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by Sandy Rose
© 2012 by Sandra Middlesworth Rose
Photo on cover: this is Quinn, a very fortunate baby who has no insurance in the United States, was uneventfully born at home in 2012 to an American mother and Austrian father; thus, she has dual citizenship. She will have healthcare coverage when she is in Europe: her human right.
This is a story of my personal trek into the subject of healthcare in the United States, attempting to find the good in our solutions as well as a way to fix our system by researching what other countries were doing. I looked in many corners and found much confusion and varying points of view. I want to present to you the various elements of healthcare as it relates to humanity, why healthcare is a human right, what a few countries have done (and continue to do) to provide healthcare, and actions you can take to help yourself and your fellow man. My premise is that healthcare is indeed a human right, one that every single woman, man, child on this planet deserves. This idea dissolves politics, crosses party lines, starts arguments, opens peoples’ eyes, brings painful reflection to some and certainly opens controversy regarding universal healthcare (which has been called socialism).
First I checked out what universal health care is and found that it means exactly what it says: “describes health care systems organized around providing a specified package of benefits to all members of a society with the end goal of providing financial risk protection, improved access to health services, and improved health outcomes.”2 Since many opponents of universal healthcare have called it socialism, I wanted to clear that up. I searched and searched to find the true definition, not just one person’s opinion – and I found that people tended to confuse the concept of socialism with communism and even liberalism. Socialism is not connected to healthcare, as it has to do with economics and production run by the people.3 I came to the conclusion that universal healthcare comes under social services, those “Benefits and facilities such as education, food subsidies, healthcare, and subsidized housing provided by a government to improve the life and living conditions of the children, disabled, the elderly, and the poor in the national community.” 4 From The Universal Declaration of Human Rights: Article 25. ● (1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. ● (2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.5
Wikipedia YourDictionary.com 4 BusinessDictionary.com 5 The Universal Declaration of Human Rights
Universal healthcare is not socialism, but it is a basic human right, that comes under the social services of each government, and those humanitarian enough to share donations of time and money. Exemplifying the human right to healthcare as above: I have been fortunate enough to have personal experience with Seattle Children's Hospital which has this purpose: “Seattle Children’s provides healthcare for the special needs of children regardless of race, sex, creed, ethnicity or disability. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho.”6 My son was treated there in 1989 for a ruptured appendix when we had no health insurance or money for traditional healthcare. He was given the best of care and we were assured his medical bills would be taken care of by the hospital if we could not afford to pay. Later, my husband, son and I participated in the several annual charity motorcycle rides to benefit Children’s Hospital! We loved giving back, never once forgetting their competency and generosity. And, if one believes in “what goes around comes around,” then my granddaughter benefited recently. She developed an infection in her left hip joint, which presented with pain and fever. The family has no health insurance and very limited funds to pay for alternative and preventative medical care. I told my daughter to take her to Children’s, which turned out to be the best place as they did surgery, treated my granddaughter and her parents extremely humanely, and will cover the bills, if necessary. This is an example of an institution founded to help children, to guarantee their human rights. Their mission would warm the heart of Michael Moore, who championed healthcare as a human right.
Seattle Children’s Hospital Website
Michael Moore - what a guy! He was brave enough to do a documentary movie called Sicko. Watching this movie in 2007 is what solidified my idea that healthcare is a human right. In 2012, I viewed it again as part of my class in Human Relations; I cried. Moore does a competent job of grabbing one’s attention by investigating healthcare in the United States in his unique, flamboyant way. He exposes how for-profit insurance companies deny coverage based on their loss ratios and how a procedure may cut into their profit margin.7 Since this was prior to the so-called health reform of 2010, he showed people with preexisting conditions denied insurance coverage, forced to live with pain and disease that could be cured. He focused on a group of 9/11 site workers who had debilitating conditions from the toxins who were denied care in the US. He finally got them healthcare in Cuba. Moore goes to the UK, France, Canada, and Cuba to check out their universal healthcare systems. To give an example of one physician’s experience working for the National Health Service in the UK, watch his short interview where a unique idea is presented; UK pays physicians extra to keep their patients healthy,8 something for which I found further documentation in T.R. Reid’s book and will discuss
From Sicko, section on insurance companies From Sicko, section on Great Britain’s National Health Service Photo http://upload.wikimedia.org/wikipedia/commons/f/f0/BigBen_2_db.jpg
March 23, 2010 President Obama Signs Healthcare Act
With the human rights essence of healthcare in mind as discussed above, please follow me very briefly into the strange world of our Patient Protection and Affordable Care Act, Public Law 111-148. The Act itself is around 2500 pages and is basically unreadable to a lay person, let alone a senator or congressman (very complicated, obviously edited and altered many times). To get an understanding of it, I downloaded a summary done by the Henry J. Kaiser Family, Focus on Health Reform, and studied it. One statement in the Act itself is so contradictory to the contents of the Act, that I find it worth quoting, “TITLE 1 - QUALITY, AFFORDABLE HEALTHCARE FOR ALL AMERICANS,”11 as it surely will be a matter of reality in 2014 whether everyone can afford the healthcare as laid out in this Act or that the quality of our healthcare will improve. This ACT is a potential disaster for the average American and there is no way that this Act, as it stands, can guarantee affordable healthcare for all Americans. The reason I say this is because many Americans, myself included, cannot afford any kind
Photo from http://commons.wikimedia.org/wiki/File:Obama_signs_health_care-20100323.jpg Licensed by Creative Commons Attribution 2.0 Generic to copy, distribute and transmit the work 11 Patient Protection and Affordable Healthcare Act
of insurance premium (even under this Act) nor can we afford the deductible and out-ofpocket expenses. It is humane and right that preexisting conditions are covered; however, there is bound to be (and has been) an increase in premiums to all. There will be a gap of individuals who cannot purchase health insurance: those whose income is too high for Medicaid and those who don’t make enough income to afford insurance – even with the proposed premium credits. Medicaid is being extended to 133% of the Federal Poverty Level ($14,856 for a family of 1 in 2012); however, by 2017 each state must come up with the funding for Medicaid after the Federal money runs out.12 As a matter of fact, when the Act took effect in March of 2010, I was working in HR. As a direct result, health insurance premiums increased by 38% for my company. The owner cancelled our health insurance rather than pay the extra! Obviously this Act heavily favors for-profit insurance companies, and makes that clear in the first section stating what the overall approach is: Require most U.S. citizens and legal residents to have health insurance. Create state-based American Health Benefit Exchanges through which individuals can purchase coverage, with premium and cost-sharing credits available to individuals/families with income between 133-400% of the federal poverty level (the poverty level is $18,310 for a family of three in 2009) and create separate Exchanges through which small businesses can purchase coverage. Require employers to pay penalties for employees who receive tax credits for health insurance through an Exchange, with exceptions for small employers. Impose
Patient Protection and Affordable Healthcare Act
new regulations on health plans in the Exchanges and in the individual and small group markets. Expand Medicaid to 133% of the federal poverty level.13 This short summary just about states the entire point of the 2500 pages within the Patient Protection and Affordable Care Act. The rest of the document is full of details: a complicated way to expand Medicaid, cover preexisting conditions (ultimately increasing insurance premiums so that the insurance companies still make their outrageous 20% profit), various costly committees, fill the pockets of the insurance companies with new money (individual mandates), increase the pharmaceutical companies’ profits, and delay getting universal healthcare. This is unacceptable; I am disillusioned as I thought there had to be more, improved healthcare benefits in this Act. I did have an open mind as I studied the summary of the Act. Obviously, the for-profit insurance companies must have done some expensive lobbying for changes to the Patient Protection and Affordable Care Act to turn out this “solution” to healthcare in the United States. The Senators, Congressmen, and, yes, our President do not need to be concerned with the provisions of the Act, because they have full coverage for life. Where is the compassion from these men who rule our government, who are supposed to be representing us? It is not there. When one has had excellent health and dental care, one very often cannot have empathy and compassion for those who don’t. I believe they must dig deeper into their souls to find a better solution.
Focus on Health Reform Summary of Healthcare Act
What we all need to do first is research to be informed about the facts. I started with T.R. Reid’s book, The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care and I recommend this book for anyone serious about wanting to do something to influence what is going to be done about healthcare in the United States. He slams right into the subject with an American story about Nikki, who died as a result of not being able to be treated for Lupus due to the fact that she lost her insurance when she lost her job. She had no money to get the care she desperately needed. He stated that his global quest “made it clear that the other wealthy democracies can show us how to build a decent healthcare system - if that’s what we want.”14 T. R. Reid is a longtime correspondent for The Washington Post and former chief of its Tokyo and London bureaus, as well as a commentator for National Public Radio.”15 As a result, he documented everything he claims and was extremely thorough in his research. There is a very clear reason why somebody like Nikki died after being denied adequate care: “The United States is the only developed country that relies on profitmaking health insurance companies [italics mine] to pay for essential and elective care.”16 I agree that this is the major problem with healthcare in our country, especially as other countries see to it that every individual has a right to healthcare when needed; except for the United States.17 The United States has the best technology, but it is not accessible to a large percentage of our population. Regarding coverage:
The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care p 1 The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care p 3 15 The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care Inside Cover 16 The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care p 29 17 The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care p 30
The Health Reform Act passed in 2010 will reduce their (uninsured) numbers significantly, but will still have about 23 million people uninsured when the new law takes full effect. Americans who don’t have enough money or enough insurance to buy medical care can sometimes go to the emergency room, but only if they’re on the verge of death or in active labor.18 I believe that when we were not looking, health insurance companies galloped away with our human right to healthcare. We need to turn a spotlight on this subject. Further, T.R. Reid goes over the subject regarding the cost of our health insurance, something about which we really need to have some awareness. He says it best: Insurance executives, securities analysts, and the business media carefully watch each company’s medical loss ratio to make sure that the actual medical payments don’t eat too deeply into administrative costs and profits. According to their filings with the Securities and Exchange Commission, most for-profit insurance companies maintain a medical loss ratio of about 80%, which is to say that 20 cents of every dollar people pay in premiums for health insurance doesn’t buy any healthcare. If a health insurance company consistently spent much more than 80% of its money on actual healthcare, its stock would plummet and its CEO would be axed.19 That makes it very clear the main reason health insurance companies exist. To see what other countries are doing, Reid thoroughly researched each country that has universal healthcare, which is every developed country with the exception of
The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care p 31 The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care p 37
the United States. In all the developed countries, only the US has for-profit insurance companies (making good health some kind of commodity subject to free enterprise); none of the other developed countries allow it. They are more interested in human rights. There are Bismarck (found in Germany, Japan, Belgium, and Switzerland - uses private health insurance plans, financed jointly by employers/employees through payroll deductions - everyone covered, no profit is made), Beveridge (mostly government owned, government pays and tells doctors what they can charge, no medical bills in Italy, Spain, UK, Scandinavia), and National Health Insurance (Australia, Canada costs controlled by limiting medical services they will pay and making patients wait to be treated) models as well as out-of-pocket (the poorest countries where only the rich can afford healthcare).20 All the countries with universal healthcare have “individual mandate”; that is, all must pay in and all will be covered.21 My favorite and one that I think could work in our country is the Beveridge model – as used by the UK. “The British National Health Service, the system that Beveridge designed and Bevan muscled into existence sixty years ago, is dedicated to the proposition that nobody should ever have to pay a medical bill.”22 There are high taxes, such as a 17.5% sales tax (a fair tax as you only pay if you can spend) to help pay for healthcare. There is minimal paperwork and no billing and the UK “has lower child mortality, longer healthy life spans, and better recovery rates from most major diseases than does the United States.”23 How Bevan got Britain to accept the NHS was that the doctors and specialists were still allowed to see patients on their own time, thus creating
The Healing of America The Healing of America 22 The Healing of America 23 The Healing of America -
A Quest for Better, Cheaper, and Fairer Health Care p 19 A Quest for Better, Cheaper, and Fairer Health Care p 37 A Quest for Better, Cheaper, and Fairer Health Care p 104 A Quest for Better, Cheaper, and Fairer Health Care p 105
a private system alongside the NHS. He also made it clear that the insurance companies could still market their policies to anyone not under the NHS, so it worked and July 5, 1948, the National Health Service opened its doors, free to all. “It is a model for any country that wants to provide quality care at low cost.”24
As I said that I would cover this unique pay system: in the UK doctors are paid with a new “experimental payment called Index of Quality Indicators.”26 This is pay for performance as opposed to the standard fee-for-service structure. There are several “quality indicators” to show if a patient is healthy. Doctors are paid bonuses of up to $125,000 per year.27 What a most brilliant idea! I call this true, preventative medicine: your doctor has a vested interest in making and keeping you well.
The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care p 113 Photo from Microsoft Office Clip Art 26 The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care p 123 27 The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care p 124
Speaking of preventative care, here’s what you can do: Check out natural medicine and other preventive care modalities. Try chiropractic, alternative medicine physicians who use both natural and traditional approaches to health, naturopathic doctors, acupuncture, massage therapy, and others. Consider supplements.
Eat your vegetables and other good foods. Do this by studying up on what is healthy for your body - spread the news to your family and friends. I kept my family healthy for years and years by doing all of the above, since we did not have health insurance. Stay active; exercise the body on a regular basis. In this way we stayed healthy and away from high medical costs - good way to take personal responsibility. To conclude, we must learn to have compassion for those who are not able to pay for health insurance or healthcare. I am one of them. I have noticed that people who have health insurance through work and can afford the deductibles and copays don’t much look into what is going on with healthcare. Whether you can afford healthcare or cannot, I would ask you to read T.R. Reid’s book, read the summary of the Healthcare
Photo from http://commons.wikimedia.org/wiki/
Reform Act, check out the additional links below and develop knowledge of the facts and more compassion for your fellow man. Be informed and take action by following what our government is doing. Speak out to your representatives. This is a non-partisan issue. Be vigilant and know your human rights, all of them. Click here for a comprehensive website on human rights - this is the best way to become aware of what your human rights are as well as the history - your right to healthcare is one of them. Speak up! Healthcare is a human right per all the developed countries of the world, except for the United States. We need to change that.
http://www.youtube.com/watch?v=_E66XxNUrxM&feature=player_detailpage T.R. Reid talks about his book The Healing of America http://en.wikipedia.org/wiki/The_Healing_of_America http://www.healthcare.gov/ http://dpc.senate.gov/healthreformbill/healthbill52.pdf http://huffingtonpost.com/michael-moore/why-the-current-bills-don_b_302483.html http://www.boston.com/news/nation/washington/articles/2010/03/21/a_historical_look_at_health _care_legislation/ http://www.forbes.com/sites/richardgrant/2012/07/15/so-what-exactly-do-we-get-for-our-new-tax/ http://www.usatoday.com/money/industries/insurance/story/2012-07-14/health-care-youngbroke/56226296/1 http://healthreform.kff.org/subsidycalculator
BusinessDictionary.com. definition of social services. http://www.businessdictionary.com/definition/social-services.html Dingell, John. Text of The Patient Protections and Affordable Care Act. Washington D.C. US Senate and House of Representatives. Published for Kindle by John Dingell, 2010. Kaiser Commission on Medicaid and the Uninsured. Focus on Health Reform, Summary of New Health Reform Law. The Henry J. Kaiser Family Foundation. Publication Number: 8023, 5/19/2011. Web http://www.kff.org/healthreform/upload/8061.pdf Moore, Michael. Sicko. The Weinstein Company. Dog Eat Dog Films, 2007 movie, Meghan O’Hara, Producer. USA, France, Cuba, Canada, UK. Moore, Michael. Sicko. The Weinstein Company. Dog Eat Dog Films, 2007 movie. Web. http://www.documentarywire.com/sicko Reid, T.R. The Healing of America - A Quest for Better, Cheaper, and Fairer Health Care. USA:Penguin Books, 2009, 2010. Book on Kindle. Seattle Children’s Hospital. Welcome to Seattle Children’s. Web. http://www.seattlechildrens.org/ United for Human Rights. The Story of Human Rights. HumanRights.com. 2012. 23 Jul. http://www.humanrights.com/#/home United Nations. The Universal Declaration of Human Rights. Full text. English. Web. http://www.un.org/en/documents/udhr/ Wikipedia. Universal healthcare. Encyclopedic information. http://en.wikipedia.org/wiki/Universal_health_care YourDictionary.com. A Closer Look at Socialism. Definition. http://reference.yourdictionary.com/word-definitions/definition-of-socialism.html YouTube. Moore interviews a Doctor in UK. 27 Nov, 2007 http://www.youtube.com/watch?feature=player_detailpage&v=GOZmvaFfjtk
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