Universal health

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				THE
Column Archive				VIRGINIA GAZETTE
				WILLIAMSBURG, VIRGINIA
Universal health				August 12, 2006

In addition to their loss of limbs and other severe physical maladies, those who serve in our armed forces frequently leave the services in a state of mental collapse and in dire need of psychiatric treatment. While we at home patriotically hype our support for our troops, we tend to forget that the traumas inflicted on those who serve can be manifold and ruinous beyond belief.

Luke, who saw action in the first Gulf War and who helped in the recovery of the victims of the crash of TWA flight 800 in New York, is such a case.

When he left the Navy in 1998, Luke was diagnosed with trigeminal neuralgia. This involves at times severe neurological repercussions, such as delirium and a general loss of control. In addition, Lukas is bipolar and a recovering alcoholic.

Last February, Luke’s condition became so uncontrollable that his then fiancee rushed him to the emergency room at Sentara Williamsburg Community Hospital. There he was given some shots to calm him and allow him to sleep. A crisis counselor visited Luke while he was asleep, but told his fiancee that, since he was not suicidal, there was not much she could do. A few hours later, Luke was released from the hospital, though he could not walk nor go to the bathroom without assistance. He was given no medication.

His fiancee was told to contact the Colonial Services Board, which she did. Colonial Services told her that they probably couldn’t do much for Luke, since he wasn’t suicidal and he had insurance. It seems that the system would work to Luke’s benefit only if he were a threat to himself or his family.

My purpose in recounting Luke’s story is not to denigrate our local emergency room, or any emergency room. Originally set up to handle only true emergencies, emergency rooms have now become the sole medical delivery system for the uninsured who are in need of routine medical attention. Emergency rooms must, under federal law, accept all patients, whether they have insurance or not. And they are in deep trouble as a result.

According to a recent report by the National Academy of Sciences’ Institute of Medicine, ambulances bringing true emergency cases to emergency rooms are rerouted to other hospitals a half million times a year. Critical patients waiting to be admitted to the hospital frequently spend eight hours or more on gurneys in hallways waiting for a bed. In 2003, 114 million patients visited emergency rooms.

Between 1993 and 2003, cost overruns forced the closing 425 emergency rooms. The problem, says the report, can be traced to the severe influx of the uninsured poor or those on Medicaid seeking routine care.

Little wonder, then, that emergency room staffs are under enormous pressure to deal with patients as quickly as possible. In addition, many are understaffed and lack specialists, such as neurosurgeons, whose liability insurance would skyrocket as a result of treating uninsured patients.

In short, the dire situation in our emergency rooms is one of the clearest indications we have that our health care system is, for the richest nation in the world, inexplicably in an utter state of shambles.

According to figures compiled by the Connecticut Coalition for Universal Health, of the 28 industrialized nations of the world, the United States is the only one that does not guarantee health care for all its citizens. Among industrialized nations, we rank 23^rd in terms of infant mortality, 20^th in life expectancy for women and 21^st in life expectancy for men. We spend 40% more per capita on health care than any industrialized country and still wind up with close to 50 million citizens uninsured.

Clearly it’s time to consider seriously a move to a single-payer, universal health care system. As it stands now, health care availability is driven by corporate greed and so-called “managed care” that benefits no one. Insurance companies, which spend as much as 30% of their income on administrative maintenance and profits, naturally boost their earnings by denying care and decreasing costs. In contrast, Medicare spends only 3% for administrative costs.

While the bugaboo of socialized medicine infects the minds of many and inevitably clouds the issue, the fact is that a single-payer system need not be conducted by the government. Studies both in Connecticut and Massachusetts suggest that a program might well be run by the administrative board of a public trust.

Pre-approval for procedures would be a thing of the past and managed care would go by the boards. Government intrusion would exist only for the purpose of granting the public trust the legal right to raise the money necessary to operate the program. Most important, every citizen, regardless of income, race or age, would be covered fully.

Long lines and long waits to see doctors would be obviated by the fact that we in the United States have more medical facilities and health care providers than any other nation now employing the single-payer plan. Emergency rooms could return to their basic function of dealing with only true emergencies.

For the sake of Luke and millions of others who find themselves caught up in the morass of swamped emergency rooms and an over-regulated, pecuniary-driven health care system, we must redeploy the billions being spent on ludicrous attempts to democratize the world to the battle being waged at home for the health and well being of all our citizens.