Americare
© David Burton 2017
Americare© David Burton 2017 |
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The cost of health care coverage for those who cannot afford it should not be placed on the shoulders of those who can afford to purchase health care insurance. Instead, federal taxes should be increased to pay for the health care of those who are unable to pay for it on their own. Let individual health care insurance reflect the cost of health care to those paying for the insurance. About 22 million individuals currently receive subsidized health coverage. For them, Obamacare’s higher insurance costs are offset by the law’s subsidies. However, that is not the case for another group of about 25 million Americans with unsubsidized individual-market coverage or small-employer plans. Those 25 million are the ones whose experience with Obamacare has basically been “all pain, no gain,” as they have been subjected to significant premium increases and coverage dislocations. “Americare” needs to correct this problem and give relief to those 25 million Americans currently experiencing higher premium and co-pay costs accompanied by fewer choices in health care providers. We need medical liability reform. “The nation’s medical liability system is broken, and it has imperiled patient access and imposed tremendous costs on our nation. The current system has forced doctors out of practicing in certain specialties; it has caused trauma centers to close; and it has forced pregnant women to drive hours to find an obstetrician. The current system also has imposed a tremendous burden in unnecessary costs on our national health care system and federal government. Estimates are that the failure to enact meaningful medical liability reform costs our nation’s health care system as much as $300 billion each year.” (Ref. 3) “Americare” should once-and-for-all address the issue of medical lawsuits that simply raise medical expenses while lining the pockets of successful ambulance chasers. Medical lawsuits should result in financial damages only when there is clear and unmistakable negligence and/or criminal intent. There should be no reimbursement for pain and suffering. Awards should only cover the actual costs incurred. Suits against drug companies for unexpected side effects or consequences once the drug has been approved by the government should not be allowed. Instead, the government should establish a fund to cover the cost of such incidents and awards from the funds should be made on the basis of actual costs incurred without the need to institute unnecessary and costly court cases. A single payer health care system has seemingly apparent benefits along with real drawbacks – one significant negative being the loss of choice in selecting a health care provider. Single health care provider systems are basically socialized medicine. Socialized health care systems exist in countries such as Canada, England, Sweden and numerous others. Socialized health care systems have proved to be a mixed bag. The big benefit is that everyone gets covered. On the negative side are numerous horror stories of unbearably long wait times and mediocre quality. In some countries, citizens have found their socialized health care to be bad enough to cause them to seek medical care at their own expense, either within their own countries or by seeking medical services outside their own countries, frequently here in the United States. In truth, the United States has had a single payer health care system for over 200 years – one for veterans. In 1811, the federal government authorized the first domiciliary and medical facility for Veterans. The current veterans’ health care provider is known as the Veterans Administration or VA. Modern veterans’ health care came into being in 1946 under Public Law 293 which established the Department of Medicine and Surgery within VA. The law enabled the VA to recruit and retain medical personnel by modifying the civil service system. By 1948, there were 125 VA hospitals throughout the United States.[4] The VA disaster is by now well known. In 2014, it was reported that, “At least 40 U.S. veterans died waiting for appointments at the Phoenix Veterans Affairs Health Care system, many of whom were placed on a secret waiting list. “The secret list was part of an elaborate scheme designed by Veterans Affairs managers in Phoenix who were trying to hide that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor . . .” (Ref. 5) Other failures, coverups, deaths and bad treatment within the VA medical system were uncovered and it does not appear that all the problems of veterans health care have been corrected some 3 years later. The VA scandal points out the almost universal failure of any socialized governmental effort to serve the public. For this reason, I am not in favor of “Americare” being a single payer health care system, especially one operated by another government bureaucracy. For more on government run single payer health care, see Reference 6. Americans should be free to choose their health care providers. Payment for their health care services should be from insurance, out-of-pocket, or by federal and/or state programs, such as “Americare”, Medicare, and Medicaid. Health care providers should accept any and all such forms of reimbursement. Health care costs for seniors are higher than for the younger population. At the same time, seniors are generally retired and have restricted incomes. Seniors rely on Medicare for access to health care and still millions more count on Medicare to provide health security when they reach retirement. Currently, the program is unsustainable and will eventually fail without significant reforms. Medicare needs to be strengthened. “Americare” should address the problem, correct deficiencies in the Medicare program and provide the funding needed to ensure its continuance. “Americare” should provide relief to the American business community in terms of the health care coverage that American businesses provide to their employees – especially to small businesses. As a minimum, this means reduced regulation and elimination of bureaucratic red tape. Once Obamacare is repealed, the next step “is to let the country move to a patient-centered, market-based system that focuses on citizens and not on the government.” (Ref. 7) As the saying goes, “The devil is in the details.” The call above for replacement of Obamacare with “Americare” is merely an incomplete first step toward what is needed. There are a multitude of other considerations and details that need to be addressed. But what has been presented here is a good and necessary start. Obamacare unwisely tried to do much too much at one time and failed miserably. Instead, let’s proceed in a more orderly fashion this time and incrementally implement a comprehensive health care plan over a reasonable span of time. But, let’s get the ball rolling now with the most important items. We need to replace the failed parts of the ACA and begin to introduce the elements of a new plan, “Americare”, with well thought out additions as the needs become apparent. This time, let’s get it right and let’s not rush to create another Obamacare type disaster. What may serve America best is a basic plan now, with additional changes implemented over time as their need becomes apparent and the changes have time to be well thought out and implemented. Let’s remember, our nation was first formed with the implementation of a Constitution and then later improved with several amendments. Rome was not built in a day and it’s probable that a workable American health care system also cannot be developed in a single pass. Obamacare was a glaring example of this truth. ---------------------------------------------------------------------------------------------- References:
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| 18 May 2017 {Article 290; Govt_70} |