some of what i'm thinking, i've been thinking for a long time. some of it was stirred up a bit by a rant someone in my networking group gave about the proposed change to our healthcare system - i.e. a move to nationalized health care instead of private. he was against this re-organization and made a lot of statements i didn't agree with, but a lot of people in my group did. and this is still bothering me. a lot.
the idea of universal health care appeals to me immensely on the whole, as a general concept. there is certainly more than one way of getting to this end point, lots of variations on a theme - any of which i would find preferable to the current state of affairs. currently, there are approximately 45 million people in the UNITED STATES OF AMERICA without health insurance. seriously, 45 million. and it's projected to hit 56 million in the next decade. i don't know about you, but this makes me angry, and ashamed. here we are, proposing to be the world's superpower, to be a civilized nation that brags about the "best health care in the world," and 45 MILLION people don't have insurance...which means they likely don't get the health care they need (and if they do, it's often too late and expensive and the rest of us pay for it - more on that later). so, for me, more than any of the other arguments this is the the one that gets me. it's appalling for me to think that there are people who don't care that this huge portion of our country is without basic care.
moving on. the big point that was brought up at my meeting was that if we move to a nationalized health care plan that we will still have to pay for it, and possibly pay more. he railed a bit against a single payer system saying that people who supported this didn't realize that we all would be paying for it. but the thing is, we already pay for it. we pay for private insurance, we pay hefty medical bills, we pay for the relentless paperwork and administrivia, we pay when the 45 million uninsured end up in the ER and can't pay. so yes, we would have to pay for for a single payer system - most likely in the form of taxes, but we'd all have health insurance coverage, and we'd make the system hugely more efficient. (another single payer link).
of the other points that were made against a nationalized health care plan - that you won't be able to choose the care you get (i.e. the goverment tells you what you can and can't have), that there are long wait times and that it's "just like medicare which is bankrupting this country." i don't have answers to everything, but what i can say to these points is this: that in all the nationalized/single payer (or some variation on this theme) systems that other countries have - you can still get elective surgery. yes - wait times are generally longer for this. but, what's the wait time on elective surgery for people in this country who are uninsured or underinsured... a long time, or never. so for me it's a bit of a non-argument. i don't ever think we'll be in the position where goverment will dictate what procedures you can and can't have (again, nationalized health care is not socialized medicine - the doctors are still in the private sector - they would just get paid by the government instead of your insurance company) and as it happens, half the time your insurance company dictates this anyway.
and while no system is perfect - there is certainly the possibility for change and improvement. in other countries that currently operate some sort of nationalized health care (UK, NZ, Canada) the populations report a greater satisfaction with their health care than we do here in the US. and these countries (and thereby citizens) are spending WAY less on health care than we do. and they're happier with what they get. and everyone is covered.
so along with a system like this some changes would happen in the administrative arena - clearly having a single payer simplifies things enormously. currently the amount of paper work physicians (and other health care providers) have to do to get re-imbursed is insane - not to mention if often varies from payer to payer. the administrative cost add up to some like 1/3 of all the health care costs in america - these would be dramatically reduced in a single-payer system. less time doctors have to spend on paperwork = more doctoring they can do - and that's the part they're good at. also, it is likely (and there are already proposed measures) that we would move to a electronic medical record system (EMR) which makes sharing health information much more efficient and reduces the number of redundant tests/diagnostics due to poor communication between providers. also, saves paperwork and paper (yay for the trees!). all of this makes medical records more accessible to patients and to their providers meaning care is more efficient and most likely more effective.
all this ties in with another recurring thought i've been having about health care in this country. it is SO based on reactionary care and not prevention. and i get it, prevention isn't sexy. there aren't cures, and dramatic outcomes and really, it's hard to sell. but that's because our paradigm needs to shift. and this is a whole other post... so more on that later. but with it's relation to a single payer/universal/nationalized health care system - think about it. if you have access to health care, if we ALL have access to health care - aren't we more likely to participate in prevention; to take care of ourselves because we have the resources; to stop injuries/illnesses from escalating because we can get care instead of leaving it til too late? all these things make us healthier, not only as individuals but as communities and society. if we're all taking preventative care, then we're all much less likely to get sick, and get someone else sick... it just makes so much sense. and all of this means it is SO much more cost effective...
it's a bit of a no-brainer to me. and as i said, it's not perfect, nothing is. but it is BETTER than having 45 million people uninsured and countless others under-insured. we can do better than that. we really can.
here are a couple of links to a blog (that has a lot more research and coherent writing than mine) looking much more in depth at health care costs in the US and what the systems look like in other countries (also, check out his other posts on health care systems in France, Germany, the Netherlands and Australia).