About The Mercer Cluster. (Macon, Ga.) 1920-current | View Entire Issue (March 6, 1989)
Universal Access Health Care rooms furnished in antiques and plush doctors* offices; business class care with well equiped hospitals and offices, but few frills; and poverty care in clinics and public hospitals. To those of us concerned with respect for every member of society this is unacceptable. Arguments for improvement of services to the poor bas ed only on equity have little success in the US. A country in which a major concern about the homeless is how to keep them out of sight of tourists, which seriously considers en couraging people to take their children out of public schools as a solution to the decay of inner city schools is not going to spontaneously decide to spend more to get “the great un washed** into their hospitals. Separate facilities for the poor are desired by many wealthy Americans who simply do not wish to be forced to face the poor. The economist who described the three tiered system of care evolving in the US titled his article “Are Americans Really That Mean?” A focus on equity alone will not bring the basic changes need ed, though it may improve funding for some public programs. Universal Access: A Better Solution There are other reasons for proposing a universal access system. Preventive medicine and agressive management of chronic illnesses reduce total social costs of health care. The best studied aspect of this is prenatal care. Early prenatal care has been shown to decrease the costs of neonatal inten sive care for low birth weight babies so much that the prenatal program’s costs are covered. Likewise, studies show that people who lost coverage due to Medicaid or VA cutbacks have poorer health and require increased hospitalization. There is ample evidence that asking people to pay direct ly for care decreases their use of prr entive services. The major cost savings associated with HMOs results from the elimination of barriers to preventive and maintenance care and the attendant decrease io more expensive hospital and emergency room usage. Countries which have a universal system and facilities as sophisticated as the US spend much less on health care than we do. An emphasis on improved health of the workforce and im proved effick ocy of society’s resource utilization makes this concept attractive to conservative, management oriented groups. Large employers, who are paying heavily for health insurance for their workforce, now feel that the lack of pay ment by small businesses is resulting in a competitive economic advantage for the small firms. Large companies may pay S3,000 or more, per employee, for health insurance coverage. Small contractors pay nothing and foreign com petition pays only a fraction of this amount. Many employer groups arc interested in finding an alternate mechanism for funding health care. The cost of a universal access system is portrayed as pro hibitive by opponents. These opponents claims that new taxes will be needed to finance such an entitlement program. However, the true cost of a unified program would be less than our society currently pays. Taxes deferred through medical deductions and employer benefits plans, tax funds paid through Medicare. Medicaid, the VA. and the hundreds of state and local programs for indigent care, cancer cire, leukemia care, etc. would be combined. Significant ad ministrative savings would result from stopping the present system of tracking every aspirin lablcfto its specific patient, determining who is eligible for whith program and billing individuals for the portion of costs they owe. Estimated ad ministrative savings are higher than the cost of providing care to the uninsured. Many analysis argue that placing a univeral access system on the political agenda just after the election of another Republican president is.unrealistic and that patching our pre sent crazy quilt is a more realistic goal. However, any in cremental program will increase total costs, as is seen in the Massachusetts plan. Plans which require poor people to pay a significant portion of their income for care would not reap the savings resulting from preventive care and early treat- Contlnued from page 8 ment of chronic illnesses. Public opinion polls continue to show that most Americans support a national health care system. A majority of Republicans and a majority of physicians support such a pro gram. People arc even willing to pay a modest increase in taxes to support expanded access. The strongest opponents of a unified system are the private insurance companies and the for-profit hospital corporations. A system which addresses questions of equity and effi ciency can be developed. It must be responsive to the needs of patients, health care workers, and institutions.'Programs differ in every country in which they have evolved, but once fully established they receive wide support. The best local model is Canada's which allows patients to chose their doc tors and pays physicians on a fee-for-service basis. Canada's total per capital cost for health care is significantly less than ours. Research and technological development have been supported because all persons benefit from new developments. Implementation Requires Broad-Based Support There are significant groups at local, state, and national levels working for the expansion of health care services. Massachusetts passed a referendum calling for universal ac cess in 1986 by an overwhelming majority A ballot intitiative is planned for California in 1990. Universal access to health care was a major portion of Jesse Jackson's platform. The American Public Health Association recently affirmed its support for a national health program. Recently formed groups of health care workers and consumers which are call ing for a national health program are being developed; broad based coalitions of health care workers, peace and justice groups, cmloyers, and citizens will be needed to work for an equitable and efficient system. It can be done. Wc encourage you to contact the organiza tions listed on page 7 to add your voice to those seeking sociaL justice through the extension of adequate health care to all Americans. ' MAKE YOUR VOTE COUNT THURSDAY, MARCH 9 # VOTE ON SGA PROPOSED CONSTITUTION 9 a.m. — 4 p.m. Lobby, CSC
