In spite of all the money we spend on medical research and health care, many Americans receive startlingly poor health care. Reform is in the wind!

To say that there is a health care crisis in America comes at no surprise to most U.S. citizens. Medical services have become too costly and too hard to acquire for many of us. Nobody answers the telephones on Wednesday afternoons, when private practitioners take off to play golf. No one is available when the child falls off the swing. Nobody seems to know how to give advice over the phone for the simplest of first aid treatment, or worse, they fear lawsuits if they should give the wrong advice. Patients are advised to “go to the nearest emergency room” instead of receiving care from their primary care physicians, all because the doctor does not want to be “bothered.”

For a family of ordinary means, the cost of a severe injury or sickness can be catastrophic. Numerous families across this nation have been forced into bankruptcy by a single illness!

For families with less than ordinary means, the quest for medical care may be a losing fight for life. Every day last year, hundreds of people died because they could not obtain emergency care. Health care investigators document this grim toll as death by “natural causes.” Some of the 1,000 victims were refused serve by private hospitals because they could not pay. Others died because emergency rooms or doctors were not available. One mother in one of my introduction to psychology courses told the class that one of her children died last year for want of emergency care. In her case, she did not have medical insurance, and the hospital let her sit outside in the waiting room with her badly injured child for five hours. Finally, the hospital staff came out and told her that they ‘did not have a bed’, and the child would need to be transferred to the county hospital. This hospital, which was 12 miles away, caused a fatal delay.

America has won world preeminence in medial research. Americans spend more on health than anyone else, yet the U.S. ranks 15th among industrialized nations in infant mortality, 12th in maternal mortality, 19th in male longevity, and 6th in female longevity. Nations that spent less did better!

The American Medical Association challenges these comparisons, saying that the “international statistics often cited to show that American health care is terrible are not generous for comparative purposes.” However, they also do not wish to imply that the health care in America is perfect. They know that there is room for improvement.

Improvement, in fact, is in the wind. In Washington, where several plans for health care reform has been proposed to Congress, a sense of urgency prevails. There is nationwide optimism that, through the Obama administration, health care reform will soon be a fact rather than a dream. The word is getting around. When the word gets around, Congress and the Administration have a way of doing something about it.

What, specifically? While the details of health care reform remain up in the air, there seems to be two “Health Care for All” initiative that are gaining steam.

The first is a national insurance belief to protect families from the cost burden of “catastrophic illnesses” such as chronic heart or kidney disease, or asthma, which for some families require annual outlays of thousands of dollars for many years. The time for this has arrived. It is politically acceptable. Under one plan before Congress, all costs over a certain dollar amount (which has yet to be distinct) will be underwritten by federally sponsored insurance.

A second initiative is “something for the abominable.” It is a program to replace and supersede Medicaid, which has been an unmitigated disaster in many parts of the country. The care Medicaid provides often is poor, and the cost is grand. Yet millions of low-income Americans, especially children, are not protected in any other way. One proposal in Congress would provide cash grants to pay health insurance premiums. Another would offer tax credits to insurance purchasers. In other plans, protection would be provided, at little or no charge, through a national health insurance notion.

Ironically, more health insurance, for most people, far from relieves the current crisis in health care. It is believed by some experts, in fact, that more health insurance will aggravate the situation. The health care system is already overworked, overloaded, and breaking down. Increasing the case load without streamlining the machinery could lead to peril.

I am reminded of the times when I had to visit the local Indian Clinics here in Oklahoma. These are free health care facilities for anyone who has a CDIB card (or in another words, can prove their Native heritage). I have never been to one of these clinics where the appointment resulted in anything but an all-day affair. The doctors tend to be foreign, whose English-speaking abilities leave much to be desired, and who have no clue about the cultural or ethnic traditions of Native American people. Even something as simple as getting a vaccination shot for your children can easily retain you in the clinic for 5 hours. I can only imagine that once a national health care system is invented, the level of care would more than likely be similar to these facilities. Frankly, the only people who go to these places are those who have no choice!

Some prescription-based savings programs have helped some people to obtain free or nearly-free medications. Sadly, the people who need health care the most cannot even access these programs, simply because they cannot afford to pay a doctor to get the needed prescription!

Critics of the prevailing fee-for-service method of dispensing medical care say that a basic question must be resolved: Is health care a business or a service? They insist that only if it is reorganized as a service will “Health Care for All” become a realistic goal.

Other critics concur in the need for basic change. Planners, physicians, and the public have begun to forge new systems of health care. These systems may rescue, or in many areas replace, the one-to-one relationship of patient and doctor and the fee-for-service setting of his private office.

In many communities the hospital emergency room has become an important round-the-clock health center for critical and not-so-critical situations. Emergency room visits have more than quadrupled in the last twenty years!

The greatest need is for health workers who can deliver famous care. That is, the simple case-finding, diagnostic and therapeutic services needed by large numbers of people. Much of the burden in our emergency rooms today can be handled by these general health care practitioners, if only care was awarded to them. Patients who have no health care insurance are regularly denied access to the simplest of doctor’s services, and therefore turn to the hospital emergency room, where they know they will receive care, even if that care comes 12 hours after admission.

All of the many plans for health care reform raise complex issues with regard to who will pay for the changes, and how, and who will lead the modern systems. How is each of us to resolve which concept or plans merit encourage and which should be resisted? How much participation and control does the plan delegate to the consumer? Who is eligible? Is the plan well-coordinated? What will it cost the consumer? Is quality control built into the system? Is provision made for continuing experimentation to rep better ways to deliver health care to the community?

American medicine is being asked to develop effective methods of continuously testing and improving the health care that brings medical advances to the American people. This may be the most crucial medical breakthrough of all!

Sources:

en.wikipedia.org/wiki/Health_care_reform_in_the_United_States
www.healthcarereformnow.org
www.whitehouse.gov/issues/health_care
www.heritage.org/Research/HealthCare/bg2128.cfm