Big Health Care Paper

What should the United States strive for in a national health care plan, and what factors have contributed to our lack of universal health?

America was the first country to land on the moon and the first to fly a plane. We've been setting social trends for the world since the 1900's. Most every world culture has become "Americanized", yet through all of this, we remain the only modernized country without universal, government paid, or single payer health care. This is an idea known as "American exceptional ism". Basically we are the only exception to the rest of the developed world which has a universal health care system in place for its people.

In America, we have HMO's (health maintenance organization), a privatized health care industry, which is a basic health care organization where those with HMO coverage are covered for care provided by a network of doctors and specialist who are registered with the HMO. Care that is provided outside of the network is not covered and their is discretion on the part of the companies to determine what can and cant be paid for. This is what the industry calls pre- existing conditions, and is the source of the countless lawsuits against the HMO's who try and provide the least care they are legally bound to provide. Because of these "pre- existing conditions" many patients are denied very vital care and often die or go broke trying to pay for the care themselves. In a system like this, it makes you wonder why after the 36 years (first created in its current form in 1973) since the program was started, it has not been replaced?

The problem in America is that we have a massive lobby for the health care industry in our nations capital. According to Michael Moore's film SiCKO, the health care lobbyist to senator ratio is 4 lobbyists for every senator. What this shows is how unavoidable it has become for senators not to push legislation and vote in favor of legislation that supports the health care industry. The way i think about it, is that if you have 4 people who constantly are giving you "gifts", large cash donations, and buying you meals, their own agenda will eventually make their way into how you vote and what you publicly support. With the creation of the HMO (health maintenance organization) system, health care has become an industry with a vested interest in making a profit (just like any other capitalist for- profit company). If this system worked, that would be one thing, still corrupt, but functional. Instead, the united states has a global health care rank of #37, just below Costa Rica (#36), and right above Slovenia (#38). For one of the worlds wealthiest countries, a ranking of 37 for the health care of its people is simply unacceptable.

This system can mostly be attributed to former president Nixon who, signed into law what is known as the HMO. This HMO- for profit medical organization was founded by Henry Kaiser and Sidney R. Garfield in 1945, but remained an option for care, not the dominant national plan. In 1973, Henry's son Edgar Kaiser proposed to John Ehrlichman (the Chief Domestic Advisor to Nixon) that America adopt his fathers program on a national level. Ehrlichman than proposed this plan to Nixon in a meeting that can be credited with the birth of privatized health care. A part of the transcript from the meeting is as follows.

Ehrlichman: “This, uh, let me, let me tell you how I am …”

President Nixon: [Unclear.]

Ehrlichman: “This … this is a …”

President Nixon: “I don’t [unclear] …”

Ehrlichman: “… private enterprise one.”

President Nixon: “Well, that appeals to me.”

Ehrlichman: “Edgar Kaiser is running his Permanente deal for profit. And the reason that he can … the reason he can do it … I had Edgar Kaiser come in … talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because …”

President Nixon: [Unclear.]

Ehrlichman: “… the less care they give them, the more money they make.”

President Nixon: “Fine.” [Unclear.]

Ehrlichman: [Unclear] “… and the incentives run the right way.”

President Nixon: “Not bad.”

After this conversation, Nixon went on to green light the HMO act of 1973 which was essentially Kaisers plan. What resulted, was the variant of HMO which we use in America today, called the Kaiser Permanente. Health care became an industry which was no different at a basic capitalist level than the auto industry. Ehrlichman proposed this for profit system to the president for the very reasons that make the Permanente an extremely corrupted and broken system today. Since 1973, Kaiser has continued operation, now in 9 states, with a non- profit corporate status. This non- profit corporation however generates an annual revenue of $22.5 billion, to me this seems like a profit.

I think that we need to move away from this HMO system as fast as possible, and towards universal health. Right now, President Obama is proposing a new health care system which does not replace the old HMO, but rather improve it. According to his website, the new plan gets rid of the main problem with the for- profit system; pre-existing conditions. In his plan, insurance companies will now be required to cover pre- existing conditions, therefor getting rid of a large part of the incentive to provide less care to generate a greater profit. Another positive step with his plan is that Obama will ensure all of the 50 million uninsured Americans through a national government health plan modeled off of the health plan that members of congress have. This government health plan will for that matter be available to everyone in America who decides to choose government health care over HMO care.

When we were interviewing people on what they thought of the health care in the United States, our class interviewed a man named Kevin Ulysses Nelson III, who told us he had just finished serving a prison sentence for the last 27 years. He made what I thought was a very simple yet important point;

"The problem in the U.S. is not that the care is bad. The care is good, and the doctors are good. The problem is that not enough people have access to it. When not enough people can afford care, the system failed, and it did. The people working for the system in the hospitals, the clinics and elsewhere are all doing their jobs as well as they could given what the system allowed, these people did not fail."

When we interviewed Mr. Marx, he told us that he thought that the HMO system could never work. He told us that when you have profit factored into health care, profit will always take priority over the health of the people who generate the profit. He also said that he was against Obama's plan, but in favor of single payer health care.

"In single payer health care you have more freedom and choice in the system, while with Obama's plan, my fear is mainly of government bureaucracy, which I don't trust, being in charge of my health care"

Single payer health care is a form of health care payment for universal health coverage. Basically with single payer, you can go to any doctor or hospital you want, with payment coming from a fund which can be national, statewide or county based. It makes it so you can get the best care for free, with no restriction on where you can seek care. An example of a country with Single payer is Canada where the people receive free care, the hospitals are maintained through provincial funds, and doctors are paid by the government for their services.

This made me think about what the Obama plan is offering, a solution to fix the system, not the care. The Obama plan offers an improvement to the system if people wish to stay on the HMO plan, but it also creates an alternative to a system which is broken. It seems that the idea here is that by offering a better system, people may stay on their old health plans, but slowly people will move towards the government care once they see that they can get the same care they get for a premium with the HMO's, at a fraction of the cost with the public plan.

If we want to strive for the best possible health care system we can get, I do not think Obama's plan is it. I feel like it is a compromise of something which is supposed to be a right as an American. I believe that Obama does want to make a plan where their is no private health care industry and the HMO's are shut down, but the lobby in our political system is to strong and the plan would get shut down very quickly. By making a less drastic plan, Obama should be able to pass his plan, and in time the CIGNA's and Humana's will no longer find it profitable to compete with the government for the business of its citizens health, and we will have universal health in America at last.


Sources

http://www.kaiserthrive.org/about-kaiser/
http://www.barackobama.com/issues/healthcare/
http://www.photius.com/rankings/healthranks.html
http://en.wikipedia.org/wiki/John_Ehrlichman
http://en.wikipedia.org/wiki/Single-payer_health_care
http://en.wikipedia.org/wiki/Richard_Nixon
http://en.wikipedia.org/wiki/Distribution_of_wealth
http://en.wikipedia.org/wiki/Health_care_in_the_United_States
http://www.reuters.com/article/businessNews/idUSTRE51P84G20090226