Saturday, June 20, 2009

Systemic Health-Care-System-Flaws

It is a good thing that there are hearings about our healthcare system. There are some revelations to get.

Some days ago I wrote about one systemic flaw of the United States Healthcare System, and that is because Insurance Companies have to decide to give their money to their shareholders or to their ill clientele.

I wrote, too, to discover the reason for this by walking in the shoes of Insurance CEOs.

Today a new system flaw was revealed to me on TV:
Health Insurance in this country is not mandatory.

Here what happens because of that:
Health Insurers argue that people do not buy any health insurance until they have a serious condition, and this behavior is very costly to the Insurers. For that reason they sort out everybody who has a serious condition and sell health insurance only to people who are really profound healthy. To further protect against fraudulent getting Health Insurance, in case there is an illness in later years, there will be a research on the patients medical records to find any sign or hint that this condition may have been recognized earlier, but not mentioned by the person who asked for Health Insurance. In case this fraud is recognized, payment will be denied, even if the patient paid his premiums over years. This is a very understandable behavior of the Insurance Company, as everybody will recognize.

What does this say?
The United States Health Insurance System has weak points and systemic flaws:
1. Because Health Insurance is not mandatory, people are denied to get Health Insurance.
2. Because Health Insurance is not mandatory, less people pay in, and premiums are higher.
3. Because Health Insurance is business for profit, denying payments is raising profits.

The result: with raising premiums less people can afford Health Insurance, so premiums are always on the raise, until the system collapses. That's why I am saying the United States Health Insurance System is shoveling it's own grave.

But now a reform of the United States Health Insurance is in the making. There are a lot of other points to look for, but if Health Insurance is not payable, it does not help anyway.

What is most important to do?
Health Insurance has to be mandatory for everybody, to make premiums affordable.
With mandatory Health Insurance denial of Health Insurance no longer has to be tolerated.
Health Insurances shall have a mix of wealthy and poor people, of healthy and ill people, this mix, based on solidarity, guarantees cost compensation and makes premiums depending on the paying abilities of the insured possible.
There have to be nonprofit Health Insurance Providers, to fully support people in need instead of insurance stakeholders. Preferable shall be nonprofit Health Insurance Providers supervised by a parliament of the insured people.
These points are totally important.

I thought by myself, would be nice if somebody has written a book titled "History of the United States Health-Care System" - nobody has, but some Universities are asking their students to write about it.

Googling for the "History of the United States Health-Care System" is really interesting.
I like to quote some of my results, starting with a remarkable one:

There is great variation between health systems around the world. In the U.S., health care providers, insurers, employers, and the government are all unofficial partners in a complicated and loosely defined health care "system." In contrast to most other nations where the government finances health care for the majority of its residents, most Americans have some form of private health insurance sponsored by employers. A sizable share have government-sponsored insurance, with those over 65 years of age covered by a federal program (Medicare) and some poor children and their families eligible for a state-federal program (Medicaid). This public-private model is unique among nations and affords those who are most affluent and who have insurance with access to among the best quality of care in the world. At the same time, 45 million individuals in the U.S. have no insurance and experience considerable barriers to care and in many instances poorer health outcomes than their insured counterparts.

And here are more excerpts of history you should know:

The history of managed health care
The history of managed health care is fraught with problems and potholes. We should not be proud of health care history in the USA - it is a disgrace. We pay more than any other country in the world and get less than two-thirds of the services received by most of the worlds population. And, the worst part of it seems that everybody says we have the best doctors, hospitals and nurses!

A Brief History of Health Care in America
Managed Care as we know it today has its roots in a number of prepaid healthcare arrangements in the early 20th century. This article gives a short history on the evolution of America's modern-day healthcare system.

Any successful attempt to reform health care in the United States must accommodate two realities:
Reality 1: The current system is increasingly inaccessible to many poor and lower-middle-class people (about 47 million Americans lack health insurance, up from about 40 million in 2000); those lucky enough to have coverage are paying steadily more and/or receiving steadily fewer benefits.
Reality 2: Open discussion of a "single-payer" system in which the government pays for and regulates health care is verboten within the political mainstream because it is presumed that Americans would never accept socialized medicine. Whatever solution arrived at by Congress and the president (in all likelihood, not this president) will have to harness market forces because, it's widely believed, markets will always outperform the dead hand of government.

Read this Website:
Why doesn’t the United States have universal health care as a right of citizenship? The United States is the only industrialized nation that does not guarantee access to health care as a right of citizenship. 28 industrialized nations have single payer universal health care systems, while 1 (Germany) has a multipayer universal health care system like President Clinton proposed for the United States.

Did I write, nobody has written a book? But wait, there is one:
Jonathan Cohn, a senior editor at the New Republic, has written such a book. Cohn's book is Sick: The Untold Story of America's Health Care Crisis—And the People Who Paid the Price. Each chapter of Cohn's book is devoted to one or two patient narratives that illuminate a particular dysfunction of the present medical system, and the chapters are arranged in such a way that the dysfunctions appear more or less in the order in which they first became significant national problems. The result is an 80-year chronology of repeated market failure, with each successive reform serving at best as temporary respite from the previous problem. Read it and weep. Capitalism can't deliver decent health care.

Do you need Health Care?
Get your Information, find out why and how a real Health Care Reform has to happen now!
Write to your Representatives, ask for the right things to do!



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