rough draft in outline form

i) Health insurance officially began in Dallas, Texas in 1929. Justin Kimball created Blue Cross as a way for local teachers to pay a hospital 50 cents each month, so that when they later got pregnant and went to the hospital to give birth, they wouldn't be charged hospital fees. This hospital maternity plan eventually evolved to include sickness and injury care as it does today.
(a) On a personal note, my wife and myself have no access because of pre-existing conditions, which make insurance premiums unaffordable. As a result of our situation, my Russian born wife is presently in Russia receiving needed medical care which is not available to us in America. The uninsured try many different approaches to secure medical access, Many times with little or no success. My wife cannot comprehend this situation, simply because in Europe medical access is a right, not a privilege as it is in America. If this crisis is allowed to continue, we will be on the verge of insanity when we speak of health care reform in America. There is absolutely no excuse for such injustice in a country that prides itself on human right issues around the world.
ii) Outline
2) Introduction
a) Anecdote
b) Define problems with current system and define terms
i) Most health care policy experts consider these 3 areas of criteria:
(1) Access- is it available to all those who need it?
(a) 47 million lack health insurance (2005 census beuroue estimates)
(i) This # isn’t counting those with terrible coverage or those who take gap years of being uninsured
(ii) 80% of # are employed or in household of employed—many are low wage, part time, seasonal, or work for small businesses. Most would rather not pay the workers premium
(iii) 17% make more then 75,000 a year
(iv) Young adults
(b) Employee sponsored coverage has declined dramatically while public sponsored care has not increased fast enough
(c) Medicaid and SCHIP program (kids) (depends on state)
(i) Many are eligible, but aren’t enrolled—beauratic barriers, minations, and lack of enrollmenteducation efforts on te part of the states
(ii) Deficit reduction act of 2005 requires proof of citizenship
(iii) Some states require you to be “desperately poor”
(iv)
(d) The issue at hand is access to health care and the uninsured, public and private insured have different experiences
(i) Medical debt and bills from being uninsured and higher income
(ii) Employee coverage often has no requirements for vision or dental, pharmasutical, HRA account on the decline because of rising prices
(iii) Non-group market (individual) have high premiums and co-payments, no mental, prenatal, or maternity coverage…in some states you are better off uninsured
(iv) HMOs and PPOs have serious coverage gaps, but are most affordable.
(v) Insured often experice a huge financial burden in the case of a medical emergency (2 in 5 Americans) some have their credit ruined, house taken away, aren’t able to rent apartments…
(vi) About half of all bankruptcies are because of medical expenses..most of these are uninsured
(vii) The Emergency Medical Treatment and Active Labor act make it possible for the uninsured to have access to emergency care (won’t be denied) but it is not free, but most forgo it.
(viii) Hard to get preventative, primary, or chronic care with no insurance 60% of uninsured report not getting it
(ix) Uninsured (mostly poor) are more likely to need medical care
(x) Institute of medicine 2005 study said nearly 18,000 adults die prematurely because of no insureance
(2) Cost- reasonable cost given the resources of the nation?
(a) Cost is approaching $2 trillion 16% of GDP
(b) Spend more on health care then we do anything else, and more then any other country
(c) 7.9% increase/year
(d) You can’t put a price on the newest expensive technologies that save life…newer technology requires more money
(e) High prices encourage investement in new technologies which have dramatically improved people’s quality of life and lifespan
(f) Costs are a direct cause of employers decline in offering health and retirement benefits
(g) 45% of health care is payed by United States—hurting public programs medicare and Medicaid cost increae
(h) As baby boomers retire, the burden to pay the rising costs will fall on the working class at the time
(3) Quality – acceptable? Achieve the best possible outcomes? Avoidable errors kept to a minimum?
(a) 44,000 to 98,000 Americans die every year from medical errors
(b) Lagging behind in implementing electronic health info that would allow health care providers to
(c) Malpractice more die form it then aids or breast cancer
(d) Other countries have these high rates as well
(4) Other criterion- freedom of choice, patients treated with respect- decision making and privacy, innovative research on medical problems and cures
c) Define what is being argued: health care reform (specific kind) due to the fact that both extremes of the argument have pros and cons
3) Part 1-The reformed plan
a) Have a private and public sector of heath care much different from the one we have currently. The private one can be for those who wish to not have government interference in the type of health care they get and be subjected to health care providers that are not employed by the government. This will accommodate the expectations of the rich and their value for the dollar: short waiting times and comfortable accommodations. The public sector will be based off of France’s socialized health care system. Also, to inspire more people to enter the nursing and doctoral professions (which there is a sever shortage) the government can provide a program where they pay for medical/nursing school in exchange for a certain amount of years spent working in the public sector of healthcare. This way the theory that health care is a privilege to those who can afford to stay well can dissolve. We will have to overcome the opposition of interest groups that profit from the current system—insurers, small businesses, the pharmaceutical companies, and organized medicine. Insurance and pharmasuetical companies will have to compete with the government so they will be forced to offer good plans of coverage. Middle class citizens can have a mix between public and private. In extreme catastrophic instances, they can go to public healthcare, in other routine instances they can over limited private plans that cover visits.
4) Part 2 – The pros and cons of Universal
a) Care for every citizen regardless of social class or situation
b) Illuminates wastefulness in current system—all the paper work and profit making
c) Development of centralized national database which will make it easier for health care providers to diagnose and treat
d) Doctors can concentrate on healing patient rather then insurance procedures and filings
e) Open doors and opportunities for those who could not afford it before to practice preventative medicine and a good well being
f) Cons: Beurocracy plain and simply sucks: all the red tape, slowness, lack of faith in,
g) Profit motives and compititoins have always been shown to lead to higher efficiency, better services, and the drive for better and newer technologies
h) It is not “free” health care. Like all other social program it will come out of taxes
i) Healthy people will have to pay for those who make poor choices like smoking, and poor diets
j) Complete transition from private to socialized will cause all sorts of chaos and loss
k) People could sue the government for malpractice (reformed policy would implement a govt. subsidized malpractice insurance for doctors. Lawsuits against the government could only happen in certain instances where the fault was not with the individual doctor.
5) Part 3- The pros and cons of Private
a) Competition sparks better services, technology, and efficiency
b) Comfort and choice of menu
c) Causes financial burdens because cost is so extremely high
d) A very large gap between quality of life saving care received between rich and poor
6) Part 4- who the system screws over the most, the evils of insurance companies, ways to support reform, incorporating alternative medicine in reforms
a) Profit and competition are a drive to provide the best, but insurance and pharmaceutical companies neglect its customers severely
b) Obama’s plan for reform
c) Encouragement to read literature about current issues with health care and to study all perspectives of the situation in order to make an intelligent plan
d) Government should look more into alternative and complementary treatments because they are less expensive and often times come with less risk and side effects then contemporary medications and procedures. Also these treatments consider the whole person: mind, body, and spirit. Other countries like India and China use traditional medicine just as much as contemporary and citizens often rely and trust the traditional more. The government should not ignore these alternative treatments
i) St. John’s Warts is prescribed frequently in Germany to treat depression.
7) Part 5- perspective of health care providers, patients, health insurance companies
8) Conclusion
a) By 2013 some estimate 56 million Americans will not be insured if nothing is done
b) Cost will be $3.36 trillion a year

Works Cited


Estes, Carroll L., and Charlene Harrington. Health Policy Crisis and Reform in the U.S. Health Care Delivery System. Sudbury, MA: Jones and Bartlett, 2008.
Jost, Timothy S. Health Care: At Risk a Critique of the Consumer-Driven Movement. Durham and London: Duke UP, 2007.

Maintenance Professional. North Carolina. September 10, 2005. Statement 10065.
http://www.healthcareproblems.org/Patients/NC/Statement10065.htm
The Health Care Problems Archive: A Collection of Problems with the U. S. Health Care SystemCopyright © The Health Care Problems Archive 2006 Site Last Modified July 27, 2006
http://www.balancedpolitics.org/universal_health_care.htm
http://www.pbs.org/healthcarecrisis/
http://www.medscape.com/resource/healthcare-reform
http://content.nejm.org/current.shtml