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NATIONAL HEALTH CARE
CONCEPT an unofficial publication of Why Nots, a provocative quandary into the lack of responsibility of the nation's citizens and elected politicians as to why there is not a functional National Health Care Plan |
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It is a false belief that having a National
Health Care system would decrease quality and/or efficiency through
values of socialism. Such a dirty word! Let's look at the definition
of socialism, and look in a mirror to see if hypocrisy is the real
issue. We apply the concept in the daily lives being United States
American citizens and refuse to the same concept to complete the circle
for health care?
"A political and economic theory of social organization which advocates that the means of production, distribution, and exchange should be owned or regulated by the community as a whole." Such an open ended meaning! But what if the socialism aspect was only applied to the meaning of paying for health care, and not change anything else of the health care management? The definition above can be applied to our use of the 911 system. There's a centralized focus to call for services and payment through taxes for roads, Worker's Compensation, and in some locations, how trash is taken care of. Hello! This is socialism at it's finest. Some people need to get off their pedestal barking about not going to be subjugated into socialism, when those same people benefit from the same socialism they have willingly become submissive to! People in today's society, most often think that someone else will pick up the ball when there is a problem. This country, the United States, does not have a functional or comprehensive National Health Care plan. Or do we? There is no reason we do not. One question that should also be pondered while reading the rest of this, is what does it mean to be a United States' citizen? Could one element of being a United States citizen include taking measures to become aware of issues and getting involved? Could one element include the understanding that the name of the country is the United States [in] America, and not just America. America is the name of the country country as well as the functional name of three land masses which make up the western hemisphere. They are North, Central and South America. Does the simple concept, that united means to include everyone? So, instead of let's "Make America Strong Again", now focusing on the complete name of the country, let's make the United States united again! Voting, jury duty, and involvement are all key elements and privileges of being a United States American citizen. Yes, jury duty is a privilege! So many think they are patriotic when actually they are hypocrites when they are chosen for the privilege of jury duty and complain! Being a citizen of the United States of America is supposed to have a sense of pride and prestige. Don't call a central billing and paying structure that will provide and ensure health care for every citizen to be 'socialism' as if the concept is negative without understanding an applied concept that could be enjoyed by everyone in the United States of America. The development of technology has fascinated and bewildered all of us. Whereas, people have not always been as responsible as others think we should be, it's easy to get caught up in wanting the next Smartphone, home theater system or go to Disney. Who is responsible to assure one's self and one's family has access to affordable health care? The government has already overseen, to an extent, as to a set price of medical office visits and procedure reimbursements through a set system. Whereas, this has not been a perfect system, it has been very effective. At times, services are billed higher then the rates set by the government, and the difference falls onto the finances of the patient or appointed medical guardian. The main focus, often falls on having insurance. Who should bear the cost when the freedom of choice includes buying that Smartphone or going on a cruise instead of procuring medical insurance when a medical emergency occurs? Often times a person that cannot afford the out of pocket medical expenses are those who chose a new 4K TV over procuring medical insurance or plan savings! The people who are paying those expenses, doesn't know the person seeking help, but the public at large has higher health care insurance directly relating to increasing medical costs to compensate for those who are not responsible and choose hub cap spinners over health insurance. Can it be said, that in a country of freedoms, that these freedoms, should be restricted when it poses personal or financial harm to others? Isn't there a "Freedom of Speech" in the Bill of Rights? But, it's illegal to cause panic, potential injury to others, if you yell "FIRE!" in a movie theater. Many United States citizens are unaware of this! Anyone can hear the complaints that we don't want socialized medicine. Having a National Health Care plan, would not mean we are becoming Communist or Socialist. But, there are circumstances when a socialistic approach in a society, even a free society should be addressed. We don't subscribe with a specific 911 service for paramedic, firefighter or police, do we? These services are organized and paid for through taxes. The United States of America already has oversight standards for medical care. Why do we not pay for health care as we pay for emergency services, through taxes? In other countries, if a new road is built in the community, the bill is incurred by those who live on that road and not paid through taxes. As a nation, we have great sympathy for the sick, injured and needy. Why as a nation, are we not accepting those with preexisting conditions? Yes, it will be costly. If there was a National Health Care Plan, it would be impossible for a preexisting condition to exist! To come up with or even debate over a government intervention that does not address health care for every citizen of this country, is not acceptable. The problem is, if the population got involved, voted, and wrote to the powers that be, there would not be a health care crisis. Many people are involved, but it's not enough for sporadic involvements. To create a system that does not provide for every single citizen of this country is not only just unacceptable, but pure ludicrous! The name of the country is the United States of America! That means, that each and everyone one of us has to get involved! Whereas President Obama made great progress, it still was not looking at the nation as a whole. He seemed to have a foundation, using the Oregon Experiment as a model, but something happened, that only focused programs and possibly a million more people obtained access to care. This seems to be a great achievement. However this achievement missed the mark! There's approximately 370,000,000 people in the United States. One million more people with access to care. Wow! A million more people! Awesome! Let's be realistic, and attenuate that awesomeness! This great achievement only affects 0.27%! Through the processes of Congressional and Senate debates, political games of hands washing hands, health care plans continue to be fragmented. Or, maybe, President Obama wasn't trying to implement more of this focus as much as this author hoped for. President Bush strongly inferred on how stupid United States citizens are when addressing Social Security with words to the effect, “the people just don’t know that Social Security does not have it’s own account, but is drawn from the general slush fund”, in his last State of the Union Address. Yes, that was a few years ago. How is it that very few people, actually heard what he said? Other than being insulted by the accusation of how stupid United States citizens are, but he just identified the problem that social security does not have it's own budget! Why not? Why could not the identified problem be dealt with a comptroller and an appointment for an Undersecretary of Treasury for Social Security. If the coffers start to dwindle, Congress, the Senate and the PotUS can focus on a particular strategy, without having to redraft the entire U.S. budget! Would this not allow for better government focus to pay attention to this detail and potentially be a greater effective government? Can not the same be said for Healthcare with a focus on this subject and the appointment of an Undersecretary of Treasury for Healthcare? The main problems with not establishing a full health care plan is OWNERSHIP and FRAGMENTATION. It’s a fair assumption, that most in political power rarely have a problem with access to or the ability to pay for health care for themselves or their family. It’s not a fact of insolence, arrogance or lack of intelligence, but innate ignorance related to not having the need. The topic is not personal for them! Thus, the urgency or a completeness of desire is not personally realized as required in creating or discoursing a plan to assure all citizens are protected and provided a reasonable health care access and affordability. There is a need to create a foundation within the government to convey the values of our forefathers to provide for a legal and moral obligation for ownership within the government. Democrats or liberals, simplified view, encourages government involvement for the good of the people. Republican or conservative, simplified, wants to preserve personal responsibility for the good of the people and drag implementation of interventions to assure the right thing is being done. Both views are good. Basic logic, as in math, requires the identification of a common denominator. The common denominator is the nation as a whole, a united nation as in the "United States of America". Factors currently publicly ignored for a true intervention for such a subject as for the government to take full responsibility to oversee and provide for a full health care plan for it’s citizens will require waking up and/or insulting many. The insult to personal choice and attenuation to business institutions will be inevitable. The political and personal gain will be the prestige of being an United States of American. The shining greatness of the outcome will make the United States truly united again and set the stage for the entire world to see this country as a model to follow again. How do we address a comprehensive financial health care plan for EVERY citizen in the United States. How could this happen? Wouldn't the cost be too much? Is this delusional? Can there be a way? Please remember, I pointed out one problem is that of OWNERSHIP? Let’s fix that. Okay, the active word in the previous sentence is ‘LET’S’ as in, ‘LET US’. It’ll take letters like this one to be sent to senators, representatives in the house and to the President of the United States (PotUS). We have to be united for the next step. The people of the United States has an introduction to support the premise of having a governing body.
The fundamentals of the Preamble to the Constitution is a great step or foundation to address government ownership to require access to and financially capable ability to receive reasonable and appropriate healthcare. And, yes, as with someone rationalizing and manipulating statistics, I am focusing on the phrase, “... promote the general Welfare, ...” The Preamble is not law or an imperative, but I believe and trust that it has great value that was foreseen by the writers, which could further reinforce morals and values to promote a constitutional amendment requiring government oversight. A constitutional amendment to add to the umbrella of the bill of rights, would force that ownership, by law, that is not innately felt by most politicians. Look at the 8th amendment, which protects people from having bail or fines set at an amount so high that it would be impossible for all but the richest defendants to be able to pay. Sure sounds like a parallel to healthcare in today’s world with less snake oil and liniment therapies and more technological efficient diagnostic tools. Now, look at the 9th amendment which provides that the list of fundamental rights is not explicit and exhaustive. There is no reason, with all the intellect of our leaders, that a constitutional amendment to assure that all Statesmen and Stateswomen (U. S. citizens) have the fundamental right for access to and affordable health care, unless they just don’t want to. You don't have to read that last sentence again, I'll restate it. Our leaders in Congress, the legislative branch of the government, consisting of congressmen, congresswomen and senators DO NOT want to create a National Health Care plan! Maintaining fragmentation to pass little bills to seem like they are doing a good job is the modus operandi for reelection. At this rate, without a bill of rights amendment, it will take our elected representatives hundreds of years to complete the task. Makes one wonder what it really means being part of a republic when the primary focus of the politician is the politician and not the country as a whole. WOW, now that OWNERSHIP has been addressed, let’s hit FRAGMENTATION! Let’s see, Medicare, which covers about 20% of the population, and Medicaid about 25%. On the job injuries, to include rehabilitative therapy is covered by Worker’s Compensation. Worker’s compensation covers injuries incurred going to and coming from work if not diverting to the pub in route to and from. Special governmental programs for those who have significant diseases or injuries have already been tackled by our great leadership in government, e.g., unemployed persons, those with chronic renal disease and black lung disease. Programs for prenatal care and preventive medicine within community health centers has also been in place for many years made possible through our political leaders. So, who is not covered? Military veterans and retirees (including their families) have health care coverage. College tuition often has low cost insurance provided to them. Why not? They make up some of the healthiest of the population. Delete all the fragmentation. Remove Worker’s Compensation from employer’s armory for a tax deduction and put that money in the employee’s paycheck. Don’t get excited, the government is going to take it back under what is now called Medicare for taxes. Let there be an undersecretary for Medical Services, just as there should be for Social Security. Let's not call it Medicare, but instead, Healthcare. Why? Because there should not be favoritism or restrictions of health care based on the state. This is the 21st century. We are the United States! Thus, Medicaid has no purpose if everyone is covered under Healthcare! What would this do? There would still need to be all those institutions managing allowable care. There would still be a need for insurance companies for what is not covered. Using the Oregon Experiment of the late 80's is a great model. An example of this concept would be, if a person fell while rock climbing, needed setting of a fractured femur, suturing a laceration of the face, and rehabilitation therapy. All these items would be covered with any applicable and deductible(s) and/or reasonable co-pay. However, two years later, that scar that is on the face, undergoes a revision at the person’s request. Just because the person was unhappy with how the laceration healed, the person's life was saved! This elective procedure would not be an extension of the original injury and not covered under a National Health Care Plan. If he/she does not have supplemental insurance, then 100% would be at the person’s expense. A scar revision would not be considered as a true health issue or an extension of that fundamental right embedded in the 9th amendment. Other examples, could include a more aggressive move to a hospice status for those at end stage disease or injuries where there is no statistical or therapeutic value for continuation of expensive therapies, medications and treatments, and thus preserving dignity at end of life would be considered appropriate use of hospice. Back to the yucky eight letter dirty word, “POLITICS”. Individual responsibility versus government oversight. Do we accept a gradual increase in taxes to pay for health care coverage system for 100% of United States citizens? Or do we continue to let voters choose the $700 smart phone that is updated annually by those who cannot afford a $100 medical bill? Those 22" hub cap spinners look great, but the owner won’t take his/her daughter to the Emergency Room because he neglected in the responsibility to provide for health insurance. By the way, spinners are very expensive! This lack of responsibility or choice of luxury will not work against the 102°F fever, risking a febrile seizure and ramifications that could present it's ugly head because of the seizure. Who protects the child from the risk of a parent that may not know that it's a poor decision to chose spinners over health insurance? The conservative, personal responsibility equation of a political party needs to be attenuated when looking at the nation as a whole. A stronger healthier nation can only help the country as a whole. Consolidation of all current government health care plans would grant a better grasp on costs or expenditures. Ownership through a constitutional amendment, would require a comprehensive action when a separate entity tries to take advantage of the public at large, as with the recent EPI-PEN fiasco. One cost saving method, would make mandatory reporting of those seeking care that are not United States’ citizens or having active Resident status or visiting Passport to Immigration authorities, just as a gunshot wound requires reporting to law enforcement. There is a small catch in the attitude of implementing such an undertaking! The year is not 1776! Nor is it 1787, the year the United States Constitution was signed. Health care or the right of health care was not a conceivable concept. The same context of the ignorance to write in the Constitution that people of color only count for 3/5ths of a vote, thus the inference of only being 3/5ths of a man? The point is, today's leadership in the country tries to interpret the intentions of what the great forefathers had. A new or updated set of values or threads of the Constitution needs to be overlaid on the old and outdated preamble to the Constitution to be current of the aughts and naughts which could be applied to the ideals of today. (Threads refers to an organizational philosophical focus with definition, i.e., values, mission, standards, objectives and possibly more. You can see how the Preamble to the constitution is a rudimentary form of this.) Small catch, is exactly the point. Today's country cannot be summed up with a direction on one piece of paper. Thus, the obstacle is for today's leadership to assure to account that the forefathers were totally oblivious as to life in the 21st century, nor the possibility that the document they conceived was so durable. The United States Constitution is the longest lasting constitution in the world. Thus, the permanence was possibly not contemplated as deep as needed. Back to the topic. Implementing a National Health Care Plan may seem overwhelming. Many want to say that a National Health Care plan is Socialism. But, do we not have a fragmented form of socialism already? We pay taxes. Those taxes pay for an emergency system to protect the community in the form of police, fire fighters and emergency rescuers. Has there been a community established that has to subscribed to the emergency service of choice? Does the neighbor subscribe to Joe's Firefighter Company, Mary's Ambulance Company and Fred's Police Department, while the other neighbor subscribe to George's Firefighter Company, Smith & Daughter's Rescue and 1-2-3 Police Department? I don't think so! That's a significant factor of socialism. Today, one has to get approval from their insurance company for procedures. This is not socialism? The only difference of what this author is proposing is who gets the bill! The process is not to change other than the elimination of Worker's Compensation, because it will be mute. Everyone will have to sign up with a health insurance agency with a minimal cost. This could be set as low as $10.00 per month ($30.00 quarterly or $120.00 annually). The charge could even be completely zeroed out, depending at level of income. Everyone would need a photo insurance card. Proof of insurance can be taken to the driver's license to be incorporated onto the license. Just like there is a 30 day moratorium to submit changes of address on driver's license, the same would be true to changing the health insurance. Children outside the nuclear family model would need an identification card. Driver's License / Identification cards would be the modality to verify citizenship. Thus, innately would be the boarder wall! Okay, now citizenship is verified and ID cards are issued. The next step, is level of coverage. Refer to the Oregon Experiment, previously addressed in this article. Truly elective procedures will not be covered in a National Health Care Plan. Side effects or complications with truly elective procedures will also not be covered by the Federal government. Blue Cross/Blue Shield, AARP, or other health insurance company of choice you enrolled with, (see, not socialism), may produce a policy to cover in part or whole these procedures. Look at the process.
The blank top right corner of the 1500 form is currently completed with name primary health insurance provider and address. With the country picking up the tab, the name and address will be completed using the billing information for the federal government unless the person is not a citizen of this country, thus would be completed with health insurance information of visiting foreigners. Item 11d. asks for other insurance information. Instead of asking for other health benefit plan, this would be completed with the information of the agency selected to provide the administration of healthcare insurance. The difference for office managers for medical billing, is that they would send the bills to the companies performing administrative duties of health benefit plans. After assuring all charges are covered by government or separating out what they need to pay or send a bill to the claimant, the 1500 would be then forwarded to the federal government. Initially, to institute a national health care plan, a stamp of approval for everything in each of the two manuals would be covered. A team of physicians, surgeons, and ethicists can be organized to go page by page to wean out those elective procedures, e.g., breast implants due to vanity versus augmentation after required breast surgery, and those treatments/diagnosis related to side effects or complications of elective surgeries. The ICD-10-CM could be updated with putting an 'elective alert' identification on line. A cross reference separate publication could be issued to those diagnosis and treatments no longer covered under the National Health Care system. These items will need to be paid by the client or the administrative health benefit plan.
Yes, it will take a little time to assign a new category or code for new diagnosis, e.g., sepsis relating to elective procedure. With a qualified medical team, it would not take but a few weeks to review these 1000 page books. Cover sheets for mailing until updated 1500s can be formulated. So why doesn't the United States of America not have a National Health Care plan that is separated from socialism except for who gets billed? BECAUSE the leaders don't think it's possible and/or don't care because they can pay full price for health care, if needed! There is little sense of urgency or need of others by those who don't need or can see the urgency. So, this is a great time in this country’s history. We, as a nation and our elected officials, can allow for the status quo and continue this fragmentation without due ownership to provide for and only partially protect the country’s citizens to further divide our citizens. Or, do we make the United States united and stronger by enforcing personal responsibility within ourselves, then forcing governmental responsibility, and finally enforcing a united leadership for others to follow with obviously needed, oversight for the people? Oh, BTW (by the way), I have written my letters and even created this web page. I hope, that, if nothing else, by discoursing this page, I've given some people something to think about. And just maybe, you'll get upset enough to GET INVOLVED and be an active United States American! Or, is being, just an American, a member of the entire Western Hemisphere, good enough for you? Jack A. Garrabrant, Jr., BSN Captain, United States Nurse Corps (retired) Statesman (vs Stateswomen) |
