Health Care
Eugene and Linda Farley
Health Care Security for all is: a social, ethical, moral and religious good; a family value and an economic necessity.
The United States has excellent health care resources. The present outmoded, irrational, complex, wasteful and administratively top heavy way of paying for them limits our ability to make the most effective use of them.
A caring, sharing just society is a non-violent society. In such a society Health care is a right – no person or society can afford otherwise.
All people benefit from health care - rich or poor, healthy or ill, old or young, employed or unemployed.
Families and individuals need health care as part of their ability to grow, develop and survive.
Businesses large or small, farmers, other self-employed, school districts and governments benefit when everybody has health care coverage.
It is unethical for investor-profit to be made by denying health care to those who often need it the most and are most unable to pay for it – the “unprofitable patient”.
Health Care Security for all will come when people finally stand up and demand it.
“America always ends up doing the right thing after it tries everything else.” (paraphrasing Winston Churchill)
“You can’t jump across a chasm in two leaps” (attributed to Winston Churchill)
Approximately 15 years ago, the Madison Institute, through its Progressive Round Table, began a study of the American Health Care “System” and concluded that as it then existed, major changes were needed in how the system was funded if we were to achieve the most effective use of our excellent health care resources and cover everybody. Costs were soaring and 37 million people lacked health insurance.
Since then, without public accountability, the Corporatization of health care has created unimagined changes in how medicine is practiced in this country. Costs are again soaring and now there are 46 million people without health insurance and many more inadequately covered. The Madison Institute endorses the following position paper produced by the Physicians for a National Health Program:
The United States spends more than twice as much on health care as the average of other developed nations, all of which boast universal coverage. Yet over 46 million Americans have no health insurance whatsoever, and most others are underinsured, in the sense that they lack adequate coverage for all contingencies (e.g., long-term care and prescription drug costs).
Why is the U. S. so different? The short answer is that we alone treat health care as a commodity distributed according to the ability to pay, rather than as a social service to be distributed according to medical need. In our market-driven system, investor-owned firms compete not so much by increasing quality or lowering costs, but by avoiding unprofitable patients and shifting costs back to patients or to other payers. This creates the paradox of a health care system based on avoiding the sick. It generates huge administrative costs, which, along with profits, divert resources from clinical care to the demands of business. In addition, burgeoning satellite businesses, such as consulting firms and marketing companies, consume an increasing fraction of the health care dollar.
We endorse a fundamental change in America's health care - the creation of a comprehensive National Health Insurance (NHI) Program. Such a program - which in essence would be an expanded and improved version of Medicare - would cover every American for all necessary medical care. Most hospitals and clinics would remain privately owned and operated, receiving a budget from the NHI to cover all operating costs. Investor-owned facilities would be converted to not-for-profit status, and their former owners compensated for past investments. Physicians could continue to practice on a fee-for-service basis, or receive salaries from group practices, hospitals or clinics.
A National Health Insurance Program would save at least 209 billion (1999 figure) annually by eliminating the high overhead and profits of the private, investor-owned insurance industry and reducing spending for marketing and other satellite services. Doctors and hospitals would be freed from the concomitant burdens and expenses of paperwork created by having to deal with multiple insurers with different rules - often rules designed to avoid payment. During the transition to an NHI, the savings on administration and profits would fully offset the costs of expanded and improved coverage. NHI would make it possible to set and enforce overall spending limits for the health care system, slowing cost growth over the long run.
A National Health Insurance Program is the only affordable option for universal, comprehensive coverage. Under the current system, expanding access to health care inevitably means increasing costs, and reducing costs inevitably means limiting access. But an NHI could both expand access and reduce costs. It would squeeze out bureaucratic waste and eliminate the perverse incentives that threaten the quality of care and the ethical foundations of medicine.
The Madison Institute also supports the possibility that a publicly funded health care plan could begin in a single state, just as Canada’s Medicare started in one province, Saskatchewan. Every biennium since 1989, such a plan, authored by The Coalition for Wisconsin Health, has been introduced in the Wisconsin legislature. The Wisconsin Health Security Act is an example of a comprehensive plan to provide quality health care to all Wisconsin residents--rich and poor, young and old, regardless of health condition, medical history or employment status. By replacing more than 700 different health insurers with a single publicly financed plan, it would eliminate waste, runaway costs, and red tape. It would be administered at the state and local level, accountable to the residents of Wisconsin.