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Universal Access Health Care
rooms furnished in antiques and plush doctors* offices;
business class care with well equiped hospitals and offices,
but few frills; and poverty care in clinics and public hospitals.
To those of us concerned with respect for every member of
society this is unacceptable.
Arguments for improvement of services to the poor bas
ed only on equity have little success in the US. A country
in which a major concern about the homeless is how to keep
them out of sight of tourists, which seriously considers en
couraging people to take their children out of public schools
as a solution to the decay of inner city schools is not going
to spontaneously decide to spend more to get “the great un
washed** into their hospitals. Separate facilities for the poor
are desired by many wealthy Americans who simply do not
wish to be forced to face the poor. The economist who
described the three tiered system of care evolving in the US
titled his article “Are Americans Really That Mean?” A
focus on equity alone will not bring the basic changes need
ed, though it may improve funding for some public
programs.
Universal Access: A Better Solution
There are other reasons for proposing a universal access
system. Preventive medicine and agressive management of
chronic illnesses reduce total social costs of health care. The
best studied aspect of this is prenatal care. Early prenatal
care has been shown to decrease the costs of neonatal inten
sive care for low birth weight babies so much that the prenatal
program’s costs are covered. Likewise, studies show that
people who lost coverage due to Medicaid or VA cutbacks
have poorer health and require increased hospitalization.
There is ample evidence that asking people to pay direct
ly for care decreases their use of prr entive services. The
major cost savings associated with HMOs results from the
elimination of barriers to preventive and maintenance care
and the attendant decrease io more expensive hospital and
emergency room usage. Countries which have a universal
system and facilities as sophisticated as the US spend much
less on health care than we do.
An emphasis on improved health of the workforce and im
proved effick ocy of society’s resource utilization makes this
concept attractive to conservative, management oriented
groups. Large employers, who are paying heavily for health
insurance for their workforce, now feel that the lack of pay
ment by small businesses is resulting in a competitive
economic advantage for the small firms. Large companies
may pay S3,000 or more, per employee, for health insurance
coverage. Small contractors pay nothing and foreign com
petition pays only a fraction of this amount. Many employer
groups arc interested in finding an alternate mechanism for
funding health care.
The cost of a universal access system is portrayed as pro
hibitive by opponents. These opponents claims that new taxes
will be needed to finance such an entitlement program.
However, the true cost of a unified program would be less
than our society currently pays. Taxes deferred through
medical deductions and employer benefits plans, tax funds
paid through Medicare. Medicaid, the VA. and the hundreds
of state and local programs for indigent care, cancer cire,
leukemia care, etc. would be combined. Significant ad
ministrative savings would result from stopping the present
system of tracking every aspirin lablcfto its specific patient,
determining who is eligible for whith program and billing
individuals for the portion of costs they owe. Estimated ad
ministrative savings are higher than the cost of providing
care to the uninsured.
Many analysis argue that placing a univeral access system
on the political agenda just after the election of another
Republican president is.unrealistic and that patching our pre
sent crazy quilt is a more realistic goal. However, any in
cremental program will increase total costs, as is seen in the
Massachusetts plan. Plans which require poor people to pay
a significant portion of their income for care would not reap
the savings resulting from preventive care and early treat-
Contlnued from page 8
ment of chronic illnesses.
Public opinion polls continue to show that most Americans
support a national health care system. A majority of
Republicans and a majority of physicians support such a pro
gram. People arc even willing to pay a modest increase in
taxes to support expanded access. The strongest opponents
of a unified system are the private insurance companies and
the for-profit hospital corporations.
A system which addresses questions of equity and effi
ciency can be developed. It must be responsive to the needs
of patients, health care workers, and institutions.'Programs
differ in every country in which they have evolved, but once
fully established they receive wide support. The best local
model is Canada's which allows patients to chose their doc
tors and pays physicians on a fee-for-service basis. Canada's
total per capital cost for health care is significantly less than
ours. Research and technological development have been
supported because all persons benefit from new
developments.
Implementation Requires Broad-Based Support
There are significant groups at local, state, and national
levels working for the expansion of health care services.
Massachusetts passed a referendum calling for universal ac
cess in 1986 by an overwhelming majority A ballot intitiative
is planned for California in 1990. Universal access to health
care was a major portion of Jesse Jackson's platform. The
American Public Health Association recently affirmed its
support for a national health program. Recently formed
groups of health care workers and consumers which are call
ing for a national health program are being developed; broad
based coalitions of health care workers, peace and justice
groups, cmloyers, and citizens will be needed to work for
an equitable and efficient system.
It can be done. Wc encourage you to contact the organiza
tions listed on page 7 to add your voice to those seeking
sociaL justice through the extension of adequate health care
to all Americans. '
MAKE YOUR VOTE COUNT
THURSDAY, MARCH 9
# VOTE ON
SGA PROPOSED CONSTITUTION
9 a.m. — 4 p.m.
Lobby, CSC
