National Health Insurance In America Part 1

President Clinton did not and now President Bush will not address health care reform in a way that deviates even slightly from the HMO and Managed Care Industries that have given large sums of money to both campaigns to keep them quiet. Thus these special interests maintain the status quo of the for profit health insurance corporations that have taken over the health care system in America.

Every day, approximately 100,000 people lose health insurance coverage in the United States. Over forty-four million Americans do not have health insurance at all. The people who have HMO's as their only choice of insurance routinely face rejection of payment when serious health problems arise. The doctors employed by HMO's make decisions about a person's health without laying hands on the patient. They do not examine, listen to or have any contact with the patient about whom life and death decisions are made regarding their health.

This is a human rights abuse in a civil society such as ours, or any other society, for that matter.

There are over 1500 insurance companies in America with different rules of what services will or will not be funded. Our facility has hired two people just to handle the health insurance questions that arise every day. They often have a frustrated and perplexed look in their eyes as they undertake to find solutions to problems, and then have to contact a faceless bureaucratic entity about whether or not a service will be paid for.

Health care providers must also take the time to speak to these people, to convince them to pay for proposed services. Letters must be written to convince the HMO/Managed Care bureaucrats to take a second look at what needs to be done for patients, to ensure good quality medical care.

Health care workers have accepted the unacceptable and do not seem to know the way out of the quagmire.

I once helped to raise $3,000.

00 for a seven year old patient who was in an automobile accident, and suffered a lower spinal cord injury. He is paralyzed from the waist down. The proposed goal for the fund raiser was to buy a handicapped accessible van. Since these vans cost anywhere from $15-30,000.

00 dollars, the family bought a computer, instead, enrolled the boy in a study offered online by the Shreiner's Hospital in Philadelphia for spinal cord injured patients.

At the fund raising dinner, I sat with the patient's grandmother. She told me she wanted the money to be put in a trust fund to pay for the child's catheter supplies, diapers and medicine that the Managed Care Insurance company would not pay for.

"Wait a minute," I said. "You mean you are paying for all of the supplies out of pocket without insurance reimbursement?""Yes," she said.

Back in the office the following week, one of the women whose job it is to deal with insurance questions, solved the dilemma and the supplies are now paid for. The child's mother had receipts, and the HMO reimbursed her from the time of the car accident.

I wondered why the insurance company did not automatically pay for these services? If I had not helped stage an elaborate fund raising event and had dinner with the boy's grandmother, this revelation may not have surfaced. A Universal Single Payer health care plan would make it possible for all people to get the services they need and free up doctors and nurses to give the care that people deserve, plus fulfill all of the reasons doctors and nurses entered their respective professions to begin with: to be of service, to help other people and to bring healing to patients and their families.

Physicians for a National Health Program in America have devised the following plan for implementation. For more information, please access www.pnhp.org.

National Health Insurance, if implemented, would minimize any disruption to the current health system because health care delivery mechanisms would remain in place while only the financing mechanism changed. Single Payer National Health Insurance would resolve virtually all of the major problems facing America's health care system, today.

Single Payer Insurance is defined as a single government fund with each state which pays hospitals, physicians and other health care providers, thus replacing the current multi-payer system of private insurance companies and other plans.

It would provide coverage for the forty-four million people who are uninsured.

It would eliminate the financial threat and impaired access to care for tens of millions who do not have coverage and are unable to afford the out-of-pocket expenses because of deficiencies in their insurance plans.

It would return to the patient free choice of health care provider and hospitals, not the choice that only the restrictive health plans allow.

It would relieve businesses of the administrative hassle and expense of maintaining a health benefits program.

It would remove from the health care equation the middleman-the managed care industry-that has broken the traditional doctor-patient relationship, while diverting outrageous amounts of patient care dollars to their own coffers.

It would control health care inflation through constructive mechanisms of cost containment that improve allocation of our health care resources, rather than controlling costs through an impersonal business ethic that robs patients of care so as to increase profits for the privileged few.

Single Payer Universal Health Care would provide access to high quality care for everyone at affordable prices. This would be beneficial for individual business as well as the government.

So why don't we have a National Single Payer Plan?