Monday, October 29, 2007

The need for National Health Care

When I presented at the Emergency Room of St. Francis Hospital with acute appendicitis back in late August, I was told there would be a seven and a half hour wait. I actually only waited about five hours because I collapsed on the floor and couldn't get up even though someone on staff demanded that I sit in a chair while I waited.

The reason for the wait, of course, is because emergency rooms, by law, are not allowed to turn anyone away and are therefore used as a primary care facility for the uninsured. Most of the cases seen there are not true emergencies. Or many would not have been if the patients had received appropriate medical care before the situation had progressed to a state of urgency.

Who can claim that such is a desirable state of affairs? Even the rich sometimes have to use emergency rooms.

I want to call your attention to an article called "Say Yes to National Health Care" by Michael Hochman and David Himmelstein. Here's part of what it says:

As doctors at an urban hospital, we see uninsured patients in the emergency room with serious illnesses that easily could have been prevented with appropriate preventive care. We waste countless hours filling out unnecessary insurance forms. And we listen to patients complain about the complexities and hassles of navigating the health care system.

This is why an increasing number of us on the front lines have started calling for meaningful change in the form of a single-payer system in which the government funds health care.

Next weekend, proponents of single payer will gather in Washington for the annual convention of Physicians for a National Health Program. Our group has proposed giving every U.S. resident a health care card entitling him or her to all medically necessary services. The new program would be funded by an increase in taxes, but that would be fully offset by savings from abolishing insurance premiums and many out-of-pocket health care costs. Those wanting cosmetic and other medically unnecessary services could still pay out of pocket.

Opponents of a single-payer system argue that single payer could be even more inefficient and bureaucratic than the current system. They point to other countries, such as Canada, that have national health insurance and yet have long wait times to see doctors.

But research supports the opposite conclusion. For example, a 2003 study published in The New England Journal of Medicine found that the average overhead of U.S. insurance companies is 11.7 percent, compared with 3.6 percent for Medicare and 1.3 percent for Canada’s national health insurance program. And the waits in Canada are a result of Canada’s low level of health spending - on a per capita basis, about half that in the United States. The efficiency of Canada’s national health insurance program coupled with our current high level of health funding would yield the world’s best health care system.

These are doctors talking. We need to listen.

One positive result of a National Health Care system is that emergency rooms would finally return to being used only in bona fide emergencies. And that way, people in severe pain would be seen quickly.

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