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.

Some Thoughts On the Anti-Vaccination Movement

For several years now, the antivaxx movement has gotten a lot of attention and gained converts. None of this is based on actual science.

There has been only one study which linked vaccines to autism and that study was retracted by the publication years ago.

What is really concerning is that anti-vaxxers consciously refuse to look at the morbidity and mortality related to the diseases which the most common vaccines prevent. One example-

Measles. Many people think of measles as being nothing but a short term illness, nothing more than an annoyance. Measles are dangerous. Measles can cause permanent damage to skin, lungs and brain, leading to lifelong disability. Measles can also be fatal. In regions with poor access to healthcare, the fatality rate can be as high as 24%. In the US, mortality has been 0.6% for decades. However, that has been during times when the disease has been controlled by vaccines.

More infections, more mutations. One thing most people fail to realize. The more active any infection is in the community, the more opportunity that infection has to mutate. Measles, mumps, yellow fever, polio have not been actively transmitted on a scale which has allowed this for many years. If that happens, then we could potentially see mutations which render current vaccines useless.

Don’t believe online claims. I have encountered numerous people online claiming they have a child damaged by vaccines. The interesting thing is that I have never encountered this in real life in 24+ years of nursing. Not once. Then the question arises as to how this was diagnosed. I find it extremely unlikely that any doctor made such a diagnosis. The exception being if a child were allergic to some component of the vaccine, such as eggs. An allergic reaction is not a condemnation of vaccines as a whole. It does not stop vaccines from preventing the illness and deaths of millions of people. Anyone can have an allergic reaction to any food or medicine they take or ingest for the first time. It cannot be predicted or prevented. It does not condemn the food or medication.

Autism. Most of the people claiming an increase in the rates of autism cannot state what the diagnostic criteria are for autism. Those criteria are primarily arbitrary and subjective. One doctor may state a person has autism while another doctor disagrees. The diagnostic criteria have also changed over the last 25 years. Screening for autism has increased over the last 10–15 years. Those two facts alone account for the vast majority of new cases of autism being diagnosed. Plus the fact that most people had never heard of autism before the same time frame.

Something else to consider about the rise in autism. Who makes money from it? Drug companies and therapists stand to make large sums of money from a diagnosis of autism. How much money do they make saying a child is completely normal? Now you have an answer to the rise in autism.

Drug company profits. Many anti-vaxxers claim drug companies promote vaccines because of the profits involved. Now, stop and think-

Do drug companies make more money from vaccines or from illness?

One outbreak. Endless profits. All it would take is one outbreak of one major disease for which we currently have vaccinations for drug companies to make profits far above and beyond what they make on all vaccines. How much more money would drug companies make from tens, hundreds of thousands of people hospitalized for that one major disease? How much would they make from tens of thousands rendered permanently disabled by such a disease and needing lifelong medical care as a result?

The literal fact of the matter is that if I were a drug company CEO, I would covertly support and fund the anti-vaccination movement. If I had no ethics, of course.

First world privilege. Just the idea of refraining from vaccinating your child is absolutely a first world privilege. Anti-vaxxers are under the assumption that either they/their children will not contract an infectious disease, that any disease they contract will not be deadly/disabling or that they can access treatment in a timely manner. If a large outbreak occurs, that may not be the case. Hospitals may fill up, medications could run out of stock nationally. Globally if we had a pandemic. Your money or insurance will not save you in that case. You even make the assumption that a doctor would diagnose the problem accurately when a disease has rarely been seen in this country for decades. First world privilege will mean nothing when your precious little snowflake is dead, comatose, has a brain injury or is permanently crippled because of a choice YOU made.

More research. Do I in any way suggest that more independent research is not needed regarding vaccine safety? Read back over this if you think I said that. However, until such research is done, there is no sane basis for refraining from vaccinations. Let me repeat that: No sane basis.

So, while so many people talk about vaccines as though they are a choice or which carry so many dangers, these are people who only read what confirms their own bias. They have become complacent by the fact that we have not had a major infectious disease outbreak in this country for many decades. Thanks to vaccines. It’s like saying we need no chlorine in water because nobody has died from tap water that they know of for decades. If you do not understand the subject, learn about it. Until you do, STFU and vaccinate your kids!!!

Nationalize SOME Industries

There can be little debate that we have specific focal problems that hold us back as a society. Income inequality, access and cost of medical care including medications and warfare being chief among them.

If Americans truly want peace, security and prosperity, the honest truth is that specific industries should be nationalized. Take away the profit motive for warmongers and apathetic capitalists who allow or even cause death and destruction of lives for their own greed.

Military weapons and aircraft. One industry that should be nationalized is military weapons manufacturing. We all know that MIC contractors are the biggest promoters of warfare. They spend huge sums of money paid by taxpayers to promote the next conflict and the next and the next. If the military weapons and aircraft industries were nationalized, completely operated by government agencies and worked by government employees, we would not be paying for advertising. We would not be paying for corporate profits. With that manufacturing accounting being subject to FOIA requests, the cost of military supplies would plummet. CONgressional representatives would be far more likely to question and criticize cost and time of development of new weapons systems. In addition, the media just might start asking critical questions about our conflicts.

The oil industry. We all know that many, if not most of our military conflicts for decades have been for the benefit of the oil industry. Iraq, Iran, Syria, Libya, the current regime change attempt against Venezuela and much of the heightened tensions with Russia. The industry uses unsafe practices which result in environmental damages while taxpayers are left to pick up the cleanup bill. We are told that America has achieved “energy independence”. Meanwhile, oil is one of our top three exports and one of our top three imports. Why are we shipping oil out, only to replace it with oil shipped in? The answer is the petrodollar system but I am being rhetorical here. The oil industry seizes land from citizens with barely a finger lifted by elected officials paid by the oil industry. What many people don’t realize is that thousands of oil workers are injured each year. In some cases, permanently disabled. From that point on, those workers are the responsibility of the taxpayer to provide for through Medicaid and Social Security. In addition, it was demonstrated that the government subsidizes the oil industry by tens of billions of dollar a year, partly by paying for surveying new oil sources. The industry never has to repay one penny of that money, they just take the profits and run. Have you seen how much the oil industry advertises? The propaganda they promote? You pay for that. You also pay for their lobbyists and lawyers to the tune of billions a year. So, if we have to pay for surveys, security, cleanup and the care of their injured while surrendering rights to our own property and environment, nationalizing the industry just makes sense. If we are net exporters of oil, then we have no need of wars in other countries for oil. Do we? Make the oil industry directly profitable to the country and assume responsibility and accountability so we have more control over it.

Medical payment systems. Yes, Medicare For All. Medicare For All does not propose making all medical care being provided by the government. That is propaganda pushed by insurance companies. I’ve written long explanations of the money the insurance industry makes, spends and distributes which has nothing to do with medical services. Advertising, executive pay and bonuses, promotional crap, commissions for insurance agents, lawyers to deny coverage, lobbyists, campaign “donations”, stockholder dividends. You pay for all of it!!! Yet your deductible and premiums keep climbing. Chances are good that your insurance never pays one cent to your medical care, so every penny you give them goes to profits. If we nationalized the healthcare payment system, the cost of medical care could be reduced as much as half. Yet everyone would be covered and have higher quality of care. No bankruptcies due to medical costs directly.

Drug manufacturing. Many new drugs are developed by universities funded through grants, paid for by taxpayers. Corporations bid for the patent and claim all profits from that point and for many years. They never have to repay the development costs which the taxpayer funded. Look at many other countries that are developing new treatments that surpass our own. Drug prices on common medications for blood pressure and diabetes, let alone cancer, have risen to the point that many chronically ill people cannot afford their medications and then suffer catastrophic health events including death, stroke, heart attack and kidney failure as a result. Or they have to make a choice between medications and food or shelter. Insulin has increased by 700+% in recent years. Once again, look how many drug ads you see. Look at corporate executive pay. Look at stock dividends. Look at chain pharmacy profit margins. Look at how many drugs have been approved which were later pulled from the market because they were unsafe to begin with. Look at how many lawyers drug companies retain and pay. Look at campaign donations and lobbying. You pay for that before and above the cost of your medications. It is no longer enough to even suggest regulating drug prices. The entire drug industry should be nationalized. If we spent our money to have universities developing new medications, that money would go toward improving education. Cutting lobbyists out of the equation would allow the FDA to do what it was intended to do. Our medications would be safer and more affordable.

Adult education funding. We’ve been having the conversation for years now about student loan debt and cost of advanced education. Student loan debt does a massive amount of damage, not only at the personal level but at the economic level to the whole country. As a nation, we spend billions of dollars per month on adult education. It is spent on student loans over decades and tuition costs over years. In many cases, the degree obtained never benefits the student. Tens of thousands of people declare bankruptcy every year thanks to student loan debt. That lowers their employment and earning potential for the best jobs. It is another system that benefits the rich and punishes the poor. If you are married and your spouse dies with a federal student loan debt, youare liable for the balance of that loan. Did you know that? If you default on a federal student loan, the IRS gets involved. They can seize your tax refund, part of your pay for years, your bank account, your car and your home. You will not be eligible for government employment at any level and may be barred from many other jobs. Federal student loans cannot be discharged for poverty, bankruptcy, chronic or critical illness, disability or homelessness. Your credit rating will be decimated for life. Did you know that? Many people do not. Millions of Americans never attend or finish college because of the cost or fear of debt. This is making the US fall behind other countries on advanced education, while we already trail much of the world in basic education. The money being spent on education and student loans is subtracted from the general economy. So that is billions every single month which is not spent in local economies to create and maintain jobs. Hundreds of thousands of people cannot buy homes because of student loan debt and it limits their options for renting as well. Colleges and universities over some years have been basically selling off parts of their facilities and educational programs to corporations. In exchange, the corporations get to dictate curriculum for various programs. Which means students are less educated than indoctrinated. While I would not yet advocate nationalization of adult education itself, it is far beyond time for us to nationalize funding for adult education. This would benefit the economy, our educational ranking internationally, the students and allow institutions to be freed from corporate shackles.

Many people still fear the term Socialism. Yet, as you can see, capitalism is far more destructive to our economy and our society than Socialism could even aspire to be. The speech against Socialism is propagated by capitalist media and politicians under the dictate of corporate entities.

Many people are pushing for complete Marxist Socialism. That’s not something I personally advocate. If we nationalized (socialized) the industries listed above, that would be a major move in the right direction which would allow true capitalism to flourish, as opposed to the corporatism we have in place now. It would lead to more secure lives, better health, better education and a more peaceful diplomatic nation.

Shrinking Medical Options

As a nurse, I love (sic) to hear how America has the best medical care available of any country. So let me correct this statement for you. We have the best medical care available to those who can afford it and live in the right areas or have the luxury of being able to travel long distances to access that care.

The distance issue is becoming an increasingly alarming issue. For years, hospitals have been closing at a rate of 30 hospitals per year across the US. At first glance, this number doesn’t sound horrible. However, then we have to dive deeper into those numbers.

According to the American Hospital Association (AHA), as of 2016, there were only 5534 hospitals operating in the US. Of those,

209 are federal government hospitals.

397 are non-federal psychiatric hospitals.

88 are counted as “other” hospitals.

All those can be removed from the total serving communities, bringing the number down to 4840. Of that number, only 1825 are rural hospitals. Yet rural hospitals and those in low income areas are the ones closing at the fastest rate.

As stated, these numbers are from 2016, so the number of active facilities are even lower as of this time.

Even worse? Included in that 4840 number are rehabilitation and chronic care hospitals. There are no accurate numbers available, so there is no way of knowing how many of the 4840 are not acute care facilities. I have worked at various rehabilitation facilities that call themselves hospitals and even then objected to that designation. People seeking emergency care will not find it available at those facilities.

To be considered a hospital only requires that a facility maintain six inpatient beds.

Total hospital admissions for 2016 totaled 35,158,934. So that equals 6353 hospital admissions per facility. An admission can be for one day or 6 months. An admission only counts one time for each facility, so that has no correlation to how many hospital days are spent on each admission.

In 2016, there were a total of 894,574 beds to accept those admissions, meaning there were 39 admissions for each hospital bed in this country.

The average cost of one hospital admission was $28,201.

So, in the country that pays the absolute highest amount for medical care of any country on earth, we are seeing a reduction in the number of hospitals and hospital beds, leaving the poor and rural in situations with even less care than they had to begin with. This coming even as the cost of insurance skyrockets yet deductibles climb ever higher.

The rate of hospital closures is expected to accelerate even faster in the near future.

To illustrate the difference over time, consider the fact that in 1975, there were 7156 hospitals in this country. Now we have 5534, which is a loss of 1622 hospitals. The population of the US in 1975 was 216 million. while in 2016 the population was 323.4 million.

As the population increases while the number of hospitals continues to decrease, this situation becomes ever more critical. The loss of hospitals also means loss of tens of thousands of living wage jobs in our communities, causing ever worsening effects on the economy.

Even now, hundreds of thousands of Americans living in rural communities must make drives or be transported hundreds of miles to access inpatient medical care while being far from family and friends, leading to more negative medical outcomes. Meanwhile those in less affluent areas suffer more obstructions to care.

I do understand that some will offer a counter-argument that hospital stays today are shorter. That is true but is more than offset by the fact that more medical procedures are performed outpatient than ever. In some cases, that’s fine, when consequences are not likely to be life threatening. When we talk about invasive or cardiac procedures, that’s a different story. Yet it happens daily. Patients are being discharged the same day as elective heart catheterizations and gall bladder surgeries, each of which should mandate at least overnight observation. Why is this happening? Simple, save the hospital beds for those with the insurance that pays more. The fact that any insurance plan would approve these circumstances tells you they are more concerned with paying a hospital than quality of care. It really is that simple.

Yes, modern medical procedures are less invasive than they were decades ago, meaning shorter recovery times on average. No sane medical professional advocates for more invasive procedures or hospital stays longer than necessary for safety. Each of those carry their own consequences, including hospital-acquired infections and blood clots (DVT). The longer you are hospitalized, the higher the risk. Yet even rehabilitation is often cut shorter than it should be based on insurance payments as opposed to patient needs.

We are already past the tipping point on medical safety as a nation. One epidemic or catastrophe means the medical systems we have in place are overwhelmed easily. The average age is rising, increasing your chances of needing hospital care at some point. Will it even be available if or when you need it? In the face of a decades-long nursing shortage, nurse pay is static or even declining locally. Experienced nurses and doctors are leaving the profession due to stress. That leaves less experienced, more apathetic people in their place that consider medicine “just a job”.

Life expectancy in the US is actually declining, alone among all developed nations. While medical advances and best practice is extending care in other countries.

There is no scenario where we can consider our medical system to be the best available under these conditions. I would love to say this cannot continue but at the moment I fully expect it to continue unabated until it becomes critical. For many, it already has but those voices are not heard by Wall Street, corporate media and bought politicians.

The question is, are you listening?

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.