Healthcare packages all inferior, except for one
By Deborah Burger, RN
January 10, 2007
With Gov. Arnold Schwarzenegger unwrapping his long-anticipated healthcare package Monday and talk about reform building in Sacramento, Californians may well be wonder if our long healthcare nightmare is finally coming to an end.
Sadly, virtually none of the proposals now being touted in the Capitol is universal, strengthens quality of care or reduces rising costs to consumers.
The sole exception is a single-payer approach, as contained in a bill by state Sen. Sheila Kuehl, D-Santa Monica, that was vetoed by Schwarzenegger in September, but will be reintroduced soon.
Under single-payer, one public entity collects all the financing and pays for all medical services through the existing private-care delivery system, with adequate funding for our doctors, hospitals, clinics and other care.
All the other approaches are fundamentally flawed. They continue to rely on a wasteful insurance industry whose focus is on making money by denying care to those who need it the most and other market-based mechanisms that created the current mess.
Californians should be especially wary of legislation requiring individuals to buy insurance. The likely result is to criminalize the uninsured, and saddle far too many with cut-rate plans with huge out-of-pocket costs and caps on payments that expose you to financial ruin in the event of a serious illness or major accident.
There’s a better way, the course charted by every industrialized nation in the world. That’s the main reason why the U.S. spends more than the 21 other wealthiest countries on healthcare yet Americans trail them all in life expectancy, infant mortality and a host of other health barometers.
Here’s 10 ways a similar, single-payer-type system, would benefit all Californians, not only those who profit in healthcare:
1. Everybody in, nobody out. Universal means access to healthcare for everyone, period — the desire of 81 percent of all Californians, as reported in a recent Field Poll.
2. Portability. Even if you are unemployed or lose or change your job, your health coverage goes with you.
3. Uniform benefits. No Cadillac plans for the wealthy and Moped plans for everyone else, with high deductibles, limited services and no protection in the event of a catastrophe. One standardized level of comprehensive care no matter what size your wallet.
4. Prevention. By removing financial roadblocks, a single-payer system encourages preventive care that lowers an individual’s ultimate cost and pain and suffering when problems are neglected, and societal cost in the overutilization of emergency rooms or the spread of communicable diseases.
5. Choice of physician. Most private plans restrict what doctors, other caregivers or hospital you can use. Under a single-payer system, patients have a choice and the provider is assured a fair reimbursement.
6. Ending insurance industry interference with care. Caregivers and patients regain the autonomy to make decisions on what’s best for a patient’s health, not what’s dictated by the billing department or the bean counters. No denial of coverage due to pre-existing conditions or cancellation of policies for “unreported” minor health problems.
7. Reducing administrative waste. One third of every healthcare dollar in California goes for paperwork, such as denying you care, and profits, compared to about 3 percent under Medicare, a single-payer, universal system.
8. Cost savings. Numerous studies suggest a single-payer system would produce the savings needed to cover everyone, largely by using existing resources without the waste. Taiwan adopted a single-payer system in 1995, boosting health coverage from 57 percent to 97 percent with little if any increase in overall healthcare spending.
9. Common sense budgeting. The public system sets fair reimbursements applied equally to all providers while assuring all comprehensive and appropriate healthcare is delivered, and uses its clout to negotiate volume discounts for prescription drugs and medical equipment.
10. Public oversight. The public sets the policies and administers the system, not high-priced CEOs meeting in secret and making decisions based on what inflates their compensation packages or stocks.
While our politicians debate inferior alternatives, it’s up to all of us to insist that Californians deserve the best.
Deborah Burger is president of the California Nurses Association.