Year in and year out, reforming America's troubled health-care system is the biggest third-rail issue in politics. No matter how you approach it and no matter how you want to fix it, you're going to get shocked.With that in mind, I recently asked visitors to Kiko's House to guest blog on how they would fix the health-care mess. I front-loaded the discussion with these facts:
* America spends far more for health care per capita than any other first world country, but as a people we're not particularly healthy. In fact, a new survey finds that older Brits are healthier than older Americans although the U.S. spends twice as much on health care as the U.K.
* Nearly 45 million Americans have no health-care insurance. A surprisingly large minority of this group are technically not poor.It is not a coincidence that the responses to my request for comments are being posted during Nurse Appreciation Week.
* Emergency rooms are groaning under huge loads because many patients don't have family physicians, let alone insurance.
* The last major effort at cobbling together a national health-care system was a disaster. (I know that from first-hand experience; see my post at the end of the comments section below to find out why.)
* Pharmaceutical and insurance companies have a disproportionately powerful voice in any discussion about fixing health care.
* Absent in what discussion there is about health-care reform are the voices of the key and arguably most knowledgeable players in the system after patients themselves -- nurses.
This is a confection pushed this time of year in the U.S. by florists and greeting card companies. Hospitals typically mark the week by sending out for bagels or pizza for their nursing staffs. Oh the generosity! Nurses do sometimes luck out when a pharmaceutical company will order up a fancier spread.
There are some nurses out there who do have voices in the form of nurses associations or labor unions, but such organizations are few and far between. (*) Some nurses also have their own blogs, but none of them responded to my request to comment. At the risk of sounding cyncial, this is because these bloggers -- a dedicated bunch of nurses to be sure -- seem to be more comfortable as martyrs than reformers, and that is an historic problem for their profession.
The one nurse who did respond happens to be someone I know very well. The other six responses below reflect a fairly wide range of backgrounds and views. As noted, they conclude with my own thoughts.
-- SHAUN MULLEN
(*) The activist Service Employees International Union is aggressively courting nurses, and the image of the unhappy nurse atop this post is from a brochure it recently mailed out. For more info on the SEIU's Value Care, Value Nurses initiative, go here. For more on SEIU's overall work, go here. This mention is not an endorsement, although I do like what I see.
4 comments:
I will make three comments about the state of the US health care system:
1) Other countries (like Finland who has a 'socialists' system (ie/govt provided health care)), it seems cheaper because it is paid for by the very high income taxes they pay (don't think it is equal in the end, but then you probably don't see too make Finnish doctors driving Jaguars).
2) The current health care setup (mostly PPO or HMO) is and has always been a crock. IT actually makes it easier for doctors to make money for NOT getting you help (this is NOT new it has been going on since the earlier days of HMO's 20+ years ago). It is like car insurance, you pay every year, but don't get much even if you do have an accident.
3) One of the BIGGEST drains on our healthcare system (and it is getting worse every year) is ILLEGAL IMMIGRANTS.
When they go to the hospital (with of course no insurance/HMO) they have to be treated and working americans (american = immigrant that has become a citizen AND PAYS TAXES, and money to other gov't programs (unemployment insurance, etc...)).
I think they should give all 12 million a specific amount of time (amnesty) to apply for legal citizenship (6 months tops), then start searching and deporting them.
You're batting one for three, Anonymous.
(1.) Using Finland as an example is misleading. Are you suggesting that the U.S. doesn't have high taxes? And think of what we could do with all the tax revenues that go to the war in Iraq and other follies.
(2.) You are correct that the current set-up is a crock.
(3.) For every study that says illegal immigrants are taking out of the economy more than they put in is another that says the opposite.
Shaun,
1) The taxes in other parts of the world, and especially in places like Finland where they have such gov't run programs, are higher than ours.
They also pay a lot more for things that we complain about (most recently gas prices), people in most of europe would be thrilled with $3US per gallon.
I ABSOLUTELY agree with you about where the money would go if we gave it to 'W' => the Iraq Farce and Haliburton (no conflict of interest there, Mr. Cheney?!? between that and the current regime's stance on same sex marriage I don't know which is more ludicris (I happen to NOT agree with same sex marriage (unless they want to make it a CIVIL union (only in the eyes of the state/gov't), but the hypocrisy astounds).
3) How can illegals contribute to anything other than the pockets of greedy businessmen that only want to get cheap labor (even cheaper than just paying americans off the books). Again so no one gets all up in arms, american = legalized american immigrant (being the grandson of an immigrant that became a citizen soon after getting into this country).
I'll take a pass on the same-sex issue, but will weigh in (again) on illegal immigrants.
Illegal immigrants are a huge problem simply by force of the huge number of them. But they do put money into the economy at large, not just the pockets of greedy businessmen. And, by golly, some of them become citizens and lots more would if there was another one-time amnesty.
Incidentally, three of my four grandparents were immigrants.)
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