Universal Health Coverage

It's time that the people of the United States of America join the rest of the industrialized world and demand that their government implement national health care coverage for all: not just for people over 65... not just for a segment of our child population... not just for people who work for the right companies... not just for the wealthy who can afford it... but universal, comprehensive, single payer, national health care for each and every American citizen.

Just as every American is entitled to legal representation... just as every American is entitled to a free public education... just as every American is entitled to protection by a local fire department should his house begin to burn, I believe (along with every president since Harry Truman) that every American is entitled to all necessary and appropriate medical care including: hospital services, emergency services, preventive care, laboratory and diagnostic services, prescription drugs, periodic medical checkups, ambulance services, home health and extended-care services, family planning, pregnancy-related care, hospice care, child immunization, outpatient care, and mental health services. Health care should not be a commodity. It should not be a product or service that exists for the purpose of profit or corporate aggrandizement. Health care is a right and it belongs to every American citizen.

I don't know how many of you remember the losing battle waged by President Clinton five years ago for his Health Security Act, but it isn't easy to forget the $10 million ad campaign conducted by the Health Insurance Association of America. It featured commercials starring the worried suburban couple known as "Harry and Louise," who spent their evenings fretting about the Government "take over" of health care. It was a fabulously successful propaganda crusade and it achieved its purpose. It actually convinced the American people--who just two years before had believed in Universal Care by a 62% margin--that this dastardly socialist plot would deny them the basic right to choose their own doctors, and subject them to decisions made by faraway bureaucrats and unfeeling number crunchers. And so, we have today's managed care instead.

And guess what happened? Exactly what Harry and Louise were worried about has come to pass... but not because of a socialist plot. On the contrary, it has been the excesses of market capitalism that have displaced patients and caregivers from center stage and replaced them with for-profit HMOs whose first allegiance, by law, isn't to those seeking medical care, but to their shareholders. It is the health insurance industry that takes premium money intended for patient care and uses it for marketing, stockholder profits, and outlandish executive compensation.

Listen to this: The salaries of the chief executive officers at the nation's 35 largest for-profit HMOs increased 32% in 1996, to an average of $l.3 million, not counting another $70 million in stock options, while all over this country medical care has taken a back seat to cost containment and non-medically-based decisions. And what about Harry and Louise's biggest fear that they wouldn't be able to choose their own doctors?

This letter was sent to me on January 28th of this year. A month ago. It was written by my primary care physician, as the managed care phraseology goes. My doctor. Quote. "For the last several years we have contracted with Prucare and Prudential (the insurance company that has the contract with my employer) to provide medical services to you. Over the years, Prucare has made changes in their policies that make it more difficult to deliver care in an efficient and personal manner. We have complied with these changes, but recently they have become constricting to the point that the patient/doctor relationship is secondary to the rules they have made. I have made a decision that, starting Feb. 9th, we will no longer be a provider for the Prudential organization." Close quote. So, unless I want to pay a lot more money to stay with this doctor who is now "out of network," I have essentially lost my family physician. Thank you, managed care.

But at least I will be able to get another doctor, as long as I stay in my current job. What about the 41 million Americans who have no health benefits at all? Who pays for their care when they seek and receive treatment, which they often do at a stage of illness or disease that requires more expensive remedies? Well, we all do in the form of higher insurance premiums and skyrocketing medical costs. So we have, now, the worst of both worlds. Millions of insured Americans taking second place to corporate profit-making, and millions of uninsured Americans who are already being carried by the rest of us.

It is clear that the time has come--indeed it is long past--that we call for a moratorium on for-profit health care in this country and agree on some basic principles:

1) That medicine and nursing must not be diverted from their primary tasks: the relief of suffering, the prevention and treatment of illness, and the promotion of health;
2) Pursuit of corporate profit and personal fortune have no place in care giving;
3) Financial incentives that reward over-care or under-care should be prohibited, as should business arrangements that allow corporations and employers to control the care of patients;
4) Every patient has the right to the physician of his or her choice; and
5) Access to health care is the right of every American citizen.

It is time to fight the powerful insurance lobby and its bought-and-paid-for congressmen and senators. The enemies of national health care have had their chance and we can now see the gaping ruptures in their worn-out clothes. Single-payer, comprehensive health care is the only program that can achieve humane, universal, and affordable care. It's time for a new suit!