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.

Yes, Tulsi IS More Progressive Than Bernie

Yes, I did a video on this subject but it had very few views. So I guess I will put it in writing and bring in even more points to consider.

Many Bernie Sanders supporters absolutely insist that he is the most Progressive candidate. No, he is not. By a long shot. He is simply the only candidate they have paid any attention to. It is willful ignorance and cult mentality. The very thing they wish to criticize in others. They believe he can do no wrong or that any wrong he does has been forced on him.

I have said many times that if Bernie has been threatened or forced in some way, that means he was controlled, is currently controlled and will remain controlled. Even if elected.

None of this means I think Tulsi is perfect. My personal preference is Hunter of the Green Party. However, as far as the two major parties, Tulsi is absolutely the most Progressive candidate. You need only do two things to understand this:

1- Read their policies objectively.

2- Understand the difference between policies and talking points. The more vague any statement is, the more it is a talking point, not a policy. Both candidates have areas in which their policy pages could be far more specific, so they come across as talking points.

With this in mind, let’s take a comparative look at the policies between Bernie and Tulsi. Anywhere quotes are offered, the quotes stated are copied and pasted directly from their websites, so you can look these things up and confirm them as you go.

Healthcare. The one which most Bernie supporters focus on solely and all else is fluff. Universal healthcare.

Bernie: “ Joining every other major country on Earth and guaranteeing health care to all people as a right, not a privilege, through a Medicare-for-all, single-payer program.”

Tulsi: “Too many people in this country are getting sick without the care that they need. As president, I will work to ensure all Americans have quality healthcare incentivized to increase health and prevent and heal disease.”

Also Tulsi: “If you look at other countries in the world who have universal health care, every one of them has some form of a role for private insurance.”

BOTH are for universal healthcare. When you look at these two, many believe Tulsi does not endorse universal healthcare. She has made it clear since 2016 that she absolutely does. It is also believed that Bernie opposes supplemental health insurance. Yet there is no indication he would oppose such a thing.

Supplemental coverage is in all countries with universal healthcare. It is fact that nearly or all countries that utilize universal healthcare have some form of supplemental health insurance. Don’t believe me? Healthcare Triage on YouTube did an entire series comparing universal healthcare in the countries that offer it. The channel is very much favorable toward universal healthcare and the series is expertly, professionally, objectively done. https://www.youtube.com/user/thehealthcaretriage

Medications. Both candidates have virtually identical stances on medication prices.

Bernie: Allow Medicare to negotiate with the big drug companies to lower prescription drug prices with the Medicare Drug Price Negotiation Act.

  • Allow patients, pharmacists, and wholesalers to buy low-cost prescription drugs from Canada and other industrialized countries with the Affordable and Safe Prescription Drug Importation Act.
  • Cut prescription drug prices in half, with the Prescription Drug Price Relief Act, by pegging prices to the median drug price in five major countries: Canada, the United Kingdom, France, Germany, and Japan.

Tulsi: “No one should be forced to choose between putting food on the table and paying for life-saving medication. But that’s exactly what’s happening to millions of Americans as a result of Big Pharma’s chokehold on Medicare. They’ve managed to buy access into Congress, barring the government from negotiating cheaper prices for consumers, so they can continue to price-gouge those trying to buy life-saving medication and rake in profits at the expense of the American people.”

Foreign Relations. This is where these two candidates part ways most severely. You can read their entire pages but here I will focus on the most crucial differences.

Bernie: Work with pro-democracy forces around the world to build societies that work for and protect all people. In the United States, Europe, and elsewhere, democracy is under threat by forces of intolerance, corruption, and authoritarianism.

Tulsi: I think it’s important, for the sake of our country’s national security, to keep the American people safe, and in the pursuit of peace, for our president and commander in chief to have the courage to meet with leaders of other countries — whether they be adversaries or potential adversaries — in order to achieve peace and security.

Why are these statements different? If you are old enough, think back. Matter of fact, think of now. What are the words, “pro-democracy forces” code for? Haven’t we heard these words before? What followed? What Bernie is saying is that he will work with countries that are already our allies, that bend to our will in worship of the American Empire. Otherwise, he will oppose them. Oppose how? Those options are really limited, aren’t they? Sanctions which kill or military force tend to be the only options available once you remove diplomatic relations with those you disagree with.

Tulsi has already clearly demonstrated that she is willing and ready to meet with foreign leaders with whom we do NOT agree for the purpose of diplomatic relations. Force and threat are used as final options. Bernie has not made any statements even alluding to such an approach.

Why is this important? If you want universal healthcare, improvements in the economy and social support programs, military spending MUST be reduced. The military budget is used as THE biggest excuse for ripping money away from or saying we cannot afford these programs. To reduce military spending, it is MANDATORY we strive for peace with other countries. Tulsi makes it clear that she would divert those funds from military spending to social spending.

“..democracy is under threat..” These are highly troubling words by Bernie. They indicate clearly that he is continuing to push Russiagate and will follow it right through with Ukrainegate, both of which are nothing but cover stories for corruption of DNC elite.

Elections. Both have similar policies regarding election rights. However, Tulsi is the only one who mentions implementing an auditable paper trail.

Criminal Justice Reform. Both have similar policies on criminal justice reform, including legalizing marijuana, ending for-profit prisons, stricter penalties for white collar crime and ending cash bail. (I have heard Sanders speak on these subjects but ending cash bail is not on his policy page.)

Wall Street Reform. Both have similar policies regarding reinstating Glass-Steagall and breaking up “too big to fail” banks. I will state Sanders has some more Progressive policies regarding public banking, capping interest rates and controlling ATM fees.

This guide is not meant to be comprehensive. It is intended to encourage voters to actually read the policy pages of the candidates and listen closely to what is being said and WHAT IS NOT BEING SAID. When I say “Do Your Research” I MEAN IT. I am telling you to go straight to the source, as you should be doing, any way.

In all cases, stop allowing corporate media or biased pundits tell you what to think. Get out of the echo chambers. If you want actual progress, you have to think critically about what that means.

Would I support a ballot that has both of them on it in the general election? Yes but ONLY with Tulsi as president and Bernie as VP. NOT the other way around.

Peace Before Healthcare Is Mandatory

We keep hearing how we cannot afford universal healthcare because we “MUST” keep paying for bombs.

Then the bombs never stop. 

Which candidate is actually MOST in favor of real steps toward peace?

Look at policies and history. Not talking points.


https://youtu.be/ZryNBKKZ-8Q