Universal coverage is not “free medical care”

Universal coverage is medical care that is pre-paid BY all the members of a political entity (those who have the means to pay) and FOR everyone under the jurisdiction of that entity, regardless of their socioeconomic condition. This payment is made through equitable and effective collection and administration. The end result is that no person who is in need of treatment will be turned away, no patient has to deal with payment at the time treatment is received, and no medical entity has to bill patients directly. It does NOT mean that doctors, nurses, hospital staff and other care providers have to work without fair compensation. It DOES mean that decisions about prevention and treatment will be based on what is best for patient and society, not on what will generate a profit. Universal coverage does not preclude wisdom in making those choices or sound financial stewardship. Quite the contrary.

This is a good time to to think about the broken medical / pharmaceutical system in the United States, lay aside old biases, put an end to name-calling, and look pragmatically at ways to do it better. A change of heart at the national level would be wonderful, but even the most heartless and self-interested individuals should be able to agree that if there is a vaccine or a cure for a highly contagious and potentially fatal disease, they should be available to ANYBODY who needs them, no questions asked, no money changing hands between patient and provider. Those with even a flicker of compassion would also agree that no person suffering from a curable or manageable illness or accident should be left to die just because they have no money.

There are many options for funding and administering universal health care and dealing with the many complexities of the effort. We can study the models provided by all the other developed nations and even some less-developed ones. Medicare for All has the advantage in the United States of giving us a familiar place to start, adapting and extending any of its policies and structures that have worked well, and building others that will make it work universally.

Any system will be less effective if it is not administered with honesty, integrity, and hard-nosed oversight. However, the decision to make the best health care available to everyone who needs it should not be postponed because of a lot of “what if’s.” Make the commitment, and then put the best qualified, most honest people you can find in charge. Perfection is not attainable, but ongoing improvement is.

Corruption and abuse can creep into even the best systems. They should be dealt with proactively and as they arise, but the possibility should not stand in the way of getting started any more than the possibility of rain should stop us from ever planning to do anything because we might get rained out.

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