The push for universal health care is mostly about covering uninsured citizens, but what I wanted to know was: What would it mean for us diabetics and others with chronic diseases who depend so acutely on the system?
Background: In California, Sen. Sheila Kuehl (D- Los Angeles) just announced the California Health Insurance Reliability Act, her third stab at pushing a universal-care bill through the Legislature. This calls for a single-payer system like in Canada, in which government pays for health care but keeps the delivery of health care under mostly private control. Supporters say the system would be more fair, cheaper and more efficient than the current patchwork system in the US. But opponents say quality will suffer, bringing with it long waits for health care services, a slowness to adopt new technologies and maintain facilities, and big bureaucracy that will rob patients and doctors of authority over clinical decision-making.
I found a neat sheet on myths and facts about universal health care from the American medical student association. But like most materials on the topic, there seems to be a strong underlying agenda/bias.
What seems clear is that healthcare spending is now concentrated on curative care, while it ought to be focused on preventative care. When patients with cancer, heart disease and diabetes wait too long to get treatment, you end up with high incidence of ultra-expensive chronic conditions. (Duh!)
Clincher: Opponents claim "the American people do not want to stifle the innovation and quality that the private sector enables" in the healthcare sphere. Hmm, why can't I picture sick people with minimal or no health insurance cheerleading for capitalism?
Take Janice Ramsey, of Deltona, Florida, the 60-year-old small business owner who was dropped by her individual policy when she was diagnosed with diabetes. This woman was left with $22,000 in debt by a fraudulent association health plan, and turned down by numerous other carriers. Now she remains uninsured and worried she and her husband could lose everything if she gets seriously ill before she becomes eligible for Medicare.
Mrs. Ramsey is one of the cases highlighted in a new study by American Diabetes Association and the Georgetown University Health Policy Institute, called "Falling Through the Cracks, Stories of How Health Insurance can Fail People with Diabetes." This study publicly substantiates many of the dirty little secrets about being chronically ill: diabetics tend to lose insurance coverage more frequently and are uninsured longer than healthy beneficiaries.
Conclusions are nothing new, really, but now have the punch of being official ADA research results:
- "the impact on the entire health system due to uncontrolled diabetes are enormous."
- "In 2002, one in ten healthcare dollars and one in four Medicare dollars went towards diabetes care. The cost of diabetes in America in 2002 was at least $132 billion.
- "We can reverse these trends, but to do so, we need a health care system that allows diabetes patients to manage their care and that provides the tools to help reduce the number of Americans who will be diagnosed with the disease.
- "Given that as many as one in 10 Americans live with diabetes today ... and one in three Americans will have the disease by 2050, it is time for policymakers to seriously rethink the flawed health insurance solutions up for debate that harm as opposed to benefit people with diabetes."
Neither the ADA nor the JDRF take an official stance in the universal health care debate. This seems to be as close as they get —- calling for a "serious rethink" of today's flawed system. If a major overhaul is in order, then sounds to me like "going Canadian" might be an excellent option. Ostensibly, fewer people fall through the cracks, and preventative care takes a front seat —- not least because a more holistic system will work together to prevent the mushrooming costs that result when diabetics and other "sick folk" are left untreated for too long.