Pt 2- Universal Healthcare Would Have To Be Adopted Gradually

I really did not think I was going to have to write a follow up on this one. I should have known better. So, this follow up is really to address the contradictions I have encountered from the left.

Some have claimed that because I am stating that universal healthcare would have to be phased in that I am in some way against universal healthcare. The first thing that is obvious about that argument is that they have not read my writing, including the entire first article. They claim they did, of course but if they did, the indication is worse. It means they are arguing for the sake of feeding their addiction to conflict. I made it very clear on too many occasions to count just how much I am in favor of universal healthcare, so their arguments hold no water at all.

Rational approach. Every single thing that I write comes from a rational perspective. In this case, I have not only formally and informally studied economics for over 30 years but have direct experience with basically everything involved. I have been a nurse for over 25 years. I have written medical protocols. I have worked as a subcontractor for multiple insurance companies and the longest position in that respect I resigned from because of my own ethical objections to changes in criteria which denied needed imaging studies. Lastly, I have been writing about politics for years. Thus, I know politics, economics, medicine, medical protocols and the insurance/medical funding processes.

Compassionate approach. Not only is everything I write rational, it is also humanitarian in nature. My detractors on the first article are still absolutely set on the idea that insurance company employees would be able to transition directly and immediately to a government universal healthcare system. That would not happen. It could not happen. It is all but impossible.

Location, location, location. First, detractors are making the completely erroneous assumption that new jobs will be created in the same cities in which they currently exist. That would not happen in the majority of cases. There may be a select few jobs available in larger cities created but not enough to replace all the jobs which would be lost by a long shot. Maybe they think workers can simply pull up their entire lives and relocate to where the new jobs are created. Leave their homes, their families, their friends and all that they know for the sake of a paycheck. A few may be willing to do this but they will be an extreme minority. That thought process also takes no account of what that would do to the housing market. So, who is thinking about the direct welfare of those workers and their families? Me or my detractors?

Money is not healthcare. Detractors have said to me that insurance is not healthcare. I agree. Know what else is not healthcare? Throwing money at the problem. I explained in detail the challenges of training, building and expanding systems, contracts, staffing, etc. Just funding is not enough. Throwing money at a problem does not make it go away. The moment that universal healthcare passes, I explained that the stock market will plummet. Perhaps they think this only has implications for rich investors. However, it would definitely affect the average American who has a diversified 401k. People could lose a significant portion of their life savings within hours. Just funding would not create the needed systems and medically trained personnel needed to provide the care and services required. Who is thinking about the average American with retirement accounts and the lapse in services? Me or my detractors?

Staffing, education and licensing. I covered this in the first article but let me repeat it. Medical training takes years. Implementing universal healthcare will place a heavy burden on the system we currently have. Waiting times will lengthen and there is already insufficient staffing in many geographic areas. Yes, you can increase pay/bonuses/benefits but then you merely move the shortage from one place to another. More people will have to be trained and licensed. Would you want your family member in a hospital which was still accepting patients at half the minimum staffing levels? I have been a nurse long enough to have had 14 patients on a surgical unit, 40 patients in inpatient hospice with one CNA, over 60 in a nursing home or skilled nursing unit, over 300 patients one time in a long term rehab unit. Those are the kinds of things that led to the nursing shortage and almost made me leave nursing. Do you want that back? Who is thinking about patient safety and who is not? Me or my detractors?

Overburdening. One thing is absolutely true. Before you can train people into a new system, the system has to exist. While those opposed to me claim workers can be trained into the existing system, the Medicare/Medicaid system is not created or equipped with the resources or even protocols needed for a universal healthcare system. However, let’s say the protocols and computer systems existed. What happens then is that you overburden the current workers with training new employees. Even after a person is trained, they have to have their work overseen and reviewed for accuracy for weeks or months. That includes for fraud, waste and abuse. During this time, the processing time for claims would be extended considerably. Perhaps taking weeks or months. So, who is thinking of the people who are actually ill, acutely or chronically during this period? Me or my detractors? Who is thinking of the stress level placed on already overworked government employees? Me or my detractors?

Offshore effects. Not many Americans have any realization as to how much of their medical claims process takes place in other countries. Yes, your private medical information is sent to other countries on a daily basis. I know this because of my experiences doing preauthorization for medical imaging studies. One big reason for this is that the insurance companies pay workers in other countries far less than domestic workers. I have also worked in medical facilities that send imaging studies to Australia to have reports written. That’s so they do not have to keep a Radiologist PhD on staff at all times. Now, while I strenuously object to our medical information being sent to other countries, I accept the fact that the workers in those countries rely on that employment for an income. An immediate change to universal healthcare would leave them without an income with no warning. So, who is more compassionate to those workers? Me or my detractors?

Probationary period. One cannot deny that implementing universal healthcare would be harshly scrutinized and criticized by capitalists. That includes the capitalist media who make many many billions per year hosting advertising for insurance and drug companies. So, how would they be reporting on this transition? If we suddenly had tens or hundreds of thousands out of work, waiting times and processing times extended to months, a stock market crash and seeming incompetence all along the way? Do you remember how much of a problem it was to bring the ACA online? The problems with the government portal? How many times the system crashed? The processing time to get people enrolled? Do you remember how the media reported on every single tiny problem? The absolute fact is that capitalists would be seeking any and every excuse to declare universal healthcare a failure. That is ALL they would report on all day, every day. While probably blaming Russia, of course. So, who is thinking of how imperative it is that universal healthcare be implemented in a way that considers all that can go wrong, plans for exceptions and has contingencies in place? Who sounds like they want it to be successful, me or my detractors?

Too many of my detractors are completely driven by emotion. That emotion is unreasoning, uncompromising, compulsive and selfish. As a nurse, I am trained and experienced in applying critical thinking to achieve results which are based on emotion, compassion, caring. As a nurse, I am also absolutely no stranger to setting my own emotions aside while applying that critical thought process or even doing what the patient wants when my own choice would be far different.

I am very much in favor of Socialism and my writing displays that. However, as a reasoning person I also think clearly that transitioning in that direction must be done gradually and with extreme planning. We cannot throw one system out completely without having a new system already built to replace it. That is the equivalent to learning you have lung cancer and the doctor’s response is grabbing a scalpel and removing your lungs with no anesthesia, no transplant organs. “Well, we have funding for it!” How would that work for you?

The whole point is that using critical, rational thinking to detail exactly HOW things can be accomplished effectively with the fewest complications does not lack compassion or emotion in the least. You would not want someone performing surgery on you or administering medications to you when they have no knowledge on the procedures. It doesn’t matter how much emotion they put into it, certain things take knowledge, planning and education. Your FEELINGS don’t matter if you sabotage the system you implement while causing very real danger to the beneficiaries of that system. If we cause more problems than we solve, we doom that system before it ever gets off the ground.

Care enough to THINK.

Universal Healthcare Would HAVE to Be Adopted Gradually

Many people voicing support for universal healthcare think it is some form of magic bullet that would be adopted and implemented in a single day and all problems would be resolved.

None of this is true. In fact, it would and should be adopted gradually over years to overcome the difficulties that would be encountered on many levels.

Supplemental insurance. This is a key sticking point for many people. I have pointed out that Tulsi Gabbard openly states her plan would include supplemental insurance, while Bernie Sanders admits his plan would as well but only under coerced admittance. Now, consider the fact that nearly every country that has universal healthcare also has supplemental insurance. If we moved to universal healthcare, think what would happen the day it was announced, if no supplemental insurance were included. That very day, the stock market would crash. Medical claims would be denied, even if previously approved. Tens of thousands, perhaps hundreds of thousands of Americans would lose their jobs. Doctors offices, clinics, hospitals and pharmacies would be forced to close their doors within weeks. Not out of greed. Out of necessity. That would suspend or eliminate hundreds of thousands of other jobs. From there, downstream spending would plummet, causing more complications.

Of course, these effects could be very slightly dampened by legislation mandating companies to keep their doors open, insurance companies to honor claims, etc. That does not keep investors from selling off stocks, cashing in bonds.

By allowing for supplemental insurance, many jobs would be maintained. Investors would still pull funding but not completely.

Timeline. There would have to be a plan which included a specific timeline which phased in the introduction. This could take many forms, such as introducing specific existing medical conditions by target dates and culminating in universal coverage.

Job creation. I have pointed out previously that universal healthcare would absolutely create more jobs than it eliminated. Meaning living wage jobs. However, this process would not be instantaneous. One crucial aspect would be funding the expansion of medical professional training. This could take the form of federal funding or even federal training programs for each state for various medical professions, especially nursing, nurse practitioners, licensed physician assistants (not to be confused with medical assistants), etc. This training takes years. Even as hospitals across the country have been closing at a rate of 35 per year, the nursing shortage has continued. Universal healthcare would make that situation far worse and spread the problem to other medical fields.

Waiting times. You can definitely count on wait times for medical appointments of all kinds to be temporarily extended. The implementation of universal healthcare should include new systems which require less direct interaction with providers for basic care. Telephone and internet consultation systems have been developed which help with this and could be adapted to such a new system. Those would have to be expanded. The current systems are for profit and if they choose to not take part in the new system, they would have to be replaced with government run systems. Self referral for some specialties should also be an option with prior approval.

Medical criteria. While Medicare/Medicaid has a strong set of medical criteria already in place, it is insufficient to cover the needs which would be required under universal healthcare. The criteria currently in place cover existing conditions and less preventative care. Some of the criteria needed could be derived from insurance companies but would still require review, rewriting and implementation to incorporate into the system. Once again, this is a process which would take years to accomplish fully.

Billing and payment. While universal healthcare would simplify medical billing, the specific systems necessary for the scale of the system would have to be not only expanded and updated but more systems put in place to reduce fraud, waste and abuse. Funding would be a challenge in the beginning, as there would absolutely be a massive surge of claims by those who may have foregone medical care for years. After 2–3 years it would decrease and level off but there would be numerous adaptations to even figure out the right balance between cost to taxpayers and payments to providers. During that time there would be a lot of bitching and moaning about how unfair the system was, it was a bad idea, etc. Nothing of this scale happens without some kinks to work out.

Contracts and logistics. Medical facilities and offices have contracts with providers of services, equipment and medications. In many cases, these are dictated by insurance plans. Many of these contracts will have to be renegotiated, which again takes time. Of course, if all service/equipment/pharmacies are obligated to accept referrals from any provider, this will simplify things. However, don’t count on this happening right away because of everything detailed above.

Quality of care. Even if we solve the problems of training medical professionals, that does not insure quality of care. With a system which would be burdened by a new large number of patients, I would expect some decrease in quality of care for a time, until we achieve a strong enough density of medical professionals to weed out the weakest links. I’ve seen horrible incompetency in my years in nursing. Just last week I had to explain to another nurse that DNR means Do Not Resuscitate, it does not mean Do Not Treat. Then I had to explain the difference. If we had a mad rush to graduate a mass number of licensed people, chances are quality of education, testing and oversight would be decreased as well if more oversight is not included in the new system, which would also take time. Oversight would have to be done concurrently with the phasing in of the new system.

None of this means that we should not be pushing for universal healthcare. We absolutely MUST push for it. Medical care should not be available only for the wealthy. It should be considered a human right above and beyond profit motives.

My entire point is that just passing legislation is not going to solve all our problems in a single shot. Changing our entire system will take time. It is a huge and complicated task, not just a change in paperwork. It affects all of our lives, not just a few. There are aspects of this that some who have an unearned sense of privilege will obviously object to. Others will object because they want to move instantaneously to a state run system with no option for supplemental insurance. While an eventual move to a truly universal system may be possible, even that seems unlikely. There should be supplemental insurance for things like cosmetic care, which the rest of us should not have to pay for. I’m certain that insurance companies would be able to devise special insurance plans for that purpose, if they do not already exist.

How Universal Healthcare Is Best Pt III

This post was published on Medium and Steemit on 9/5/18. 

In the first two parts of this series, I examined and pointed out things which are more factual and can be validated quite easily. Now to delve into things which are more murky but clearly show which side of ethics any person is on. Including how much they are willing to blindly follow corporate propaganda.

Advertising- I mentioned before that insurance policy holders pay for $millions spent on advertising by insurance companies PER DAY. It comes to $billions spent per year. TV, internet, snail mail, email, telephone, “free” health fairs, advertising products (key chains, bags, etc), newspapers, magazines, you name it. YOU pay for ALL of it.

Hint- NONE of that money is being spent on medical care.

No Debate- Where do most Americans get their information about the universal healthcare debate? Corporate media. The very same media corporations that collect the advertising $billions every year. Whom do they have as guest speakers to discuss these issues? If they discuss the issue at all, their “guest speakers” invariably come from insurance companies, lobbying firms or politicians who have received large sums of money from the insurance industry. Possibly WAR Street “experts” who sell stock in insurance companies. Even when a recent Libertarian-funded study proved universal healthcare would save $billions, numerous corporate media outlets ignored the actual study and instead interviewed the author of the study, who argued against his own findings, yet had no hard numbers, made no revisions to the actual study. He’s a Libertarian. Of course he will argue against the truth which he, himself, revealed.

So, who represents the pro-universal healthcare side? Basically, nobody on corporate media. That side of the “debate” (sic) consistently states that universal healthcare costs too much, yet never explains how that is possible, considering the costs I detailed in part one of this series. Nor the benefits detailed in part two. Those are never discussed at all. Americans have become so accustomed to having one sided corporate opinions spouted as fact that they never even question that only one side, the corporate side, is represented. Such is the danger of allowing corporate media to do your thinking for you.

Main detractors- Who are the main detractors voicing objections to universal healthcare? There are the obvious corporate entities mentioned above. Insurance companies, advertising agencies and media companies that make huge sums of money from the current system. However, there are local insurance agents and their employees. I understand their concerns though most of them have other revenue streams because insurance agents tend to cover multiple forms of insurance. Plus drug companies who are often in bed with the insurance companies. Consider CVS buying Aetna insurance while they also run clinics in many of their locations. CVS has one of the largest drugs by mail systems in the country. So they control the medications and collect the profits from premium to clinic to pharmacy.

On top of that, there are those who believe the claims of “death panels” and so forth, which makes no sense when you consider a system that has the benefits I’ve already laid out. They can never answer why Medicaid and Medicare have never had such “death panels”, aside from those imposed by the capitalist insurance and drug companies that have been involved since GWB privatized parts of it.

We cannot mince words about it. There is no shortage of people who are literally cruel. They enjoy the thought of others suffering, as long as they are not suffering or even inconvenienced. Some don’t even care if they pay more but get less, as long as they can feel somehow instrumental in the suffering of others. These people cross all religious, ethic and gender boundaries.

Human ethics- The saddest part of all of this is that so many Americans have the opinion that healthcare is a privilege, not a right. As long as they have their own, it doesn’t matter if others get sick, possibly chronically, or if the “other” person dies. Most interesting in the prevalence of this sentiment is how many claim to be “Christian”. While Christianity is supposedly a belief system that speaks clearly of caring for your fellow human more than you care about money.

Those who even think about ethics are in favor of universal healthcare. It hurts us to see our fellow human beings suffer, sicken and die for lack of access to healthcare. We cannot stand seeing people unable to afford crucial medications, making decisions between medication and food. Or asking themselves if that nagging, increasing pain in their stomach or chest can wait another month, another year. Is that purple spot or oddly shaped mole that keeps getting larger a concern? Can’t afford to think about it.

“I hate Socialism!”- Since I began this series, I have encountered a number of people who use this argument. The interesting part is how many of them are on SOCIAL Security. Hmm, where do they think that name comes from? It comes from the fact that it is a SOCIALIST concept and always has been. Social Security is funded by society for the benefit of society. The people paying into it now pay for the benefits of those collecting on it now. The same is true with Medicare and Medicaid.

Let me repeat that definition of Socialist programs. A Socialist program is any government program or policy which is funded BY society for the benefit OF society and the members of that society.

The others who argue against universal healthcare are members of the system which profits from the current system. Insurance corporations, lobbyists, politicians who get “donations” from the above, insurance agents, advertising companies. Note that these people rarely work in the same sense of the word that manual laborers do. They will claim that manual laborers need to work harder, work multiple jobs, “get an education” (In what? They cannot answer.), leave their children in daycare while they work 80 hours a week (until they become sick and never mind the cost of child care), don’t have children, don’t buy a vehicle, don’t eat out, don’t have that latte.. Oh, and be sure to get lots of exercise and watch corporate media in between.

Karma- The blindest part of this viewpoint is that younger people who pay into the system at this point are getting sicker. They lose days of productivity because of illness. They lose income because of it. They pay less into the system because of it.

The logical end result of this is that you wind up with huge numbers of people winding up with chronic illnesses, possibly disabling illnesses, unable to work, unable to make a living. What happens then? They get kicked off of insurance and placed on Medicaid and SSI. So they are no longer contributing to the system, they are a drain on the system.

The insurance companies get to keep their profits, taxpayers pick up the bill and fewer people are paying in. Such a system is doomed to failure because it is unsustainable. The worst part is how much of it is preventable.

End points- Some people want to blame Russia or China or immigrants or whomever they can for the failure of the current system. This is not anyone else’s fault, this is purely an American problem brought on by greed. That greed is at many levels. I’m sure with the details I have offered that I have only offered the most obvious culprits, yet it is still not discussed openly.

So, call me a Russian troll, tell me I hate my country because I think all Americans should have health care without going bankrupt. Call me a Socialist like it is a dirty word because I care about society. You can offer insults but until you can explain how the current system is better for everyone, not just the most affluent, you have no argument as far as millions of us are concerned. Even for the low upper middle class, the cost of access to medical care is slipping out of reach at this point.

Is universal healthcare perfect? Probably not but name a system that is perfect. When I say “best” I mean just that- best. Not perfect. When we come up with a perfect system, let me know. We’ve never been there and no country has been. That’s not even on the horizon as long as we keep fighting the fight of money over human life and well being. This is not about “perfect”. This is about the greatest good at all levels for the greatest number of people.

How Universal Healthcare Is Best Pt II

This post was published on Medium and Steemit on 8/30/18.

When I state universal healthcare is best, let me clarify what I mean by “best”.

I am speaking in medical outcome and ethical terms. When I say “best”, I mean that universal healthcare offers the best medical outcome for the largest number of people at the most reasonable cost.

There is no actual debate on this conclusion unless you prefer entities that sabotage a system for personal gain. Capitalists that try to torpedo such a system for profit. Malevolent system administrators that go against evidence based medical criteria with the explicit purpose of making that system fail. Each of these do so at the cost of human suffering and life.

Of course, we are having this discussion in a country that has left millions without medical care, millions bankrupt in an attempt to afford care. Millions with permanent disability or dead for the sake of profit. As a nurse for decades, I find that situation unacceptable.

Most Progressives know that a recent Koch-funded (Libertarian) study found that universal healthcare would save consumers over $2 Trillion over 10 years. Yet that study does not bother to touch on any of the points I raise in this article, all of which mean the actual amount saved would be far greater.

In part one, I detailed how universal healthcare is the most cost effective system by eliminating extraneous costs that have nothing to do with actual delivery of medical care. But it goes beyond that. Universal healthcare provides societal and economic benefits inside and outside the medical system which improve the economy as a whole. Here are only some of the benefits universal healthcare offers to the economy.

1- Increased disposable income. Because universal healthcare costs less than our current system, it results in more money left in the pocket of the average citizen. For most people, that money will be spent in the general economy. The economy operates on money being spent. That is how jobs are created. I’ve detailed before how money spent at a grocery store supports numerous jobs such as cashier, manager, maintenance, truck drivers, farmers, ranchers, food processors, dock workers. So the same holds true here.

2- Living wage jobs. Expanded access to healthcare would mean people using that access. The end result would be an increased need for doctors, PA’s, nurse practitioners, nurses, CNA’s. Those are obvious but it goes beyond those jobs. You would need more radiologists, radiology techs, respiratory therapists, physical therapists, dietitians, psychologists/psychiatrists/therapists, pharmacists/pharmacy technicians, medical equipment supply specialists, medical equipment manufacturing engineers, medical waste specialists.. The list goes on.

3- MORE disposable income. With all the jobs listed above making a living wage, that means a considerable number of professionals with disposable income. Most of that income would be spent in the general economy, buying food, clothing, cars, homes, eating at restaurants. At each stage of consumerism, jobs are maintained and created. These workers pay taxes which are (ideally) spent supporting schools, libraries, maintaining roads, etc, in each case maintaining if not creating more jobs, more consumers, more taxpayers.

4- Decreased bankruptcies. Millions of Americans per year declare bankruptcy due to medical bills. With universal healthcare, this would be almost if not completely eradicated. The result would be the preservation of credit ratings for responsible people. Which would prevent them from falling prey later to predatory lending practices by payday and high interest lenders, being denied credit, mortgages, etc. Businesses, especially smaller businesses, lose money to bankruptcies every year, causing a cascade effect leading to those small businesses closing or declaring bankruptcy themselves. This would slow that process considerably.

5- Early detection of chronic illnesses. Millions of Americans have chronic illnesses which are only diagnosed when they become advanced or even critical because they cannot afford routine care which would detect those conditions at a much earlier stage. More of these conditions would be detected before they become severe to critical. In many cases this would prevent catastrophic illness. Meaning they would live longer, healthier, happier lives. Not to mention it is far less costly to provide preventive care than corrective to critical care. The cost of one ICU stay for one patient would pay for insulin and testing supplies for hundreds of diabetics for a year. This is NOT an exaggeration of any kind.

6- Stress/anxiety/depression. Medical issues alone can cause stress, anxiety and depression. It doesn’t matter if the illness is chronic or acute. In addition, medical bills can cause the same emotional issues. Combine the two sources of emotional distress and the effects can be devastating. Each one alone can affect self esteem, how one sees themselves. It is no personal failure when one cannot afford medical care, medications, hospital care, etc yet in our society today it is made to seem (by some) to be a personal failure as a human being when you are unable to afford these things. It becomes an issue which many people are too ashamed to discuss openly with friends and family members. Look at the cost of medical care today and it is no wonder so many struggle with the bills involved, putting off care until it can no longer be put off. We live in a country where a series was successful where a teacher becomes a meth dealer simply because of his medical bills and fear for his family’s welfare because of that. The series would not have been successful if it had been a scenario which was less realistic.

7- Health conditions related to stress/anxiety/depression. Always remember that chronic negative emotions can cause physical health complications of their own. High blood pressure, ulcers, obesity, malnutrition, increased tendency to self medicate with alcohol or drugs, gastric disorders, etc. By instituting a system where these negative emotions are lessened, we prevent many of the physical complications which increase the cost of health care. For those who already have these medical issues, stress makes them worse and harder to control. There is no way to truly predict just how much money this would save in the long term but my personal guess (as an experienced cardiac and neurological care nurse) is that the amount would be highly significant.

Now, this list is probably incomplete and could well be added to. However, these are aspects I have not personally seen/heard anyone else discussing to date. Which sucks, considering we’ve had at least two years of discussion about the issue. Just keep watching my page for views you don’t find in other places.

Of course there would be some negative effects involved. I consider all of those ethical concerns and will cover that in part III of this series, coming soon. Long as I don’t get bumped off by some insurance agent before I write it.

How Universal Healthcare is the Best System Pt I

Note: This was originally written and published on Medium and Steemit on 8/23/18.

The debate on universal healthcare has been heating up again. Just in time for midterms. Of course, the election of Ocasio-Cortez has a lot to do with that but the issues first came to the surface somewhat in 2008, then got dropped. Next it arose in 2016, as we are all aware. The obvious hope of corporate America and the elected officials owned by the corporations on both sides of the aisle was that it would again fade away, which has not happened.

Much of the time, we hear how universal healthcare is far less expensive than the system we have. What we rarely if ever hears is why this is true. And we NEVER hear how it would benefit the economy in general. The MSM is NEVER going to explore universal healthcare in a favorable light because they make too much money from insurance and drug company advertising. Elected officials get $millions per year in campaign “donations” from the same entities, so of course they are against even discussing any alternative.

So, this is going to be the first installment of a series. I was considering making this only one article but the subject is extensive and complex. The first part explains HOW universal healthcare costs less than our current corporate system or private pay models. The second part will focus on how universal healthcare benefits the economy in general. Beyond that, I will keep adding as needed, mostly debunking the arguments against universal healthcare.

Let’s begin with why it is far less expensive than the current corporate insurance system.

1- Advertising. If there is only one system and everyone is included, why advertise? The corporate insurance system spends many $millions of dollars PER DAY on advertising. TV, radio, internet, full page magazine and newspaper ads, telephone, email and snail mail. It’s not just one company but all health insurance companies competing with each other for your money.

2- Corporate executive pay. Universal healthcare may pay the administrators high sums but it would not be possible that it could equate to the amounts paid to all the major insurance groups ruling healthcare today. Not just CEO’s but CFO’s, COO’s and on and on for corporation after corporation receive $multi-million pay plus stock packages and bonuses annually. Narrow all of that, eliminate numerous positions and the money saved on healthcare decreases dramatically.

3- Stock dividends. If what we had were a public system with no investors, owned by the people, then there would be no stock dividends to pay out. These account for an unknown total but it would be easy to wager a guess of hundreds of millions, even billions of dollars a year. Stock holders themselves demand decreases in costs, meaning more care being denied to the people who need it most.

4- Criteria. Right now there may be similarities between various insurance plans but each insurance company has their own set of criteria in approving any medical charge submitted. Some of those criteria I actually agree with because they make sense. (Like requiring an x-ray before doing an MRI for a suspected chronic fracture.) The problems lies in the fact that each office or facility must check the criteria for each procedure according to the individual procedure, company and specific insurance plan the patient has. Even then, the charge can be denied. With only one system, one set of criteria, there is no confusion. The cost of hours researching, calling and submitting multiple forms to multiple payment offices would be reduced to a fraction.

5- Agent fees. Across the country, there are tens of thousands of insurance agents who get paid for every insurance policy they sell. They get what is termed “residual income”, which means they sell you a policy once but then they get paid some portion of your payment each and every month you keep the policy. While nobody begrudges them earning a decent living, the combined total of each agent being paid each month for each policy drives the cost of medical care much higher than is ever truly examined.

Summary so far- Have you noticed anything in common with all the issues listed above? What each of them has in common is that they all drive up the cost of medical care significantly, yet not one of them have ANYTHING to do with the delivery of medical care. They are ALL administrative and investor-driven costs and they account for at least half of your cost of medical insurance. They also have great determination of what care you receive, what care is denied and even laws regarding insurance, more than any medical criteria. Medical criteria are debated for years based on results and science. How it gets paid for and how much gets paid is determined by corporate entities.

However, those are not the only ways that universal healthcare saves money.

6- Fraud, waste and abuse. With only one authorization, record keeping, billing and payment system for all healthcare, the opportunity for fraud, waste and abuse becomes narrowed greatly. Most of us have had instances where insurance records state a doctor, lab, etc was paid by our insurance yet we receive a bill stating we owe money for the exact same service. If we have multiple insurance providers, each one gets billed for one service provided. And we may still receive a bill on top of that. Plus duplicate procedures like MRI’s when a second one is not needed would be less common. Fraud, waste and abuse accounts for $billions in healthcare dollars each and every year. While insurance companies may pursue the issue, they do not have the same power as the government, who can impose fines and even criminal charges for extreme abuse instances.

7- Simplified paperwork. Medical facilities and offices spend massive amounts of money on paperwork and billing, even if done properly. In the end, it is we, the consumer, who foot the bill for this expense. If all billing goes through only one system instead of being forced to submit paperwork to numerous entities, calculating, appealing denied claims, recalculating and on and on, the cost of this expense would plummet dramatically.

8- Indigent care. We have all heard that many indigent people are forced to use Emergency Rooms as their primary care system. This is because by law an ER cannot turn patients away. Yet because they are low income, many of those bills go unpaid. This drives up the cost of care for those that can afford care because the cost is split among them. Still, it may limit the ability of not-for-profit facilities to expand services. Some facilities have such a high proportion of indigent patients that they cannot afford to stay in business. Which results in hospitals and clinics closing in the areas where they are often needed most. That means access to care become MORE expensive due to longer ambulance rides and patients waiting longer to seek care. Which can mean their condition deteriorates further.

9- Chronic care. Low income patients with chronic health conditions such as high blood pressure and diabetes often delay care and may not know they have a condition until it does become critical. Most often this is due to financial concerns. The earlier many conditions are detected, the better they can be treated and controlled. Better control means they stay healthy longer, able to work and cost LESS money in the long term. You can treat a diabetic for years for less than the cost of one hospital stay. The same is true of treating high blood pressure caught early and NOT allowing it to progress to heart attack or stroke. Insurance continuously looks at the short term profit, actually functioning with the hope that many of those patients will DIE before needing care. And many do. Or they become so ill that the first thing they must surrender is medical insurance just to eat or keep a roof over their heads.

10- Cost to society. Millions of Americans go bankrupt each year due to medical bills. Some lose their homes. This becomes a cost to all of society in terms of money, morale, fear and anxiety. Those who suffer such fates often wind up with more health problems from anxiety, depression, high blood pressure, possibly sinking into substance abuse, homelessness, exposure and suicide.

11- Administrative costs. I covered some of this above but there are other aspects to consider. Like the fact that doctors, physician assistants and nurse practitioners are currently forced to spend many hours per week on the phone personally to debate/defend their own decisions with insurance companies. In some cases, I will state clearly this is well warranted. However, more often it is because of arbitrary criteria which does not fit a medical case they are handling. These are hours spent for which they get paid nothing. Instead, it forces them to raise prices on all patients or take on more patients than they can handle effectively, spend less time with each patient and even less time than that keeping current with new medical information (which changes constantly).

I could probably keep listing more items in this article but this is a good starting point and none of it is ever included in the so-called “reports” or “debates” on the subject on MSM. Frequently, many of these subjects are not covered even on Progressive media in any detail. Yet each point is valid and important. These are issues which should be discussed widely and openly.