Wednesday, June 17, 2009

Health Care Reform, Socialized Medicine, Bankruptcy & Michael Moore

President Bush announced that he believes in democracy and that democracy can exist in Iraq. ‘They can have a strong economy, they can have a good health care plan, and they can have free and fair voting’. Iraq? We can’t even get this in Florida.” – Jay Leno, American TV Host and Comedian (b. 1950)

Four years ago, at age 72, my Dad had a triple heart bypass operation. After having had one heart attack back in 2001 from which he made a full and speedy recovery, his doctor advised him that another was likely and that he may not be so lucky the second time around. Sixty one years of smoking had taken their toll. The problem was we didn’t realize how much of a toll until Dad was admitted to hospital for the procedure. Back in the day when the VHI had a 100% monopoly on the Irish private healthcare market (as opposed to the 80%+ monopoly they have today) my Dad was lucky enough to have good coverage, so he was able to have his procedure carried out at the Mater Private hospital in Dublin. The doctors told us that the procedure itself would be pretty straightforward and factoring in a few days post-procedural recuperation in the Mater, he could expect to be home within 7-10 days. However, as I already mentioned, 61 years of smoking had taken their toll, so much so that after the operation, my Dad’s lung capacity was so low that his lungs could not support his heart without the application of oxygen from a machine. This continued to be the case for another four weeks and while we waited for Dad’s heart to grow stronger, he was simultaneously being eased off of the artificial oxygen.

After 6 weeks Dad came home and made a full recovery. Then the bills start to arrive; actually correction, let me refer to them as statements. All told, the entire cost (to include consultants fees, lab fees, surgery and stay at the Mater Hospital) came to somewhere in the region of €50,000 - €60,000 ($70,000 - $84,000 for my greenback loving American friends), and maybe even more. The reason I say statement as opposed to invoice – Dad’s portion to be paid? Zero. Everything was paid. At the time I believe his annual VHI premium was approximately €700. So, did having private healthcare insurance, even with a provider that had a 100% monopoly on the market, at a premium that was eminently affordable, pay dividends for our family? Absolutely.

The provision of universal health care for all Americans has been an issue that has been a central plank of the Democratic Party agenda in the United States for half a century. Ever since the introduction of Medicare (a social program that provides hospital insurance, medical insurance and a prescription drug plan for citizens aged over 65 and certain categories of disabled citizens) by the administration of Lyndon Johnson in 1965, successive Democratic presidents have tried, unsuccessfully, to pass legislation that would provide universal medical, dental and mental health care for all its citizens. It’s a widely known fact that the United States is the only country within the coalition of nations that would be categorized as “wealthy and industrialized” that has not implemented a universal health care plan. Former first lady Hillary Clinton and long time senator Ted Kennedy are just two of the most high profile public representatives that have dedicated much of their political lives to the advancement of the argument of universal health care for all Americans and its passage into law. Historically, even when the Democrats have held majorities in the House of Representatives and/or the Senate, the long arm of the drug, pharmaceutical and insurance companies and other stakeholders in the debate has been able to embed itself into the body politic of the country and wield tremendous influence and power among the nations’ politicians, both Republicans and Democrats alike.

That being said, Republicans have never wanted universal health care, period. It has never been a priority for them on any level and they have fought tooth and nail to impede debate on the matter and to consistently vote down proposals to advance the implementation of even the most basic universal health care plan. Their opposition is, at least to my mind, almost entirely along ideological grounds. You consistently hear the words “socialized medicine” being used by prominent Republican politicians, big business tycoons and far right commentators, as if the word “socialized” is designed to drive fear into the minds of Americans that the concept of universal health care is some kind of communist based, big government, liberal, left-wing conspiracy. In fact, most famously, back in 1961 then private citizen, B movie actor and prominent Republican supporter Ronald Reagan recorded an 11 minute LP record, sponsored by none other than the American Medical Association, setting out his opposition to “socialized medicine”.

The hard facts are that today there are almost 50 million Americans that have no form of private medical insurance at all. A large percentage of those that are insured are paying extraordinarily high premiums for what I would consider to be average cover. For example, my wife and I recently enrolled in my company sponsored health plan that provides medical, dental and optical cover. Luckily, my employer is a Dutch company, so from a cultural perspective they understand the benefits (not only a human level but also in terms of them being a good corporate citizen) of providing a high quality health care plan to its employees. When my wife and I were private contractors our joint annual medical premiums totaled almost $7,000. The huge cost of health care coverage in this country has sadly forced hundreds of thousands of people to declare involuntary bankruptcy. Michael Moore did a masterful job of highlighting the issues that Americans face every day in relation to health care costs in his movie “Sicko”.

The two most basic elements of the argument being made by those folks in favor of universal health care are that a) health care is a basic human right or entitlement and that b)ensuring the good health of all citizens ultimately benefits a country economically. The opposition proponents argue that health care is not a right and that as such it is not the responsibility of government provide health care to its citizens. Maybe it’s me but why does it always seem that the anti-health care people are the more well-off and affluent members of our society?

President Obama has vowed to pass landmark legislation in his first term that would finally bring America into the mainstream in providing a universal health care plan for all its citizens. It seems more and more likely that he will actually send up legislation this year to the Congress for passage into law. Let us wish him luck in this brave and momentous endeavor.