Friday, February 6, 2009

The Push for Universal Health Care

Earlier this week, President Obama signed an expansion to the State Children's Health Insurance program:

WASHINGTON (Reuters) - President Barack Obama on Wednesday signed a law expanding a health program to include 3.5 million uninsured children, advancing an overhaul of the U.S. healthcare system despite the embarrassing withdrawal of his nominee to lead the initiative.

Obama signed the legislation at a White House ceremony just hours after the U.S. House of Representatives voted 290-135 for the $32.8 billion expansion of the State Children's Health Insurance Program, or SCHIP, which was approved by the Senate last week.

"In a decent society, there are certain obligations that are not subject to trade-offs or negotiations -- healthcare for our children is one of those obligations," Obama said.

The bill was "a downpayment on my commitment to cover every single American," he added.

President George W. Bush twice vetoed similar bills, arguing it would raise taxes and encourage businesses and families to drop private insurance and switch to the program.

The bill signed by Obama aims to increase the number of children covered by SCHIP to 11 million from the 7.4 million currently enrolled. [...]

The SCHIP program is designed to help working families who cannot afford private health insurance but earn too much to qualify for Medicaid healthcare coverage for the poor.

Republicans had criticized provisions in the bill that allowed states like New Jersey and New York to provide coverage for higher-income families, some earning as much as $88,000.

Those greedy Republicans! How dare they suggest that people making $88,000 a year can afford their own insurance for their children! Of course, the reality is that people making significantly less than that amount will end up paying, via taxes, for insurance for people who earn more, but we can't let reality get in the way of feel-good government and huge increases in the number of people who qualify for government health care.

The push for socialized medicine continues; I expect that only the dismal economy has kept a new mandate for universal health care off of the Democrats' legislative table for the time being.

One of the things I find frustrating about my fellow Catholics is that more and more of them seem to think that universal health care is not only a good idea, but is what Christ would want, and is the most fair, just, equitable way of making sure that everybody gets adequate health care imaginable. Sadly, there is evidence to the contrary:

TOKYO (AP) - After getting struck by a motorcycle, an elderly Japanese man with head injuries waited in an ambulance as paramedics phoned 14 hospitals, each refusing to treat him. He died 90 minutes later at one facility that finally relented—one of thousands of victims repeatedly turned away in recent years by understaffed and overcrowded hospitals.

Paramedics arrived at the accident scene within minutes after the man on a bicycle collided with a motorcycle in the western city of Itami. But 14 hospitals contacted to provide medical care for the injured 69-year-old all refused to admit him citing a lack of specialists, equipment, beds and staff, according to Mitsuhisa Ikemoto, a fire department official.

The Jan. 20 incident was the latest in a string of recent cases in Japan in which patients were denied treatment, underscoring health care woes in a rapidly aging society that faces an acute shortage of doctors and a growing number of elderly patients.

One of the hospitals finally agreed to provide care when the paramedics called a second time more than an hour after the accident. But the man, who suffered head and back injuries, died soon after from hemorrhagic shock, which occurs when cells do not receive enough oxygen and nutrients to function.

The victim might have survived if a hospital accepted him more quickly, Ikemoto said. "I wish hospitals are more willing to take patients, but they have their own reasons, too," he said.

The motorcyclist, also hurt in the accident, was denied admission by two hospitals before a third accepted him, Ikemoto said. He was recovering from his injuries.

The man's death prompted the city to issue a directive ordering paramedics to better coordinate with an emergency call center so patients can find a hospital within 15 minutes. But hospitals still cannot be punished for turning away patients if they are already full.

Similar problems have occurred frequently in recent years. More than 14,000 emergency patients were rejected at least three times by Japanese hospitals before getting treatment in 2007, the latest government survey showed.

Japan has had universal health care the 1960s. But with an aging populating, rising costs--though Japanese citizens pay a monthly health-insurance fee to the government--and shrinking numbers of doctors and other health professionals willing to accept the pay which is determined for their services by the central government, the system is beginning to implode.

So while Americans agitate for "free government health care," many of them aren't looking at the real costs. A hard look at what's going wrong in Japan might be worth taking--if anyone were willing to take it. Unfortunately Americans have not been inclined to do so; too many Americans think that health care should be "free" and that only greedy medical profiteers think otherwise.

For now, we just have to deal with a huge expansion of SCHIP at a time when we're ill-prepared to pay for any such expansions. In the long run, adding more and more middle-class families to SCHIP may end up diminishing access to services for more and more of those who sign up for the program. We tend to forget that we get what we pay for, and this is espeically true when what we're getting is "free."


eutychus said...

One of the dirty little secrets of nationalized health care is that it often leads to a shortage of doctors and specialists that the article mentions. It's a rather ironic posting considering that I went to the the ER at 7:30a.m. Tuesday morning and was told "we've had a bit of an emergency in the emergency room today." They were full up. Like wise the hospital where I would be later admitted for appendicitis. Even so, I was diagnosed within an hour and under observation while I waited for my surgery later that evening. Yes, I had to share a room because of the crowded conditions but other than an overdose of spanish television (another story) I can't complain. I shudder to think what might be the case a few years down the road.

Red Cardigan said...

Goodness, Eutychus, I hope you're feeling better! Appendicitis can be very scary.

Anonymous said...

I've also been baffled by a couple of Catholic acquaintances who seem to think nationalized healthcare is something any serious Catholic would be in favor of (almost on par with pro-life issues).

Why any Catholic would be in favor of a bloated secular government being in charge of health care is beyond me.

--Elizabeth B.

eutychus said...

Feeing better, thanks. My wife said I've just given birth through my belly-button, just on a smaller scale. (ha!) It really never felt too bad. Just felt like I had eaten something that didn't settle well. It lasted four days. The last day I had a little trouble standing up straight after getting up from my chair. And my wife said I was cranky in a different way than usual. She of course knew before I did what it was.

Anonymous said...

As a Canadian, I am very happy that we have universal health care. I am not rich and it affords security. Fortunately, I do not have to use it often, but I have friends who do and they are also in the low-income bracket, so it is very useful for them.
I do not see that it is in conflict with Christian teachings. The Governement programs do not cover everything and there remains a lot to do for volunteers.
Elise B.

KC said...

As a military dependent, I feel I see how it would be if there were universal healthcare as we receive our healthcare from the government.

Oftentimes, I cannot get my children in to see a doctor for any sort of sickness due to lack of appointments. I have had to take my children to the ER for something as small as an ear infection because I've had nowhere to go. I can't let the ear infection go. I could, I suppose, wait another day and hope to get in then, but when I call at the moment they open up, they are usually filled. It's a very frustrating experience made even harder when your little ones suffer.

Anonymous said...

I will say that this family's $80K doesn't seem to go far far as I thought it would before I had kids. And if I did not have employer-sponsored group health insurance (self-employed perhaps), a private plan would either have incredibly high premiums, and/or very high deductbles, and/or provide limited coverage. I pay around $4K a year including premium, deductible, and copays. The company pays about $12K. Without such a generous plan, healthcare could easily consume 15-20% or more of a family's budget even in a year when everyone remained relatively healthy. Whether that's unreasonable is another question. But I can see why even "rich" people want in on the govt program. Especially in Northeastern and West Coast cities with very high costs of living WRT housing, energy, state income taxes, etc.

Then again... we do have to consider those premiums that our employer "so generously pays" as compensation, don't we? Surely if they didn't have to spend that much on my insurance, they could afford to pay me a higher salary. In the end, TINSTAAFL.

I haven't read up on the subject extensively, but I think there needs to be a better balance here. A govt program that gives individual buyers the leverage and discounts that other employer-sponsored programs enjoy, but with a premium more in line with household income.

Anonymous said...

The key is CHOICE, not MANDATE.

Scott W. said...

I do not see that it is in conflict with Christian teachings.

It's not inherently, but the problem is that people running around thinking that universal health care is a binding Christian mandate (and even run afoul by making it equal to the abortion issue and thus we get ham-fisted defenses of voting for pro-abortion politicians).It ain't. In fact, the Holy Father warned in his last encyclical that we cannot seed charity and social justice to the State because of the state's tendency to dehumanize. Or as I've heard it put: free hay and a barn for human cattle.

Scott W. said...

"cede", not "seed". [slaps forehead]

Anonymous said...

Currently, do all children in the US have access to timely healthcare? Why, or why not? This is not a simple issue, (and neither is the matter of whether an income of $88K/yr is considered wealthy or not, and the wage-earner should be able to pay a personal private insurer).

The matter of private insurers as the be-all, end-all solution is definitely a no-brainer. For one thing, employers choose the health insurance package deal from jillions of insurers, and make two or three levels of care available to an employee. Within the package, however there is room for all matter of benefits manager squirminess which can change from day to day, week to week and so on, such as denial of pre-existing conditions, services that must be received at specific sites, prescription benefits which must be accessed through mail-order only.

I remember when patients checked with dentists to see how much a crown would cost and then made a decision based on whether it would be replaced this year or next, but really, is it befitting that a patient call the radiologist ahead of time to determine whether his insurance would cover a chest X-ray or the price of a treadmill exam--hmm, nope, too pricey now, guess I'll wait until next year.

Just ask the druggist at Wal-Mart if they can predict how much a prescription will be BEFORE the patient has the prescription for a drug has been processed.

In this day and age of people not having regular jobs, it is often a case where employee benefits are no longer available to dependents of the out-of-worker.

As suggested, analyses of healthcare and access in other countries e.g. Canada, Germany, Japan, Norway etc. might be useful to determine usefulness of US strategies compared to analogous situations in other countries when considering 'universal health care' or 'universal health coverage'. Various healthcare provider organizations publish statements periodically which indicate that upper managment is aware of in iniquities in healthcare.

The current level (or quality) of healthcare is not the same as even 10 yrs ago in the US, but it also is not the same in other countries as well.

We've heard good thing about care in Germany. We've Canadian physician friends who've immigrated because of a better comparable wage here. We've had Japanese relatives receive excellent care in Japan, but also made sure family members were in attendance around the clock.

And, federal laws require that accessibility to healthcare is unrelated to whether one is a Catholic, Buddhist, or Hindu, etc!


Marianne said...

The UK's NHS is being held up as a model to aspire to by some recently. Do they know that it isn't uncommon to wait for a year between referral and hospital treatment because the waiting lists are so long?
One argument we heard today, was that Drs are rewarded for keeping their patients healthy, but this also means they are rewarded for NOT referring them to specialists.
Oh and take dental care... I didn't know that Novacaine existed before coming to the USA!

Anonymous said...

Recently published WHO assessments of healthcare around the world suggest that speed of care ranks high in US but that costs and efficacy benefits as well as the quality indicator--level of healthiness, rank well below other industrialized nations.

Brian said...

Most of Canada's Catholic hospitals, and the Catholic population warmly welcomed the arrival of nationalized medicine in the 1960s. As did the may Protestant hospitals.

By the end of the 1970s most were losing their religious identity. Now it is rare to find one with any vestige of their once strong Catholic identity.

There is a push to get Catholic hospitals to accept abortion, sterilization, all sorts of questions that would not arise were the state not the sole supplier of funds.

There are also long waits for treatment and a lack of specialists as others have pointed out. Whereas in the American system, those who can afford good insurance can get farily quick access to doctors because not everyone can afford to pay that level of premium; here in Canada the government rations care because it cannot afford for everyone to have quick and easy access.

There are benefits, there are cons. Ask me tomorrow and I might have a different answer on which system I prefer.

My only warning, religious hospitals need to make sure the Nuns and other Orders remain in charge, not state bureaucrats