Universal Health Care – The Ideal Health Care

There are various theories floating around about health care at the moment. Each and every single one has an ideal attached to it, in which every single individual gets accessible health care whenever they need it at an affordable rate. However, very few of them actually put a plan into action that dictates how the ideal would be achieved. One of those that does is universal health care. It does imply that every person in the world should have access to basic health care, which would raise the health level of the world. Universal health care also refuses to take factors like age, location and status into account. However, it is slightly optimistic considering the third world does not even have access to basic utilities yet.

However, the idea of universal health care is backed by several ideas as to how it can be carried out. Universal health care should in fact be administered via a series of insurance policies that are controlled by the government of any given time. In this way, universal health care will give everyone access to health care whenever they need it at very little personal cost, thus ensuring that every single person can actually call a doctor out whenever necessary. Universal health care may also be administered through a series of clinics and other medical establishments to ensure that lower class individuals that cannot afford private health care can just drop by.

Universal health care could actually be administered by any number of schemes in effect, but at least there are ideas in place to ensure that it could work if governments in power at the moment changed their policies. The ideal behind universal health care are valid as preventative as well as remedial because it would actually encourage everyone to have regular health checks to ensure that they stay in the best of health. This would include testing g younger people for STIs and monitoring their progress as they grow up via a series of vaccinations against diseases that may cut their lives short. Similarly, under universal health care would actually allow older people to be tested for ailments like diabetes on a regular basis too.

Universal health care could provide treatment for every individual, whether they could afford it on paper or not. This would provide great positives for all of humanity and make for a much better world. There is so much more resting on universal health care than just health care alone. If we want a better world, we have to take the chance whenever we can. Universal is one of the chances we should take.

Reorganize the Health Care System

All citizens of our country deserve the security of universal health care that guarantees access based on needs rather than income.

It is a fundamental human right and an important measure of social justice. The government should play the central role of regulating, financing, and providing health care. Everyone faces the possibility of poor health.

The risk should be shared broadly to ensure fair treatment and equitable rates, and everyone should share responsibility for contributing to the system through progressive financing.

The cost of health care is rising. Over the past years its expenditure have risen faster than the cost increases reported in other sectors of the economy. As a matter of fact, the free market doesn’t work for the health care system.

* * *

There are two ways of financing health care:

The first is a private method of financing, by means of using workers’ and corporations’ money as premiums for acquisition of private insurance, which provides medical care. The established order leaves far behind 47 million people without health insurance.

The second way, which is used by all developed countries of the world, is by taxing the workers for health care, which generates a pool of money, financing it through the budgets of the countries. The people of our country prefer private medical insurance and private health care. Getting accustomed, in the course of time to the existing system, our people reject all other proposals independent of their merits.

An analysis of the acting system of private health insurance shows that this in essence is a social method of distribution of collected premiums. The insurance companies collect premiums from all insured workers and spend a part of them for health care of needy patients. As we see, private stays only the misappropriation of profits. Social distribution is carried out not on the scale of the full country, but is only limited by every medical insurance company.

Medical insurance companies use as the basis of their operations an unfair practice. They select for medical insurance only relatively young, healthy, working people, which rarely are sick. They constantly increase the premium rates, excluding retirees who need substantially more care. Thus, the health insurance companies established for themselves hothouse conditions. They make billions of dollars in profits, which in essence is a simple misappropriation of unused means of healthy people, that don’t need medical services. Justifiably these means should be set aside in a special fund and used for care when these workers retire.

Under the existing system, medical insurance companies have every reason to limit our care and increase our co-payments and deductibles. HMOs are famous for refusing to cover necessary hospital stay, denying people coverage for emergency room visits and balking at medically necessary procedures and therapy. The main reason our system is so expensive is that it has to support profit-hungry HMOs. In the U.S. thirty percent of each premium dollar goes to pay for administrative expenses and profits.

HMOs stand as a useless obstacle in between doctors and their patients. A question occurs. It is necessary to have HMOs in the system?The answer is clear. There is no need for HMOs. This is an unnecessary link and it need to be abolished. It is necessary to establish a system that allows providers to concentrate on care, not on profit margins.

* * *

The health care system needs a fundamental change and improvement. It consists precisely that is necessary to decide a ripe task about improvement of medical care, simultaneous lowering the expenditures and providing all citizens of our country with goo care. This major problem brooks no further delay. It is generally known that health care in our country equates with small business, and all participants are interested, like every business, in receiving the highest possible profits.

Breaking up the medical care into small medical offices don’t favor the development in this field and the fundamental medical tasks of lowering the cost of medical care by following reasons:

advanced medical technology can’t be used in these offices;conditions don’t exist for a high level of organized health services;doctors prefer to minimize the time for medical examination of patients;fee for service is not the best idea in this field.

The enumerated shortcomings in its turn lead to:

the growth of serving medical staff and administrative expenses;deterioration of efficacy of outpatient treatment, increases visits of patients and needless referrals to hospitals;aggregate increase of expenditures on medical care.

* * *

Under existing circumstances of irrational organization of medical care in our country, it is necessary to look for new structures to satisfy the requirements of contemporary reality.

Inevitably comes to mind a conclusion of advisability to reorganize the whole structure of medical care. Instead of great numbers of small unproductive medical offices it is preferable to organize large-scale multi profile medical clinics, each of them to be attached to a near hospital and working in two shifts.

These outpatients’ clinics should be equipped with modern medical and information – computer technology, as well as contemporary laboratories, and carry out in them all necessary medical examinations, tests, procedures etc., considerably raising the quality of medical care and labor productivity of all medical staff.

Another important measure – fundamental change of existing payment system for medical doctors care. We offer the introduction of pay by the hour remuneration system in the form of rate of salaries. Salaries for doctors should be established in dependence with the qualification, confirmed every five years, exemplary 150-200-250 thousand dollars yearly. Besides that should be established a distribution of bonuses for successfully carried out surgeries and excellent medical treatments of patients. This undoubtedly will switch over the attention of medical doctors to quality health services for patients. In essence, only such radical changes can be called medical care reform.

* * *

It is advisable to set up a public, non-profit organization for medical care of the population of the whole country, with branches in all states. The leadership of the non-profit organization should be carried out by the best experts in medicine, science, economics, finances and public relationship. They must take full responsibility for the medical care of the entire population and the use of means for financing it. It must include effective mechanisms for controlling costs of medical care. All controversial questions should be decided between medical doctors-experts from this organization and treating doctors. This will be a managed health care system. Managed care reflects the country’s distinctive approach to a universal human challenge. The cost of medical care must be contained. The rational for limit setting policies must be explicit and readily available to the public. The rational must show how the policy promotes good care for individuals and optimal use of available resources for the large population.

It is advisable to free the medical doctors from the necessity of insurance against cases of committing medical errors, lifting of them the heavy burden of unnecessary wasted expenses. Medical doctors, undoubted should carry the responsibility for committing criminal negligence in the performance of their duties, causing irreparable harm to the health of treating patients.

* * *

It arises a question. How to carry out the financing of health care in the new term?

The main thing and the only source of financing should be the use of a special tax for these purposes. It should be worked out a scientifically grounded percent of tax for the income of workers and profits of corporations and businesses, generating a fund, which should defray expenses on health care. To this fund should be directed the means from Medicare and Medicaid. Thus, all the means for financing medical care should be directed from the budgets to the public non-profit organization. This organization, in a proper way, should work out in detail an estimate expenditure of its budget. Within reasonable limits of this budget will be maintained the full medical care system.

A scientific institution of appropriate profile should work out such a budget. If one may put it that way, undoubtedly we can assume that the maintenance cost of medical care under the new favorable conditions will be considerably lower than at present time. It seems to us, that the proposed perfected system sets a shield to uncontrolled expenditures of medical care, which under the system of unlimited presentation of bills to Insurance companies, Medicare and Medicaid becomes similar to a snowball, uninterruptedly going downhill on the verge of disaster.

The system of medical care and financing of a new type should decide the topical problems of contemporary health care.

Making the Choice to Execute a Health Care Power of Attorney and Living Will

Advances in medical technology, recent court rulings and emerging political trends have brought with them a number of life-and-death choices which many have never before considered. The looming prospect of legalized physician-assisted suicide is one such choice which severely erodes the inherent value and dignity of human life. The much-publicized efforts of certain doctors to provide carbon monoxide poisoning or prescribe lethal drugs for their terminally ill patients constitute euthanasia. So may the removal of certain life-sustaining treatments from a patient who is not in a terminal condition. Euthanasia and willful suicide, in any form, are offenses against life; they must be and are rejected by the vast majority of U.S. states.

However, people faced with these difficult dilemmas should be made aware that there are morally-appropriate, life-affirming legal options available to them. One such option, for Catholics and others, can be a “health care power of attorney” and “living will.” South Carolina State law allows you to appoint someone as your agent to make health care decisions for you in the event you lose the ability to decide for yourself. This appointment is executed by means of a “health care power of attorney” form, a model for which can be obtained from your attorney.

A health care power of attorney can be a morally and legally acceptable means of protecting your wishes, values and religious beliefs when faced with a serious illness or debilitating accident. Accordingly, for persons wishing to execute health care powers of attorney, see the following instructions and guidance from the authoritative teachings and traditions of various religious faiths.

The intent of the health care power of attorney law is to allow adults to delegate their God-given, legally-recognized right to make health care decisions to a designated and trusted agent. The law does not intend to encourage or discourage any particular health care treatment. Nor does it legalize or promote euthanasia, suicide or assisted suicide. The health care power of attorney law allows you, or any competent adult, to designate an “agent,” such as a family member or close friend, to make health care decisions for you if you lose the ability to decide for yourself in the future. This is done by completing a health care power of attorney form.

You…

o Have the right to make all of your own health care decisions while capable of doing so. The health care power of attorney only becomes effective when and if you become incapacitated through illness or accident.

o Have the right to challenge your doctor’s determination that you are not capable of making your own medical decisions.

o CAN give special instructions about your medical treatment to your agent and can forbid your agent from making certain treatment decisions. To do so, you simply need to communicate your wishes, beliefs and instructions to your agent. Instructions about any specific treatments or procedures which you desire or do not desire under special conditions can also be written in your health care power of attorney and/or provided in a separate living will.

o Can revoke your health care power of attorney or the appointment of your agent at any time while competent.

o May not designate as your agent an administrator or employee of the hospital, nursing home or mental hygiene facility to which you are admitted, unless they are related by blood, marriage or adoption. 1996

Your agent…

o Can begin making decisions for you only when your doctor determines that you are no longer able to make health care decisions for yourself.

o May make any and all health care decisions for you, including treatments for physical or mental conditions and decisions regarding life-sustaining procedures, unless you limit the power of your agent.

o Will not have authority to make decisions about the artificial provision of nutrition and hydration (nourishment and water through feeding tubes) unless he or she clearly knows that these decisions are in accord with your wishes about those measures.

o Is protected from legal liability when acting in good faith.

o Must base his or her decisions on your wishes or, if your wishes cannot be reasonably ascertained, in your “best interests.” The agent’s decisions will take precedence over the decisions of all other persons, regardless of family relationships.

o May have his or her decision challenged if your family, health care provider or close friend believes the agent is acting in bad faith or is not acting in accord with your wishes, including your religious/moral beliefs, or is not acting in your best interests.

CONSIDERATIONS FOR ALL PEOPLE FROM CHRISTIAN/CATHOLIC TEACHING

The following is an attempt to gather information from the doctrines of Christianity, Catholicism, and Judaism to see if there are any commonalities with regard to health care agencies and living wills. We will see that all three religions have placed a value on dying with dignity and the right of the person to direct how their dying process will occur.

A major tenet of the faith is that it is unethical to take a life. It is not the highest of all values to stay alive, but you cannot affirmatively take steps to kill someone. The church is strongly against euthanasia and suicide. But often if the patient and medical care providers permit nature to take its course without heroic intervention, the person’s life may be taken by God.

This is a narrow path. Taking a life is inappropriate; on the other hand, using heroic medical measures to keep a body biologically functioning would not be appropriate either. Mere biological existence is not considered a value. It is not a sin to allow someone to die peacefully and with dignity. We see death as an evil to be transformed into a victory by faith in God. The difficulty is discussing these issues in abstraction; they must be addressed on a case-by-case basis. The Christian church’s view of life-and-death issues should ideally be reflected in the living will and health-care proxy.

Roman Catholic teaching celebrates life as a gift of a loving God and respects each human life because each is created in the image and likeness of God. It is consistent with Church teaching that each person has a right to make his or her own health care decisions. Further, a person’s family or trusted delegate may have to assume that responsibility for someone who has become incapable of making their decisions. Accordingly, it is morally acceptable to appoint a health care agent by executing a health care power of attorney, provided it conforms to the teachings and traditions of the Catholic faith.

While the health care power of attorney law allows us to designate someone to make health care decisions for us, we must bear in mind that life is a sacred trust over which we have been given stewardship. We have a duty to preserve it, while recognizing that we have no unlimited power over it. Therefore, the Catholic Church encourages us to keep the following considerations in mind if we decide to sign a health care power of attorney.

1. As Christians, we believe that our physical life is sacred but that our ultimate goal is everlasting life with God. We are called to accept death as a part of the human condition. Death need not be avoided at all costs.

2. Suffering is “a fact of human life, and has special significance for the Christian as an opportunity to share in Christ’s redemptive suffering. Nevertheless there is nothing wrong in trying to relieve someone’s suffering as long as this does not interfere with other moral and religious duties. For example, it is permissible in the case of terminal illness to use pain killers which carry the risk of shortening life, so long as the intent is to relieve pain effectively rather than to cause death.”

3. Euthanasia is “an action or omission which of itself or by intention causes death, in order that all suffering may in this way be eliminated.” “[Euthanasia] is an attack on human life which no one has a right to make or request.”

4. “Everyone has the duty to care for his or her own health and to seek necessary medical care from others, but this does not mean that all possible remedies must be used in all circumstances. One is not obliged to use ‘extraordinary’ means – that is, means which offer no reasonable hope of benefit or which involve excessive hardship.

5. No health care agent may be authorized to deny personal services which every patient can rightfully expect, such as appropriate food, water, bed rest, room temperature and hygiene.

6. The patient’s condition, however, may affect the moral obligation of providing food and water when they are being administered artificially. Factors that must be weighed in making this judgment include: the patient’s ability to assimilate the artificially provided nutrition and hydration, the imminence of death and the risks of the procedures for the patient. While medically-administered food and water pose unique questions, especially for patients who are permanently unconscious, decisions about these measures should be guided by a presumption in favor of their use. Food and water must never be withdrawn in order to cause death. They may be withdrawn if they offer no reasonable hope of maintaining life or if they pose excessive risks or burdens.

7. Life-sustaining treatment must be maintained for a pregnant patient if continued treatment may benefit her unborn child.

Such principles and guidelines from the Christian heritage may guide Catholics and others as they strive to make responsible health care decisions and execute health care proxies. They may also guide Catholic health care facilities and providers in deciding when to accept and when to refuse to honor an agent’s decision.

CONSIDERATIONS FOR ALL PEOPLE FROM JEWISH TEACHING

Jewish tradition as understood by Conservative Judaism teaches that life is a blessing and a gift from God. Each human being is valued as created b’tselem elohim, in God’s image. Whatever the level of our physical and mental abilities, whatever the extent of our dependence on others, each person has intrinsic dignity and value in God’s eyes. Judaism values life and respects our bodies as the creation of God. We have the responsibility to care for ourselves and seek medical treatment needed for our recovery-we owe that to ourselves, to our loved ones, and to God.

In accordance with our tradition’s respect for the life God has given us and its consequent bans on murder and suicide, Judaism rejects any form of active euthanasia (“mercy killing”) or assisted suicide. Within these broad guidelines, decisions may be required about which treatment would best promote recovery and would offer the greatest benefit. Accordingly, each patient may face important choices concerning what mode of treatment he or she feels would be both beneficial and tolerable.

The breadth of the Conservative movement and its intellectual vitality have produced two differing positions put forward by Rabbis Avram Israel Reisner and Elliot N. Dorff, both approved by the Conservative movement’s Committee on Jewish Law and Standards. Both positions agree on the value of life and the individual’s responsibility to protect his or her life and seek healing. Both agree on a large area of autonomy in which a patient can make decisions about treatment when risk or uncertainty is involved. Both would allow terminally ill patients to rule out certain treatment options (such as those with significant side effects), to forgo mechanical life support, and to choose hospice care as a treatment option.

Nevertheless, important differences between the two positions may be found regarding both theoretical commitments and practical applications. Rabbi Reisner affirms the supreme value of protecting all life. Even the most difficult life and that of the shortest duration is yet God given, purposeful, and ours to nurture and protect. All nutrition, hydration, and medication should be provided whenever these are understood to be effective measures for sustaining life. Some medical interventions, however, do not sustain life so much as they prolong the dying process. These interventions are not required. The distinction may best be judged by our intent. We may choose to avoid treatments causing us fear or entailing risk or pain, in the interest of the remaining moments of life. We may not avoid treatment in an attempt to speed an escape into death.

Rabbi Dorff finds basis in Jewish law to grant greater latitude to the patient who wishes to reject life-sustaining measures. He sees a life under the siege of a terminal illness as an impaired life. In such a circumstance, a patient might be justified in deciding that a treatment that extends life without hope for cure would not benefit him or her, and may be forgone.

Both Rabbis Dorff and Reisner agree that advance directives should only be used to indicate preferences within the range allowed by Jewish law. They disagree as to what those acceptable ranges are. In completing a health care power of attorney and living will, it is recommended that you consult with your rabbi to discuss the values and norms of Jewish ethics and halakhah. You also may wish to talk with your physician to learn about the medical significance of your choices, in particular any decisions your physician feels are likely to be faced in light of your medical circumstances. You may find it helpful to discuss these concerns with family members.

CONCLUSION

In the end, the decision to execute a health care power of attorney and living will is a uniquely individual choice. Every person has their own set of principles by which they will live, and by which they will eventually pass on. When executing these documents, it is wise to examine how these documents assimilate into your worldview and religious beliefs. While the topic of death and dying is an uncomfortable one, you are well advised to discuss this decision with your family members, friends, and members and leaders of your religious community that you respect. Having done this, you can rest easy knowing that you have made a good decision with regard to your health care power of attorney and last will, and that your last wishes will be respected and undertaken.