RSS Feed MenuTens of millions of Americans lack health insurance. Extending coverage to them has been a core goal of health reform proposals since the 1960s. President Richard Nixon offered a universal health plan in his first administration, but since then Republicans have hesitated to commit the nation to so costly an undertaking. Is it time to rethink? Should Republicans accept universal coverage as a goal? We posed this question to NewMajority’s contributors.
Bradley Smith notes that the United States already has a universal health care system called “show up at the emergency room” which he thinks works pretty well and that it makes no sense for Republicans to push for universal healthcare since it messes with freedom.
Frankly his idea of universal healthcare is probably the most expensive kind of healthcare, tackling problems when they are more serious and therefore more costly.
In 1996, I moved to Minneapolis. I was in my mid-20s and making $6 an hour and not able to buy healthcare insurance. I got sick with the flu in November of that year and the flu later became pneumonia. When I had trouble breathing, I went to an emergency room and was looked at. The doctor on call gave me a five-day supply of antibiotics and sent me on my way. My illness only became worse. Days later I went to a clinic for low income people and the nurse practitioner found out that I had a massive infection and needed to be placed in the hospital immediately. I was afraid since I didn’t have health insurance, but she told me not to worry about it.
In the end, I was able to get on to Medicaid which paid for a good chunk of what turned out to be a two week hospital stay.
I don’t favor single payer, or Obama’s public option. I also don’t think healthcare is a “right.” That said, I do think that Republicans should find a way to ensure that when someone is faced with illness, they are able to focus on getting well and not about if they can afford it.
Republicans should try to get to some sort of universal healthcare through things like health savings accounts and subsidies. We can show that one can achieve this without a massive government program.
My illness taught me that relying on emergency room care is not a good approach from a physical or fiscal standpoint. If Republicans truly care about this issue (which at times I wonder about), then we need to find ways to make sure that all Americans have access to affordable healthcare.
To read other contributions to this symposium, click here.
Should Republicans Endorse Universal Health Coverage? // Aug 23, 2009 at 4:35 pm
[...] Sanders, Universal Coverage: One Man’s Story Relying on emergency rooms to provide universal care is probably the most expensive kind of [...]
ottovbvs // Aug 23, 2009 at 5:44 pm
……..When you’re reduced to arguing that the emergency room is the way out and that most people are content with it, then it really demonstrates how totally bankrupt the Republicans are on this issue…..Mr Sanders tells an emergency room horror story from his own experience so I’ll tell one from mine that I put on Smith’s thread but he ignored as he did the fact that I pointed out emergency rooms are not free…….A 27 year old guy takes care of the fences and arbors and other garden woodwork at my property…….a couple of years ago he broke his leg and had to go the emergency room…..serious fracture in two places…..admission to hospital……emergency surgery…..three day hospital stay….bill $54,000….it was this high because most emergency rooms charge full tariff not the insurance company or Medicare negotiated one……$54,000!……..is it any wonder about 2/3 or personal bankruptcies are brought about by medical bills…….what’s most interesting about this is that although Sanders can see the problem, has indeed experienced it himself, he is still so married to ideology that he’s going to put his hope for a solution in small govt and nonsensical chimeras like health savings accounts which don’t work for anyone earning less than about $175k…….that you Dennis?
balconesfault // Aug 23, 2009 at 6:07 pm
Dennis – you’re absolutely right. For a myriad of reasons, anyone claiming that the requirement that public and non-profit emergency rooms accept anyone who walks through the door represents a form of “Universal Care” that is good for anyone involved should be basically excluded from the debate as someone who is not serious at all about the topic.
sinz54 // Aug 24, 2009 at 11:24 am
balconesfault: I second your motion.
Emergency Room care is urgent care. It’s to stabilize the patient and stave off a catastrophe (and, as ottovbs sez, at a relatively high cost). But then the E.R. doctor will tell the patient to go find himself a specialist for whatever continuing care will be needed.
Example: The E.R. can stop a kid’s asthma attack. But for long-term asthma control, the kid has to go to an allergist who can do the necessary allergy tests and so on.
I’ve been through that myself.
The brutal fact of the matter is that the disadvantaged simply get worse care. Their chronic conditions are poorly managed. And while E.R. doctors will strive valiantly to save their lives in medical crises, eventually their chronic conditions will take their toll.
If you’re Steve Jobs or Ted Kennedy or Bill Clinton, you get the best care America can provide. If you’re poor and obscure, you get something else.
Universal Coverage: One Man’s Story - Hip Hop Republican // Aug 24, 2009 at 11:42 am
[...] The New Majority has a piece out by Dennis Sanders on his battle with health coverage as a Republican. [...]
The Progressive Republican // Aug 24, 2009 at 2:27 pm
[...] Note, the following was originally posted at New Majority.com. [...]
Brad Smith // Aug 24, 2009 at 9:31 pm
Boy, that’s what I get for describing the reality. Look, this is the law in the United States – if you show up in the ER, they have to treat you.
This simple assertion of reality seems to have sent a lot of people into full hyperventilating mode. Look, I’m an old veteran of health care. I was doing health care when it wasn’t cool to do health care. Years before the Clintons reached the national stage, I was doing health care cost containment. So this is an issue I know a bit about.
I did not suggest, and do not suggest, that ER care is cost-effective. Nor do I suggest that it is the equal of the care and attention one gets if one is insured. Nor do I suggest that it means we should not try to get more people covered by insurance and provided with better care.
But while Balconesfault may think anybody who thinks that ER care is good should be kicked out of the room, I suspect that for most people, ER care is better than no care, in much the same way that full pay care is better than relying on mandatory ER acceptance.
If we want to deal with this problem seriously, we have to be willing to state what the law actually is. If we can’t do that, we’ll get no where. From that starting point, I have asserted a couple of points that no one seems to have taken on, for whatever reason: a) that most Americans seem pretty satisfied with the health care system in the U.S., at least with their personal situation; and b) universal coverage proposals have been rejected over and over by the American public. Universal coverage sounds good in the abstract, but Americans don’t want it in the concrete, when they are forced to consider the actual tradeoffs that would have to be made. I don’t think that any of this is controversial; and therefore c) Republicans should not endorse universal coverage, but should continue to work on a wide variety of pro-freedom solutions that will improve healthcare access, affordability, and quality, especially for the economically disadvantaged and those who will suffer chronic diseases that make it difficult to obtain insurance.
Anybody wants to debate that, let’s go to it.
balconesfault // Aug 25, 2009 at 1:39 am
But while Balconesfault may think anybody who thinks that ER care is good should be kicked out of the room,
Let’s see … does relying on ER care to take care of the uninsured really address their healthcare needs? Not really.
Is relying on ER care to take care of the uninsured best for the physicians? Nope.
How about for the ER’s that have to maintain excess resources to take care of people who would have been been treated days or weeks before by some kind of physician visit? Not hardly.
I’m standing pat. The idea of relying on ER’s to provide universal care does nothing good for anyone involved. The only benefit flows to those not involved, who save money by not having been part of this great inefficiency.
NM Symposium Part 2: Universal Coverage: Right Goal, Wrong Principle? // Aug 25, 2009 at 7:27 am
[...] Sanders, Universal Coverage: One Man’s Story Relying on emergency rooms to provide universal care is probably the most expensive kind of [...]
Brad Smith // Aug 25, 2009 at 8:54 am
So Balconfault has now, having had time to think it over, officially adopted the position that it is better for the indigent and uninsured to receive no health care at all than to go to the emergency room.
OK, if that’s really the position you want to take.
Meanwhile, the fact remains that the current law in the United States is that ERs take all comers, no matter how much Balconsfault doesn’t like that policy. The starting point for any reform is to look realistically at what the situation is, and then use that to evaluate changes, and public acceptance for changes. Pretending that reality is not what it is, simply because you don’t like the reality, doesn’t provide a sound basis for formulating policy.