DISQUISITION

This essay is still under construction and I am aware that there will be much to add and/or change under further reflection. Perhaps when I crystallize my thoughts I might submit this somewhere as an OP-Ed if it seems worthwhile. I am also well aware that there is material present that may be repugnant to some. Again, where religious or ethnic beliefs are a factor they should not be imposed on those who believe different.

However, since it is the national topic of the moment-as it should be-I am going to post it in several instalments perhaps not in daily sequence depending on other daily occurrences. In the meantime I hope it will be some sort of a road map in your appreciation of the development of a Health Care policy. HSY

DISQUISITION

I have attempted to present an overview of the Health Care Reform project before the Congress and some of the problems that have been delaying any action and might even end in a repetition of the Clinton disaster of 19 years ago.

This dissertation will be most likely biased and controversial since it reflexes my opinions some based on years of hands on involvement with patient care, interpersonal relationships, and intrusive bureaucratic interference from both lay sources and governments.

I have compartmentalized my thoughts in to the following topics knowing full well that this will flow into several pages or days if posted. The groupings are;

· 1-Consumer

· 2-Producer

· 3-Provider

· 4-Miscelaneous or Others.

CONSUMER:

The Consumer is obviously you and I. Every person living in the legal boundaries of the United States of America is the subject of the need for health care.

It is not a “Right” but rather a social and civic responsibility. No one should be denied that care no matter what their ethnic, religious, and economic or citizen status may be.

That of course raises the question of the “Illegals”. I submit that on moral grounds how can anyone `professing any religious consciousness deny another human being the right of life? Even the agnostic or atheist must have inherent compassion for another human.

That is difficult to perceive but must be combated in this age of terrorism, murder, crime and bigotry if we are to survive.

Accepting that principle, let us review what I understand to be the President’s basic goals accepting as a fact that 47 million Americans have no insurance.

The majority has some degree of coverage either as individuals or through some group be it Union or Employee based. There are several gross deficiencies that must be corrected.

· No one should lose coverage because of an illness or accident.

· No one should be denied coverage because of a preexisting condition.

· No one should lose coverage because of a job loss or change in employment. There should be provision for continued insurance for a sufficient period of time to transfer to another carrier or some sort of “Public Option”

· The “playing field musty be leveled so that the individual buying insurance or the small business providing it should be offered comparable rates to the major employers, unions, and government agencies.

· Individuals or families with income restraints should either get subsidies for their insurance or be entered into a pool; this is similar to the Automobile program for the uninsured.

· The elderly should not be penalized by rate increases as the result of actuarial determinations. It is true the older one gets the more likely that there will be need for medical and hospital care.

o In commodity insurance such as property or vehicle coverage risk factor is the determining principle for the premium rate.

o Health insurance which must include all the 19-40+ age groups who use very minute amount of resources should spread it rate determinations universally so that the elderly are not priced out of coverage. This is radical and I have not seen it addressed, but I feel is the cornerstone of any successful program.

· The unemployed or the Illegal should be covered by either a Federal sponsored plan or by an insurance group pool program. Their premium would be flexible or paid by the government depending on ultimate Congressional decision.

· The so called “basic coverage” should not limit or ration health care. It may restrict physician and/or facility availability to closed panels, whereas the “better plans will allow choice.