Healthcare Deja Vu Come True?

As health care access decreases and costs increase, we must look ahead to improving it for everyone.  In 2011 employers paid an average of $11,000 for employees and their families, while yearly insurance premiums rose from $13,000 to $15,000.  The following is an excerpt from "Building an American Healthcare System" released in 2002 when the average premium paid by employers was $6500. While proposing ways to decrease cost and access, one is able to see that good healthcare can be deja vu come true.

One stop shopping for medical care is in order. By having more clinics, easy access to care will help people to get what they need in a timely manner. Waiting to see the doctor is one of the reasons our health care is out of control. The Public Health facilities will be a setting in which health care providers will employed and compensated as in the private sector. It will be just as prestigious to work for the Public Health as the private sector. In addition, permanent protection of physician incomes can be guaranteed by the government much like the recent ruling in Britain (British Medical Journal, April 5, 2003). The concept of second rate, low paying health care for the low income associated with Public Health Service must be changed and amplified. We must be proud to work for our country’s health system, and to obtain top notch health services! In this set up, the uninsured are insured and objectives of the Fair Care to the Uninsured Act of 2003 will be met. This is very important. Those without insurance are sicker, die younger and receive less care for many conditions. The risk of illness increases the longer one is without insurance.


More emphasis from the USPHS for education, prevention and screening, eldercare, disabled care, chronic condition care/ chronic multisystem illness (CMI), health awareness, and education is needed. The Public Health clinic will evolve from the barely visible building or little trailer in the field to highly visible, easily accessible structures. Vacant malls and warehouse buildings can be bought and transformed to mini-medical facilities that provide it all. Pre-existing clinics in the area can be merged, or remain as satellite facilities. The goal is to have health care at every corner much like the neighborhood convenience store. The era for traveling 100 miles to your doctor, waiting half a day or more only to spend the average 5 minutes with your health care provider must cease.

Minnesota has set up a system that covered about 95% of its residents under 65 in 2001 (86% in 2000). It uses government and private insurance together to achieve insurability.  "Approaching Universal Coverage: Minnesota’s Health Insurance Plans" by Debra Chollet & Lori Achman of Mathematica Research Policy, Inc.states that it has been successful at serving "all populations in need at all levels of income". Coverage is included for the "medically uninsurable" like the person with chronic multisytem disease, or pre-existing conditions. Its GAMC and MA plans includes coverage for expenses that occurred in the 3 months prior to application, and do not have premiums or co-pays. Minnesota's programs have been, or are currently used in other states, and can be used to help lay the foundation for health care uniformity. The Commonwealth Fund has several publications that look at other states' health systems, and universal health coverage.

The effort to consolidate the American health system is a priority. Karen Davis' summary, "Time to Change: The Hidden Cost of a Fragmented Health Insurance System", states that the present system "is not up to the challenge of ensuring a healthy and productive nation because it is 'fragmented' ". The focus of her summary exemplifies how lack of uniform health services costs more with less results.


Attention must also be placed on employer health provisions.  In 2002 companies spent an average of $6500 per person for health care. This does not include the patients' out of pocket payment for services. The pages of uncovered services listed in many insurance handbooks grows longer. About 41 million employed by small business pay directly for services at prices compatible with the Medicare and Medicaid models. Through the leadership of the Public Health Service all businesses are uninsured primarily because it is unaffordable. Congress is presently looking at a concept called an Association Health Plan (AHP) as part of the Small Business Health Fairness Act. This would allow small business owners to offer large corporation health discounts. It would also be uniform nationwide. The AHP is in use in some states, and has come and gone in some. Last year 16 states closed down 48 AHP plans. This would be a great opportunity to "phase in" national coverage. As employer health programs are phased out, patients should be offered the option to obtain national insurance. Each person preventive and screening will be done without charge. Eventually this will lead to a healthier people, and health system at a much lower cost.