Module III

This week's reading assignment covers a good amount of topics. With institutional resources they of course mentioned a national public health system and access to care. I think this of course will always be a permanent topic of much debate as long as our health care system remains as is. http://www.burtonreport.com/InfHealthCare/BritNatHealthServ.htm is a link to an online British journal regarding their views about the English National Health Service as well as the idea of the United States emulating a similar structure. Basically they believe that "standing patiently in line for rationed goods" is not in the American mindset. I agree. Considering all the moaning and complaining that currently exists over taxes. Can you imagine the degree of discord if taxes were to be raised to a level to support a national health system?

Currently, most medically necessary interventions are available to us. For the medically indigent you are covered by Medicaid, those stuck in between have the "safety net" and no one is denied life care within emergency situations. Would Americans stand by while those who need medically necessary surgeries were denied due to rationing under the new system? Americans work for and basically expect nothing but the best. Will Americans be willing to wait patiently for their grandmother to wait a few months to have her tumor removed because a ration based limit has been met for that type of surgeries that year? Doubtful.

However, I don't think a national health system is the only answer. There are many alternatives such as initiatives that require employers to distribute some level of health insurance or monies used for health care. Right now a great portion of the uninsured are the "working poor" or those who make enough not to qualify for Medicaid but do not make enough to buy insurance or have the ability to save enough for private pay. There could always be a government program that provides insurance to those who qualify, based on their income, for a insurance program where premiums were affordable. However, that's just me. I remember Dr. Unruh used to say that HSA's wouldn't really work since those who are healthy would opt for them leaving the very sick to stay with insurance companies. Inevitably this would skew the case mix for insurance companies and raise premiums so high that the very sick would suffer which is obviously not the aim of health care.