planning and allocation of resources. We now know that these "progressive" innovations produced only generalized poverty and the loss of individual freedom and initiative.

Indeed most of the "reforms" introduced in the past ten years by the Blair government in the UK, for a public health system that was then regarded to be failing badly, have involved elements of competition and devolved financial risk. Could they be trying to tell us something?

Few of the advocates of universal government-managed health care appear to have thought through the effects of such a system on other aspects of our lives and governance. Consider the public impasse over the matters of immigration, border controls, and personal identification. Whatever may be your views on these matter or their remedies, consider how vastly more complex they will become with a government run health care system.

We should also expect that such a government-controlled system will very quickly become the tool of self-interested unions - just as has happened in our educational system. How many of you would be willing to trust a medical establishment with all the committment to excellence exhibited by our public schools?

It is easy to affirm that we need such things as a "sliding scale for medical fees, based on income or assets", but much harder to implement. Shall we give the government complete access to the net worth of every person? How will this be done?

All of this is much easier to talk about than to organize or actually do. Free markets work much better. We already have government sponsored medical care for the poor and the old.