SCHIP: A Former Welfare Mother Asks Questions: Why Aren’t the Other Five Critical Parties’ Voices Louder on the Issue of Health Care for Children? Part 1 of 3
Oct 18th, 2007 | 20 responses
I’m a former welfare mother.
I’d just quietly offer that I’ve known the struggles in that arena firsthand. Scared by them, scarred by them, and strengthened by them. All of the above.
And, it’s for those reasons that I’ve been following the SCHIP debate. I’ve been looking and reading and wondering, How will SCHIP in any form make child health care be different for the poor now?
How will the children of the working poor, the poor and downtrodden, the poor and incapable… not so easily be left to suffer through illnesses, or else die because even minimal interventions that could help, were out of reach?
Will such aid as proposed by SCHIP, pay for preventative medical care that can ward away childhood illnesses that are otherwise devastating if left to fester
… like childhood diabetes type one, for instance, which when caught can be helped, and if not caught, can lead to blindness, neuropathy; loss of sensation in limbs, and diabetic coma.
But before final decisions about all of those matters, I have another question that keeps returning. Am I just missing something, or has the contretemps about ‘who is saying what to assassinate whose character’ with regard to SCHIP debate, created a smoke-screen that is making us forget that FIVE additional major players are needed to hammer out an effective plan of child health care, have been significantly missing from the debate and negotiation table?
1. Insurance companies, which have the ability to cluster patients across a broad spectrum of risk, and lower their rates reasonably, as well as humanitarily… insurance companies \also have the ability to work out a plan to cover pre-existing conditions in children at reasonable charge. Yet, we hear little about how they will contribute to the solutions regardless of whether they are direct insurers or whether the government will be.
2. Churches are major players in helping those in need. They have the potential under President Bush’s faith-based initiatives, to be deeply funded and deeply involved in child health care. Yet, we hear little from them.
3. Pharmaceutical companies, the same as insurance companies, have ability to create new and/or further expanded policy to offer low cost programs for ‘the real deal’ drugs. We have heard little from them
4. The Hospital Industry, which is a set of corporations that is for profit and can, if they choose, create a subsidiary temenos that subsidizes for tax write off, the care of the children of the poor.
5. Doctors and nurse practitioner groups at the national organization level, can contribute much to the dialogue/ debate about what would be needed to keep costs down and quality care high for children of the poor.
Each of these five powerful corporate and professional groups have within their reach, enormous public relations machinery to state their cases in the SCHIP debate: how they’d help, what they can do, how they see it all…
Yet isn’t the hot under the collar ‘irate debate’ actually leading us away from the most salient questions about how come these five have so little presence at this time?
I’d add a sixth group too, one that has no pr machine at all, or barely so. The genuinely poor. The poor who have children. Thus far none of the poor have had a voice in this debate.
There’s an old saying in our family: You cant craft a pair of shoes that will fit even half-way, without first measuring the foot that will wear them.
20 Responses to “SCHIP: A Former Welfare Mother Asks Questions: Why Aren’t the Other Five Critical Parties’ Voices Louder on the Issue of Health Care for Children? Part 1 of 3”
A couple of nitpicks.
Most (in-patient) hospitals are really not for profit and many of those are currently losing money. Most universities have had to spin off their teaching hospitals because they were losing so much money and the business operations of hospitals are so different from the business operations of universities. In the greater DC area, there is only two hospitals that are run for profit. In the District of Columbia, only two of the hospitals are not losing money. To think that hospitals need tax write-offs or have money to spend is not fully correct.
[...] unknown wrote an interesting post today on SCHIP: A Former Welfare Mother Asks Questions: Why Aren’t the …Here’s a quick excerptlike childhood diabetes type one, for instance, which when caught can be helped, and if not caught, can lead to blindness, neuropathy; loss of sensation in limbs, and diabetic coma. But before final decisions about all of those matters, … [...]
You seem to be asking the fat cats to address their perceived discrepancies.
Ain’t gonna happen.
What is in it for them? If there is no money to be made then Doctors who spend 12 years just getting ready to be a doctor its seems are not going to donate their time to helping children when their is a rich “Fat Cat” paying customer that would have to be turned away to provide such service.
Many a time Doctors are in debt to a tune of a quarter million dollars in loans they must repay in order to remove the debt they incurred from their cost of becoming a doctor. To then ask them to DONATE their time while noble is hardly in their best interests.
This is why the health care issue in America is so great and so very difficult to dissect and deal with.
This is why we need a national sales tax to take care of paying down the debt and paying for national health care.
Simply put……leave everything alone. Leave everything as it is and let the government instill Medicare type “reasonable charges” and let a national sales tax pay for not only the national health care that is needed but also to pay down the debt.
Once SOMETHING is in place then we can work on it, tweek it, adjust it, monitor it and complain about it. Nothing will be perfect coming from the government but something must be done and this gets the ball rolling until we can make the adjustments necessary to make it work in a capitalistic society.
While I am on a roll this morning and taking a break from work, let me point out that I think there are 3 items on the plate of America that I would consider national emergencies.
!. Health care
2.National Debt.
3.Immigration
My national sales tax would be written to address all 3 of these. With the establishment of a balanced budget along with the institution of a national sales tax would take a tremendous burden off of the states and allow them to further address the needs of its citizens which is now going in the direction of taking care of health and welfare of citizens and addressing a very large immigration problem.
With the simple balancing of the budget along with a national sales tax whose funds would go to pay for health care, immigration redress and paying down the debt this country could and would embark on becoming strong once again.
We want it that badly? Nothing in life is free. It costs. If we want this we HAVE to pay for it. Simple as that.
There’s a good chance that if you were working 35 years ago you also would have had a job that provided you with a decent health insurance plan. Those days are over too and that’s just one of the reasons why so many people are going into debt to get decent health insurance. In fact, medical debt is the number 1 cause of bankruptcy in the U.S. You might like to see a new video that is running on YouTube called ‘The Raymond Report’. You can do a search to find it or go to their website: theraymondreport.com
The guy helps people with insurance problems and has very interesting info that most people don’t know about just how bad the healthcare crisis is in the country.
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I have my doubts about SD’s claim about the majority of hospitals being non-profits. The overwhelming majority of hospitals in my area are not. They are part of the large corporate chains.
Secondly, numbers 1, 3 and 4 on the list are publicly held corporations. They have no interest beyond profit. Asked about it they will either deny that fact or cite the standard reasoning that their responsibilities lie with their stockholders. Do not expect them to address social concerns. Instead, expect them to actively lobby against any action for the greater social good that they perceive as having a negative effect on profits.
All of that is very true, which is why I wish someone would propose a program to increase the number of physicians by providing scholarships for qualified students, to be repaid with a couple of years of service in communities that need more doctors.
And to increase the supply of providers by requiring medical boards to rewrite the rules about which professionals can provide which services (increasing the scope of well care services that can be provided by physicians assistants and advanced trained nurses, so that more clinics could be staffed with primary care providers who don’t need to charge the higher rates that an MD does.)
Hows that ice skating down in you-know-where going? CS and I agree on something.
CS and I agree on something.
That perhaps is because most conservatives are not as heartless as they are portrayed.
This debate must be reshaped into not a left vs. right debate but rather it should accentuate the positive and the left and right both must be willing to give ground to achieve the goal.
The goal is health care for every American in this country without drastically changing America into a socialist nation.
Its doable. There just needs to be a coming together to get it done.
Thanks, Somebody- and also, it’s because my proposal is different than a typical big govt, wave the magic wand and create a program to pretend we can make the problem go away solution. It would involve govt spending, but in the form of an investment, not a handout. Some conservatives would oppose it, but moderate conservatives and moderate liberals can probably see the sense in it- and it’s those kind of ideas that can garner support from both sides of the aisle that are most needed, IMO.
Of course this is only one part of what needs to be a very multifaceted solution to health care problems- but it’s the type of thing that we need to get the people of this country motivated to support. We need to tell the lobbyists and special interests to go to hell if they don’t like the changes which would help bring down healthcare costs- the elected officials work for the people, not the industry, and it’s time someone pointed that out.
Jim,
According to
http://muse.jhu.edu/journals/journal_of_health_politics_policy_and_law/v027/27.4white.html
about 75% of the money spent at hospitals are spent at not-for-profits. Remember, the Mayo Clinic, Mass General, Sloan-Kettering, and Fred Hutchinson are all not-for-profits.
SD,
All I could get at that link was a summary of a 7 year old study and the summary did not mention the ratio. I don’t have time right now to look further, that will have to wait until this evening.
Maine already does something like this (main gov site rather than FAME site identified here). No doubt this would also happen if Medicare were extended to everybody. The goal (seeing more health professionals in underserved areas) would be better sought by government than through private arrangements (going to a community or a rural county and offering to practice there for five years if they paid for someone’s medical education).
“Students matriculating under the Access Program are required to sign a Student Participation Agreement that obligates them to complete at least two primary care clinical rotations in Maine. One rotation must be at a Maine Family Practice Residency Program during the third year; the other at an ambulatory care site in rural Maine during the student’s fourth year. Applicants to the Access Program should be aware that the State of Maine will make every effort to encourage students to select primary care specialties and to practice in Maine.”
“The Maine Dental Education Loan Repayment Program is intended to increase access to dental care to underserved populations in Maine by providing repayment of dental education loans for dental services providers. The loan repayment recipient must provide dental services regardless of a patient’s ability to pay. Loan repayment is available at the rate of $20,000 per year of services for up to 4 years for outstanding education loan debt.
The Maine Dental Education Loan Program is also intended to increase access to dental care to underserved populations in Maine by providing need-based dental education loans to Maine residents attending dental school. Dental students may be eligible for forgivable loans of up to $20,000 per year for up to 4 years. Loan forgiveness is available at the rate of 25% per year of service. The loan recipient must provide dental services regardless of a patient’s ability to pay.”
JIm,
the try http://www.uannurse.org/research/pdfs/industry.pdf (2003 data).
For profit hospitals are generally smaller since they do not have the research or residency programs.
there is just not that much money floating around in healthcare. The medical device industry has been through a massive contraction since there is really not that much money involved. Medical Schools are incredibly expensive and usually a money loser for a university. Nursing schools are an even bigger money loser.
CS-
I was glowing in the agreement between you and Jim S– until you described your excellent proposal as this:
“in the form of an investment, not a handout”
Investing in the future is what I, along with many others, have been trying to promote for eons.
We hit a brick wall of difference, however, when we discuss the particulars of where that investment shoul be applied.
I see investing in people’s health (on an individual basis, as needed) as an investment in the future, as well, along with other measures.
We also differ wildly on what a ‘handout’ looks like when it’s actually handed out.
Rather than worrying so much about handouts, I would much prefer that the wise of the nation concentrate on devising ways to turn every handout into an investment.
I’m thinking of a local news story about a grandmtother who has successfully reared many children and grandchildren, although she has never had an outside job and has never paid taxes.
Is her welfare check a handout or a thank-you for what she has contributed to the future of the country? In my book, she’s been a darn good investment.
While recognizing the constraints of fiscal realities, I often think that defining everything in terms of economics leaves huge gaps in what our national future sorely needs. By necessity, money matters rule. Let’s just not confuse necessity with ideals.
Of course we hit brick walls of difference, because we all see different ways of handling these things. Now, the question is, do you want to focus on ways that we differ, or put our energy into promoting the ideas that could reach broader agreement?
CS=
You are right, of course.
Areas of agreement are to be cherished.
I just have to invest in more anti-allergy salves for when I hear code words like: handdout, big government, personal responsibility, etc etc
Again: you are right to make the point.:)
While the paper you linked to acknowledges that there are more non-profit hospitals than for-profit it also points out that the number of for-profits is holding steady while the number of non-profits is decreasing.
Doma: Fair enough- I have my own set of allergens to deal with as well.