President Clinton did not and now President Bush will not
address health care reform in a way that deviates even slightly
from the HMO and Managed Care Industries that have given large
sums of money to both campaigns to keep them quiet. Thus these
special interests maintain the status quo of the for profit health
insurance corporations that have taken over the health care
system in America. Every day, approximately 100,000 people lose health insurance coverage
in the United States. Over forty-four million Americans do not have
health insurance at all. The people who have HMO’s as their only
choice of insurance routinely face rejection of payment when serious
health problems arise. The doctors employed by HMO’s make decisions
about a person’s health without laying hands on the patient.
They do not examine, listen to or have any contact with the patient
about whom life and death decisions are made regarding their health.
This is a human rights abuse in a civil society such as ours,
or any other society, for that matter.
There are over 1500 insurance companies in America with different
rules of what services will or will not be funded. Our facility has
hired two people just to handle the health insurance questions that
arise every day. They often have a frustrated and perplexed
look in their eyes as they undertake to find solutions to problems,
and then have to contact a faceless bureaucratic entity about whether
or not a service will be paid for.
Health care providers must also take the time to speak to these
people, to convince them to pay for proposed services. Letters must
be written to convince the HMO/Managed Care bureaucrats to take a
second look at what needs to be done for patients, to ensure
good quality medical care.
Health care workers have accepted the unacceptable and do not seem
to know the way out of the quagmire.
I once helped to raise $3,000.00 for a seven year old patient who
was in an automobile accident, and suffered a lower spinal cord injury.
He is paralyzed from the waist down. The proposed goal for the fund
raiser was to buy a handicapped accessible van. Since these vans cost
anywhere from $15-30,000.00 dollars, the family bought a computer, instead,
enrolled the boy in a study offered online by the Shreiner’s Hospital
in Philadelphia for spinal cord injured patients.
At the fund raising dinner, I sat with the patient’s grandmother.
She told me she wanted the money to be put in a trust fund to pay for the
child’s catheter supplies, diapers and medicine that the Managed Care
Insurance company would not pay for.
“Wait a minute,” I said. “You mean you are paying for all of the
supplies out of pocket without insurance reimbursement?”
“Yes,” she said.
Back in the office the following week, one of the women whose job
it is to deal with insurance questions, solved the dilemma and the supplies
are now paid for. The child’s mother had receipts, and the HMO reimbursed
her from the time of the car accident.
I wondered why the insurance company did not automatically pay for
these services? If I had not helped stage an elaborate fund raising event
and had dinner with the boy’s grandmother, this revelation may not have
surfaced. A Universal Single Payer health care plan would make it
possible for all people to get the services they need and free up doctors
and nurses to give the care that people deserve, plus fulfill all of the
reasons doctors and nurses entered their respective professions to begin
with: to be of service, to help other people and to bring healing to patients
and their families.
Physicians for a National Health Program in America have devised the following
plan for implementation. For more information, please access www.pnhp.org.
National Health Insurance, if implemented, would minimize any disruption to the
current health system because health care delivery mechanisms would remain
in place while only the financing mechanism changed. Single Payer National Health
Insurance would resolve virtually all of the major problems facing America’s health
care system, today.
Single Payer Insurance is defined as a single government fund with each state
which pays hospitals, physicians and other health care providers, thus replacing
the current multi-payer system of private insurance companies and other plans.
It would provide coverage for the forty-four million people who are uninsured.
It would eliminate the financial threat and impaired access to care for tens of
millions who do not have coverage and are unable to afford the out-of-pocket
expenses because of deficiencies in their insurance plans.
It would return to the patient free choice of health care provider and hospitals,
not the choice that only the restrictive health plans allow.
It would relieve businesses of the administrative hassle and expense of maintaining
a health benefits program.
It would remove from the health care equation the middleman—the managed care
industry—that has broken the traditional doctor-patient relationship, while diverting
outrageous amounts of patient care dollars to their own coffers.
It would control health care inflation through constructive mechanisms of cost
containment that improve allocation of our health care resources, rather than
controlling costs through an impersonal business ethic that robs patients of care
so as to increase profits for the privileged few.Single Payer Universal Health
Care would provide access to high quality care for everyone at affordable prices.
This would be beneficial for individual business as well as the government.
So why don’t we have a National Single Payer Plan?
