Giving Back
By Nelson Bradshaw
Catskill Mountain Foundation
Excerpts from http://www.catskillmtn.org/publications/articles/2007-12-giving-back.html
The Oneonta Free Clinic will make a valiant effort meet the medical needs of these people. But small, private clinics are not the real answer to the nation’s mounting health care crisis, according to Doctor Friedell. “A free clinic is just a band-aid,” says the physician. “It’s a way of getting care to people in a hurry. My personal belief is that we need a single-payer health insurance system in this country. A simple name for the program might be Medicare for Everybody. Medicare is the Federally funded system that pays for everybody who is over 65-years-old or who is disabled. It is a single-payer system. All the bills go to the Federal government. It works very well. The customers are quite satisfied. Nevertheless, there has been a tremendous amount of resistance to establishing a similar program for the whole country.”
Friedell notes that the existence of a one-payer, national system would mean that just by virtue of being a citizen of this country, you would be insured from the time of your birth to the time of your death. Friedell expands, “You would never have to worry about that, no matter how many times you changed your job or college or your status in the military.”
Most opponents of a proposed national system say that the country can’t afford it. Dr. Friedell argues that, first, a patient wouldn’t be able to get just any treatment or an infinite amount of care under a national plan. “There would be a cut-off point,” Friedell asserts. “Medicare, Medicaid and the Veteran’s Administration are all examples of government-run, single-payer systems. They have cut-offs.”
Second, a single-payer system would save a lot on administrative costs, the doctor points out. “The advantage of using a single-payer program is that it eliminates bureaucracy and expense,” he says. “If you come to my office now for treatment, for example, you have to show your insurance card. My staff has to get on the phone or a Web site and verify that you still have coverage. There is a plethora of insurance companies in our area alone, and they all have different rules and different measures of membership and services covered.It is really very frustrating.”
Friedell concedes that one point frequently raised by national health care plan critics is valid—some procedures would have to be rationed. “If we go to a single-payer system, certainly if you want an elective procedure like having a cataract removed or a hip replaced, you’re going to have wait a few months,” says the doctor. “These things are not emergencies. However, if you come into a hospital with a true emergency, if will get taken care of that day or the next day.
Doctor Friedell also points out that health care is rationed under the current system. “If you live in New York City, you can get in to see a gastroenterologist quickly,” he states. “But, if you live up here and you want to see one, you’ve got a long wait ahead of you. If you have the money or insurance and you live in an urban area or can travel, you can get whatever medical care you want. But, you can’t if you lack insurance or if you reside upstate or in a poor part of town. We’re doing de facto rationing right now. We’re limiting medical care on an economic basis.”
Another fear raised by the critics of a proposed national care system is idea that the government would make a mess of it. “They talk about the idea that you can’t trust government to run health care,” Doctor Friedell notes. “But, the government’s been doing it very effectively for over 40 years. Medicare and Medicaid have been in existence since the mid ‘60s. Medicare spends a very small percentage of its funding on administration. That allows more money to be spent on doctors, nurses and medicine.”
After the next presidential election, there could be a public debate on a national scale about the single-payer idea. But a small, determined group in Oneonta is ready to do what it can right now.