National Universal Health Care: Could It Really Work?

October 10, 2009

by Russell Longcore

I was in a hotel room in Nashville, Tennessee on Wednesday evening, October 7, 2009. I randomly and fortunately surfed channels and landed on MSNBC, where commentator Keith Olbermann was just beginning to talk about health care in America.

I sat for the next 60 minutes absolutely glued to the TV.

Mr. Olbermann made the most eloquent speech I’ve heard about the state of health care in America. You should hear this speech.

You can watch his comments by clicking on this link below. I strongly urge you to watch this program. Copy and paste this link into your browser:

Keith Olbermann Health Care Comments

The Declaration of Independence states that we are endowed by our Creator with certain inalienable rights. That AMONG these (not JUST these) are Life, Liberty and the Pursuit of Happiness. That to secure these rights, governments are instituted among men.

Life. The right to life. This article is about what we as a society are doing, and should do to protect our right to life, and life itself just for the sake of life. Not abortion…that’s another article.

As Keith points out, this debate is ultimately about DEATH. The prevention of death…the avoidance of an untimely death or a premature death is the very definition of health care. Because, let’s face it…there is a lot of stuff out there that can kill you if left untreated. A simple infection in a cut on your leg can kill you if left untreated.

Over time, the health care debate had degenerated into a debate about insurance coverage. Then the trial lawyers jumped in with malpractice issues. Then Big Pharma chimed in, wanting to argue for new drugs and sell the old ones. Then the Medical Associations answered the call, and joined the debate. Everyone seems to have a dog in this fight. Pitifully, the ones who aren’t being heard are the people for whom all this health care fighting is about.

Does insurance have to define the debate? Do the insurance companies have to be a participant in the health care system? I say no.

Insurance companies are just like any other company in one respect. They exist solely to return a profit to their shareholders. Insurers use their claims processes as one tool to hold down expenses and maximize profits. That means that they constantly seek ways to delay, deny or defend claims. So, their very stated purpose for existence is opposed to universal health care.

The insurance companies, in league with Congress, have had a large hand in making the health care system in the USA a sinking ship. And, because the insurance companies hold such a large amount of government securities as investments, they hold the US federal government hostage to their desires. But their desires have resulted in a health care system that doesn’t work.

In 2008 the World Health Organization carried out the first-ever analysis of the world’s health systems. Using five performance indicators to measure health systems in 191 member states, it found that France provides the best overall health care followed among major countries by Italy, Spain, Oman, Austria and Japan.

The United States ranks 37th…yet it ranks first in money spent on health care as a percentage of its Gross Domestic Product (GDP).

So we spend the most and get a product that is inferior to 36 other nations.

According to the Centers For Disease Control, the USA ranks 29th in infant mortality rates among nations. The US average is 6.9 deaths per 1,000 live births. However, black infants die at the rate of 14. 1 deaths per 1,000. The US average is three times higher than Singapore, who has the lowest infant mortality rate at 2.3 per 1,000 live births. Dismal and embarrassing, isn’t it? Your baby has a much better chance of living in Cuba.

Any state that successfully secedes from the United States will have the opportunity to create a brand new health care system for their new nation. They surely won’t want to replicate the failed American system for themselves.

The most important question of all is this: Specifically, who is going to pay for any individual’s health care? Will we each go it alone, and let our own wallets be the measure of our quality of health care? Will we all agree to pool our money together to take care of ALL OF US?

We as a society have already tacitly agreed to tax-funded health care. That is what Medicare, Veteran’s Administration benefits and Medicaid is…tax-funded health care. So, the indigent get tax-funded health care. Those over 65 get tax-funded health care. Veterans of the Armed Forces of all ages get tax-funded health care.

What about the rest of us?

Let’s use Texas as an example. Texas has an economic output equal to that of the entire nation of Canada. Canada has universal health care, although their system seems to be inferior to others. Many Canadians come across the border for health care that they cannot get in Canada in a timely manner. But Canada can afford universal health care because they are not trying to be a worldwide empire.

It seems to me that if the citizens of New Texas decided that they wanted a single-payer health care system funded through their own tax dollars, they could do it. It is just simply a matter of priorities. Rather than funding war, or foreign aid, or a standing military, or a million other wasteful uses of tax revenue, Texans could decide to fund….human life.

All of the other spending shown in that last paragraph takes tax revenue from the entire population and bestows it on small groups of people. A single-payer health care program would take tax revenue and bestow the benefits on the entire population of the nation. The tremendous advantage for a new nation is that they can invent a new health care system unimpeded by the vestiges of the old system.

What would happen if we took out a clean sheet of paper and started to invent an entirely new health care system, funded by the taxes collected by the entire new nation? Could we design a health care system completely disconnected from insurance? Can we design a system that cares for people without violating their other rights? Could the system work without corruption and politics?

Lots of people think that single-payer health care is socialism. But is a single-payer system socialism? Not by the truest definition of Socialism. Webster defines “socialism” as “a theory or system of social organization that advocates the vesting of the ownership and control of the means of production and distribution, of capital, land, etc., in the community as a whole.” In my opinion, funding a single-payer health care system does not qualify to be labeled “socialism.”

This new health care system would be more like an association than insurance. Traditional insurance covers unexpected but predictable occurrences. The old concepts of insurance and risk must be put aside. Single-payer healthcare is NOT INSURANCE in the strictest sense. It is a benefits program into which tax revenues flow and from which health care payments flow out to health care providers.

Here is what a national single-payer health care system might look like. Let’s call it “Texacare.” This takes the best characteristics from health care systems around the world.

1. Funding through some method of taxation, possibly a sales tax. That would collect revenue from non-citizens who get no benefits. That would include tourists, other non-citizen residents of Texas, or illegal aliens.

2. No individual underwriting. All living persons of national citizenship are covered from birth to death. No health or disease exclusions.

3. No deductibles. Copay for any doctor visit from $20-$100.

4. Prevention-based health care at the General Practitioner level will encourage citizens to adopt healthy lifestyles. Doctor compensation based upon health of the patients. Healthier patients, doctor makes more money.

5. Medical school 100% paid by Texacare in exchange for 10 years service as a Federal employee. This would include additional training in medical specialties. Compensation levels could be set lower since there would be no school debt for the new doctor to repay.

6. Insured persons are free to choose their own doctors, which will bring market forces to bear in quality of care.

7. No pre-certifications necessary for any medical procedure.

8. Some elective surgery, like plastic surgery procedures, are not covered by Texacare.

9. Texacare system includes mental health, nursing home and hospice care.

10. Texacare negotiates prices for pharmaceuticals, medical procedures and medical supplies. Texacare determines wages for all medical employees, including administrators, nurses, med techs and doctors.

11. Tort reform. If health care was universal from cradle to grave, torts would be limited since the patient would automatically be eligible for additional medical care required by malpractice, an unintended consequence of treatment or a medical complication. Doctors would still be liable for negligence, but awards would not need to compensate the individual plaintiff/patient for anticipated medical care costs into the future.

12. Electronic Medical Records, a database of all medical records for each patient, accessible by all medical providers, would be established. Would eliminate all medical records duplication. Living wills and advance care directives would be part of every patient file. This has the potential to drastically reduce end-of life invasive care and duplication of procedures.

13. Individual health insurance policies would still be available in the free market for those that wanted a higher level of care, and would be excess insurance, like a Medical Supplement policy.

14. Private medical providers, including doctors and hospitals, would still exist, offering custom care for those willing to pay extra for it.

15. No lifetime maximum benefit limit.

I’m sure that there are considerations that have not been addressed in this article. But make no mistake. New nations like a New Texas will have to deal with this thorny issue very early in the planning and formation stages. Let’s hope that the decision makers surround themselves with the brightest minds available and craft a revolutionary new health care system that is the envy of the world.