HEALTH CARE CONT.

Plainfield/Health Care; two distinct but interrelated subjects. There is the vacuum created in the Plainfield Area Health Care by the loss of MHRC and the potential for recovery of adequate quality services as the result of "Obama Health Care " reforms. Whatever will happen will be driven by the "$" sign.

In the ideal world every one would have the same degree of health services that the President receives. But that costs money, the root of all evil. There are only two theoretical forms of government that could potentially create such a state, neither of which has ever evolved politically. They are "Communism" or "Socialism". There are unique difference s between both, so a definition is included at the end of this post.

Plainfield lost its health anchor because of supposed increasing operational debt. That was reportedly due to the patient mixture and increase in the number of indigent patients. Obviously the answer to their care is to walk away, with State approval.

If one holds to the tenet as I do that everyone is entitled to complete health care irregardless of ability to pay understanding that it is not a right or entitlement but a societal responsibility, it is imperative to include the undocumented residents.This is a great stumbling point, but in the end it is less costly financially by preventing long term institutional care. It is less costly morally because by excluding any group of society you deny that "all men are created equally".

Unfortunately, there has to be a compromise because there is no way such complete care can be afforded. Government can not pay without increasing its source of income, Taxes, or by increasing debt. With the later the reckoning day has to come . The politician hopes that will be someone else's problem long after he is gone.

The Universal Health Care plans passed in Congress addresses the issue in several ways, all which if explored completely will compromise the quality and quantity of care. I will admit that I am not familiar with all of the nuances in the plan and I will bet that none in our Federal Government understands every thing that was legislate.

However, I think the percentage of the population excluded by the plans runs abut 20%. Of the 80% covered the care can only be fiscally justified by: (a) limiting services; this is accomplished by giving the insurance carriers and Medicare/ Medicaid the right to determine necessity or substitute alternate procedures which may not be equal but "similar". (b)The other option is to progressively reduce reimbursements while at the same time increasing costly legal operational requirements. The later often has no relationship to quality but satisfies bureaucratic thought process. Examples are the constant reduction by Medicare or Insurance plans of reimbursement to "providers".

Since I do not believe that any Hospital/ ER setup will be able to survive at present much less than in future reimbursements. I can not conceive any operator opening even a small 125 bed "full service" and expect to survive.There is a change in the last 20 years that could still make remotely make a commercial operation potential. That is in the human delivery of services.

Since the advent of the HMO's there has been a tendency for physicians to form group practices. The members take scheduled turns in visiting hospital patients.In other cases the hospital is employing its own physicians to treat in patients while excluding the referring doctor.

In the doctor's office the MD is becoming less the deliverer of care but more and more the administrator by increasing the role of less trained Physician's Assistants and Nurse Practitioners or Social workers for actual patient contact.

No longer is there a personal relationship. Patients are no people but have become a case number. Much of the population has accepted that because it saves them money. Health c are is no more than grocery shopping.

If the Feds/States/ Insurance carriers increase Hospital/ER reimbursement to cover expenses and with the employment of in house based physicians and auxiliaries to render care a commercial operation could succeed.

Pure communism, or the stage in history after socialism, refers to a classless, stateless society, one where decisions on what to produce and what policies to pursue are made in the best interests of the collective society with the interests of every member of society given equal weight in the practical decision-making process in both the political and economic spheres of life

Posted 4/1/11 Title added 4/2/11

Socialism any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods

Socialism is an economic and political theory advocating public or common ownership and cooperative management of the means of production and allocation of resources.^[1][2][3] A socialist society is organized on the basis of relatively equal power-relations, self-management, dispersed decision-making (autocracy) and a reduction or elimination of hierarchical and bureaucratic forms of administration and governance, the extent of which varies in different types of socialism.^[4][5] This ranges from the establishment of cooperative management structures to the abolition of all hierarchical structures in favor of free association