Health care for Americans who can't afford health insurance

Of course all 50 U.S. states and possessions each have their own health services for the indigent, both alone and in concert with the federal government, depending on the program, but often we forget the biggest and oldest provider of all, the U.S. Public Health Service, under the Surgeon General, Department of HHS.

The U.S. Public Health Service Commissioned Corps is a team of more than 6,500 full-time, well-trained, highly qualified public health professionals dedicated to delivering the Nation’s public health promotion and disease prevention programs and advancing public health science. As one of America’s seven uniformed services, the Commissioned Corps fills essential public health leadership and service roles within the Nation’s Federal Government agencies and programs. Officers serve their country in communities that are most in need by providing essential health care services to underserved and disadvantaged populations.

If you have unmet medical needs because you have no insurance and low income, seek help at the nearest USPHS hospital, clinic, or field facility. 

Learn more about the USPHS services, and also how you can find a career as a civilian medical professional or uniformed PHS officer with them here.

Native Americans receive medical care without cost to them, regardless of income, through the Indian Health Service (IHS) and, if low income, also are eligible to participate in all low-income programs offered by the states and federal government. Native Americans do not pay for doctor visits, surgeries, hospital stays, wellness care, emergency care, maternity and pediatric, prescriptions, or medical equipment. Medical, dental, vision, hearing, addiction, and counseling services are available free of charge to Native Americans through IHS facilities and clinics.

Healthcare update

Many Americans watched the great health care square table summit, ostensibly to give Republicans a chance to give their input into a bill which Obama says is set in stone. It was defeatist and futile from the onset, but it gave me a chance to see how polarized the two parties are and how they just used the occasion to repeat their talking points. At least that is what I came away with from my hour or so watching of the non-event.

The Democrats talked about our moral responsibility to pass universal health care, and the Republicans talked about the equal need for fiscal responsibility. I personally think we need a big dose of both, not one or the other.

Some of you may suspect that I am not in favor of big government. I sort of like government by the people rather than government by the government. However, the deep need for some things have made me moderate my position for some big causes. Health care is one of those exceptions.

I have blogged about this before, and I made a list of the things I wanted. That list has been refined after a year of debate. Some things are still the same.

---------

1. I want everyone to be covered. No exceptions.

2. I want everyone to participate in both the coverage and the payments for it.

3. "Everyone" means nobody gets to opt out or have their own special plan. Not even congress.

4. There must be one price for everyone. No special people and special low risk pools. One pool. Everyone is in that pool.

5. Every disease and injury is covered. Elective things like cosmetic surgery is not covered.

6. People who abuse the system go to jail.

One problem: the bill they came up with doesn't do this. Did we not say that congress would screw this up? Ha!

---------

What do we do about insurance companies who now employ zillions of people?

Do we get to choose our own company still? (I don't want the government as my insurance company, friendly and compassionate and efficient as they are.)

Do we get to go across state lines to choose a company? Why would we want to if all charged the same and covered the same?

Where does the competition come from if all companies charge the same and cover the same?

How about all the people who don't have to pay because they made wrong life choices and don't have any money? I mean, are we going to do anything to make them go to work, or just pay their way? A lot of them are deserving and have nowhere to turn. But a lot of them just chose not to work as hard as others did or educated themselves. Will there be some justice there? Will they get to do some work for us one day a week? No? Not fair to them? Well, so be it.

---------

A work in progress.

Medicare

Sometimes we in the U.S. don't think about, or don't remember, that we already have the beginnings of a national health care program here. Perhaps - and this is just a thought - we should consider taking what we have now and expanding it gradually until it either serves all of us or it at least serves all of those who no have no health insurance (or no eligibility for free health insurance.)

I'm speaking of Medicare, of course. Right now, Medicare is pretty restricted as to whom it covers and what it covers, but the bureaucracy is already in place and it seems to me perhaps we might consider expanding this government medical insurance to cover more and more people and more and more situations rather than starting completely from scratch.

What is Medicare? From the government website:

"The Centers for Medicare & Medicaid Services (CMS) administers Medicare, the nation's largest health insurance program, which covers nearly 40 million Americans. Medicare is a Health Insurance Program for people age 65 or older, some disabled people under age 65, and people of all ages with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant)."

From this we can glean that Medicare is already the nation's largest health insurance program.

This is a complicated subject, and I want to only present it in little chunks, so I am going to stop here for now. But consider that Medicare is

1. Already in place, with its own self-contained bureaucracy of paper-pushers

2. Already serving many people

3. Paying more or less promptly

4. Keeping records in a uniform manner

5. Using uniform forms.

Health care

This is not a post about Obama's national health care bill that is now working its way through Congress. That was so hastily put together that it probably won't pass. (I don't know if that is a good or bad thing, because nobody seems to know the particulars or fine print of that bill - only that, like the infamous "stimulus package", Obama wants it rushed through immediately one way or the other.) I am not one who believes that ANY health bill is better than NO new health bill. So we will have to wait and see on that.

The talk about a national health care program, however, has prompted me to give it considerable thought. I have seen interest in my blog travels to other blogs, for example on the blog of Stephanie B, so I am apparently not alone in my pondering.

As usual, I clarify my thinking (for myself, in my own mind) by writing out what I am thinking, and I am now in the process of trying to put in writing what I think is a workable solution. This is certainly not the the place that bit of writing, but I will link to it when it is finished. Right now I just want to throw out an outline of what a good health care bill should include, as well as some of the obstacles or problems that I see. Here are my initial observations. Some are obvious, some may not be.

1. Everyone who lives in the USA should have access to adequate and quality health care. (Everyone in the world should too, but this post is about U.S. health care.)

2. Not everyone can afford to buy private health insurance.

3. History (especially recent history) shows us that large private corporations are often dishonest, lazy price-fixing entities which defeat the concept of honest competition.

4. History shows us that the Federal Government is good at doing certain things, but are often not the most economical or fast-responding people in the world.

5. Although our Federal Government is corrupt to varying degrees in every branch, Congress is the real obstacle to getting a GOOD health bill passed, because they are just too beholden to special interests.

My own version of such a health bill would HAVE to include AT LEAST the following points, or I wouldn't support it.

1. Everyone would have to be covered.

2. Everyone would have to help pay for it (although perhaps with their labor or service instead of money.)

3. It would have to be administered fairly, effectively - and as economically as practicable while still providing the proper coverage and level of service.

Must stop here or I will break my shortness rule, if I haven't already. But if I WERE to continue, I would talk about how I want to see GOOD SERVICE, MORE HEALTH CARE PROVIDERS, BETTER FACILITIES, AND WELLNESS CARE INSTEAD OF JUST EMERGENCY CARE.