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Monday, May 2, 2011

Health Care For Some

With a recent report that showed that Howard County was the healthiest county in Maryland you would think that things are fairly good heathwise for county residents. However what that report points out is that you would expect this from a wealthy county that has a low unemployment rate. For citizens of this country we have a cornucopia of health plans that work reasonably well for families with good health plans but leaves large holes in coverage for the unemployed or those with limited or no coverage where they work. Defenders of our present system are right when they say we have the best health care in the world. What is incomplete in that statement is the world “system.” Having the best health care providers in the world but limiting access to those providers only to those with insurance is where the problem exists. This problem of access is growing with many companies using high deductibles to limit the usage of care for their employees. Many have the employees being responsible for the first $3,000 or $4,000 of health care costs each year. It is no surprise that the leading reason for declaring bankruptcies in this country is for health care debt.

What I have never understood is why a country that believes in free access to libraries, schools and most roads has not been willing to provide one of the most important needs that anyone has- health care. As a country do we care less about the health of our fellow citizens than any other modern country? Are we controlled so much by insurance companies and health care providers that we are willing to have over 40,000 of our fellow citizens die each year because of lack of health care?

With state budgets strained some states are attacking the Medicaid program to cover their shortfalls. This has led to some dramatic consequences. None more dramatic than in Arizona where Gov. Brewer has decided that the state will not fund organ transplants for Medicaid recipients. This decision was based on a statistics that have proven to be inaccurate.

Are there no other choices between what we have now and government run universal care? A few years ago “Frontline” did a report called “Sick Around the World” that looked at the different systems of U.K., Japan, Switzerland, Germany and Taiwan. The show is available on DVD from Netflix and is well worth watching. It shows how each country has provided universal coverage in different ways. I actually liked the Taiwan system the best as a model for our country.

Currently the political climate is for cutting health care access and coverage rather than expanding it. Cost control is all about limiting coverage rather than reforming the delivery system. We have the most expensive system in the world but are getting poor outcomes in comparison to other modern countries. Efforts to reform that reality get demagogued by defenders of the businesses benefiting from the present system. Profits and lobbyists still have more capital in Washington than people. This reality is seen when the banks can get hundreds of billions to clean up the mess they made but ordinary people can’t get health care in their time of need. We should be concerned to see that for many people without health care they only have free clinics like the one that the National Association of Free Clinics hosted this year in DC. Is this how the richest country in the world responds to health needs of the uninsured?

When President Obama indicated recently that the administration would grant states waivers to the requirements of the health plan approved last year if it found a better way to increase access to health care in their state most people felt it was directed to those states with Governors that opposed the legislation approved last year. It however may have been for states like Vermont that want to develop more liberal plans. Last week the Vermont Senate approved a bill that would provide people in Vermont with a “Medicare for all” type of program. The Vermont House has already approved a similar bill which now goes to a conference committee to work out the slight differences in each bill. The Governor has already indicated that he will sign the bill. So we may have an opportunity to see how one state will provide a universal care program. You can bet that other states will be watching.

Here in Howard County we have a program called Healthy Howard that is attempting to provide a way that any resident of the County has access to health care. First it will screen residents to see if they are eligible for Medicaid, MCHIP or the Adult Primary Care program. If a person or family is over income for those programs but below 300% of the federal poverty line then they can enroll in a program to gain access to health care.

The range of services is comprehensive and will be available at an affordable monthly cost. The County administration should be applauded for trying to insure that County residents don’t have to go without health care. The program has its critics who say that the number of people using the program was below what was projected. Advocates for the program acknowledge the lesser number but point out that many of the people coming in to apply have been found to be eligible for one of the other programs. It really doesn’t matter which program people enroll in as long as more County residents are covered for health care. The County program isn’t perfect but it is at least a stopgap program until our federal legislature brings health care in this Country into the 21st century. It will happen someday and hopefully soon.


The power of HowChow. Yesterday’s mention of my blog on burgers made a usually slow view day (Sunday) into one of the most views my blog has ever had. Thanks HowChow.

1 comment:

Kate Dino said...

Wish more providers in county accepted medicaid, though. You'd think my mother-in-law was trying to pay them in an imaginary currency the way they closed their shutters when she said "medicaid."