Why I Support Universal Healthcare

As a future physician, I have a unique perspective on the issue of universal healthcare. I would like to take some time to underscore some of the main points for why universal healthcare is good for Texas. At a later time, I will delve into the specific reasons to support universal healthcare in Texas. In the meantime what follows are the most fundamental ideas behind universal healthcare.

The central tenant of universal healthcare is that it is a basic human right. This is based on the idea that everyone should be entitled to competent, timely, and quality medical care when they need it. As a doctor, try to imagine for a minute the practical reality of saying to a teenage girl that does not have health insurance, “I am so sorry. I know you are having labor pain and you might be within hours of delivery, but since you can’t pay for the medical costs we cannot admit you to labor and delivery.”

This obviously would never be tolerated. What happens instead is the hospital sends her a bill totaling upwards of tens of thousands dollars in medical fees. This uninsured girl will have effectively mortgaged her future prospects for college education in exchange for medical care.

This is not a rare scenario, quite the opposite in fact. Experts estimate that upwards of 45 million people sometime in the last 2 years were without healthcare insurance.

The problem with that is you don’t get to pick when you have a car accident or when you get sick. So, what do we do with people who cannot afford to buy insurance but get sick? Do we ruin them financially? These same people are the ones who can least afford to pay the costly medical bills, otherwise they would buy insurance!

Think about this, for example: Given that we are in a recession, it’s not implausible that your company could cut your job, and six months after that your COBRA healthcare coverage could expire. So, you could be without insurance unless you can pay the full premiums that were previously subsidized by your employer. Would you be able to afford 500 to 600 dollars more a month after you have been laid off?

A corollary to the central tenant is that universal healthcare is not only the morally right thing to do but it is the economically smart thing to do. As we all know you can walk down any county or city Hospital, like a Ben Taub Harris County Hospital, on any given day and find any number of uninsured patients (and not just undocumented ones!) who are not going to be turned away for medical treatment, but who cannot afford the costly medical interventions they require. These unpaid costs get absorbed by medical system and ultimately passed onto everyone else who pays for healthcare insurance.

The particularly damaging thing about absorbing these costs from the uninsured is that the interventions required are much more costly, because they went without any medical coverage for so long (hoping that they would stay healthy). What this means is that the uninsured wait until there is something seriously wrong with them before they seek medical care. So, it shouldn’t be a surprise that when they wait this long it is much more expensive to care for this person because the medical condition is much more serious.

Just like investing in the financial markets you want to buy low and sell high and make a huge return on your investments. In the healthcare setting buying low means being insured from the start and staying insured and selling high means you prevent the debilitating and costly medical complications that arise from lack of proper continuous medical care.

So, those are the underlying reasons for why I support universal healthcare. The implementation of such a plan is the hard part. But, for starters, you have to agree at least in principle on the overall strategy. The rest of the hard work comes afterwards on determining how best to pay for it and how best to insure everyone. I submit to you that it is possible to do both and that the Democrats have outlined some bold and enthusiastic guidelines to do exactly those two things.

I will continue to post on this topic and explore in detail a number of related topics including: economic and race-based disparities in medical diagnosis and treatement, healthcare access inequities, insurance discrimination and profits, and preventative care medicine.

The Idea of Universal healthcare is a great one. Practically carrying this out is another. There are many countries in the world that provide universal health care. None of these countries do it well. And Mind you, we are a young nation compared to the rest of the world. They have had more time to tweak and perfect their Healthcare.

Ex. Germany has universal healthcare. To receive anything but the basics, they have to be scheduled. Well this schedule is months down the road for Catherizations, dental, bypass, etc. Nothing is done with the speed at which it is handled here.

Universal healthcare is not the answer. The answer is to provide the uninsured with the ability to pay for their health insurance, similiar to CHIP. As for undocumented, whether we like it or not they are a drain on our public resources. They do not pay income taxes for fear of being found out. As yall like to lump together people, the “Republican” - meaning just bush - party tried to get immigration reform passed recently to bring the undocumented into the american fold. But BOTH parties fought this for whatever reason. NO compromise was ever made. We can eliminate the passed on costs of covering the uninsured by helping to provide low cost insurance and by getting undocumented people to pay taxes. (No, I don’t want to see all undocumented get instant amnesty. But put them on guest visas and let them become citizens like every other immigrant that has worked hard to be here legally.)

These are excellent points and it seems that at least we agreed from the outset on the main principles of providing healthcare to everyone. I would note that you even support CHIP. (Which was legislation championed by Democrats and for which expansion was recently vetoed by Bush and a razor thin margin of Republican congressman).

Also, the universal healthcare plans offered by the Democrats are not trying to increase state-run insurance (as is the case in Germany) but rather make it fair and affordable for citizens to get on private insurance.

To be sure, I understand that it’s not an easy system to implement. I said as much in my post. Also the comparison of the U.S. medical system to foreign countries is definitely apples and oranges. As you point out we are much younger and what works in one place may not work in another (and vice versa). I would suggest however that we can do it well, but we just need to get motivated.

You also touch on how complicated the problems of the system are bringing immigration into the mix. I avoided that specific topic, even though it is related, because it represents a much larger set of policy issues that have to be flushed out. I’ll save this topic for a future post.

I understand your criticism that we lump “Republicans” together in an overreaching manner. I will try to be more specific in the future. But please note that where I used “Republicans” I am referring usually to specific legislation that was overwhelming voted for in favor by republican leaders whether it be at the federal or state level. Which is not to say that on any given legislation there were not members from the Dem side that supported it as well.

Update - Also you mention the “speed with which it is handled here”. I just noticed this comment and wanted to point out that the speed with which you receive medical care here in the US also depends on a) if you have insurance and b) what type of insurance you possess (i.e. your available access to health care providers). As any person who is uninsured or under-insured can tell you the waiting lines are every bit as bad as they are in Canada or the UK for example.