Healthcare is NOT a basic human right.

[Asystole RN]

If one were to read the Constitution one would realize that the Constitution does not grant anyone freedoms, liberties, or rights. The Constitution only protects freedoms, liberties, and rights from transgressions on part of the government. A right is something that is inherent to the individual, comes from that individual, and is maintained by the individual. You are born with such rights like the right to speak freely, the only thing that can be done to that right is to have it infringed. No one can grant a right to another, only limit or impede the exercise of that right.

Healthcare is a human invention that does not exist in the natural environment. Only through the work of others and through the taking of resources from one party and giving to another does healthcare exist. You cannot force someone to give effort and resources to another and call that a right. In the absence of human intervention the individual would live their lives and succumb to the natural forces which would act upon their bodies.

Do I think we should provide preventative care and basic primary care? Sure. Do I think that we can? Maybe. Do I think that healthcare is a basic human right? Absolutely not.

[agvfc]

You might be right with the fact that healthcare is not a basic right according to the constitution, however, everyone should be granted healthcare. This is a basic human intervention and invention which should not be exclusive to anyone. I am a nurse with my full heart for over 30 years and I feel privileged to take care of the sick and the dying as this is the right thing to do.

[cdsga]

No hospitalization is covered with Medicare, Medicaid and children's plans (PeachCare in Ga for example) If you need hospital care you can get it.

Most hospital people don't know about billing, don't know about different coverages unless they are in social services, case management, a physician, or are a nurse navigator for cancer care.

There's alot we don't know. I'm working in a transitional care facility where I am learning more about all this. It's interesting.

[Susie2310]

No hospitalization is covered with Medicare, Medicaid and children's plans (PeachCare in Ga for example) If you need hospital care you can get it.

Most hospital people don't know about billing, don't know about different coverages unless they are in social services, case management, a physician, or are a nurse navigator for cancer care.

There's alot we don't know. I'm working in a transitional care facility where I am learning more about all this. It's interesting.

What about the people who aren't covered by Medicare, Medicaid, or children's plans, and can't afford or can't obtain insurance because of pre-existing conditions? What about people who are unable to work for various reasons but do not qualify for Medicaid/Medicare? People who cannot find work with medical insurance? How do they obtain primary and specialist care - they access care through community clinics and the ER. Do you believe people must spend all their resources until they qualify for Medicaid or a government program, or become so ill that they are admitted to hospital in the late stages of illness through the ER? Must they forgo health care until they qualify for Medicare? Please tell, what should these people do?

[cdsga]

A friend of mine wrote this which I think sums up what I'm talking about-

the issue is not access to health care by the poor, nor has it been, at least in recent history. The Emergency Medical Treatment and Labor Act of 1986 prohibits hospitals from turning away or transferring patients based on their ability to pay. If a patient who lacks the ability to pay requires treatment, he or she must be provided that treatment and the facility eats the cost - there's where the problem begins. Hospitals never like doing anything for free. They would much rather charge CMS or an insurer than to do anything pro bono.

Where the two sides differ is in determining who should pay for this health care and the degree to which the government should be involved. One side sees entirely too much government involvement in health care (among other things). That side believes that the American public already pays too much. They also believe that our government has repeatedly demonstrated its inability to manage the taxpayer's money and their medling in health care in the form of the establishment of seemingly arbitrary reimbursement rates and actuarially unsound Medicare premiums are examples of CMS' lack of ability. Lastly, this side believes that everyone should contribute - there should be no free rides for anyone. The other side thinks of government as a parent that should take care of everyone. This side is very good at allocating money without actually determining where the funding will come from. Currently, it appears that this side would have us beleive that the wealthy are not paying their fair share and should be require to pay more because other people need it.

Currently there are 50.1 million people on Medicare and 57 million on Medicaid (these groups overlap as it is possible to be eligible for Medicare as the primary coverage and Medicaid as the secondary - 9.2 million are dual enrolled according to CMS). The net is that there are 97.8 million Americans who receive health care that is paid for by the taxpayer. To provide care for this large group of people, the Federal Government collects 2.9% of every working employee's pay off the top (The employer and employee split this equally while self-employed people pay the full 2.9% themselves. This figure has steadily risen since it began in 1966 at 0.7%. There are approximately 120 million workers in the US who are tasked with funding these social programs. The 2013 submitted budget for CMS is $898 billion. This comes out to an average total cost of $9,238 per enrollee at the federal level - this does not include the amounts that the states spend on Medicaid. The administrative cost of CMS averages $121,000 per CMS employee. The point is that these programs are incredibly expensive, extremely wasteful and naively administered. While it sounds nice to provide free health care for all, nothing is free - someone must pay. Every dollar the federal government collects comes from someone who earned that dollar.

Since WWII, many employers have provided either no cost or subsidized health insurance for their employees. This has put distance between the employee and the actual cost of care. Folks just don't realize how much health care actually costs. Many people would think that paying $1,000 per month for health insurance is too high, but when you consider that the total claims for their family greatly exceed that amount, the cost of coverage is justified. What isn't justified is the cost of care. However, arbitrarily determining how much CMS will pay for a specific service will not actually reduce the cost of care. Instead, this will result in the access to health care problem that your post mentioned - If CMS will reimburse a doctor $50 for a service that costs him $60 to perform and for which he charges a privately insured patient $120, the doctor will do one of two things. He will either charge the privately insured patient more (subject to contractual limitations) or he will stop seeing Medicare/Medicaid patients...and then the issue will actually be an access to health care problem.

[vintagemother, BSN, CNA, LVN, RN]

Yes!! To what CGSDA said!!

[Susie2310]

A friend of mine wrote this which I think sums up what I'm talking about-

the issue is not access to health care by the poor, nor has it been, at least in recent history. The Emergency Medical Treatment and Labor Act of 1986 prohibits hospitals from turning away or transferring patients based on their ability to pay. If a patient who lacks the ability to pay requires treatment, he or she must be provided that treatment and the facility eats the cost - there's where the problem begins. Hospitals never like doing anything for free. They would much rather charge CMS or an insurer than to do anything pro bono.

Where the two sides differ is in determining who should pay for this health care and the degree to which the government should be involved. One side sees entirely too much government involvement in health care (among other things). That side believes that the American public already pays too much. They also believe that our government has repeatedly demonstrated its inability to manage the taxpayer's money and their medling in health care in the form of the establishment of seemingly arbitrary reimbursement rates and actuarially unsound Medicare premiums are examples of CMS' lack of ability. Lastly, this side believes that everyone should contribute - there should be no free rides for anyone. The other side thinks of government as a parent that should take care of everyone. This side is very good at allocating money without actually determining where the funding will come from. Currently, it appears that this side would have us beleive that the wealthy are not paying their fair share and should be require to pay more because other people need it.

Currently there are 50.1 million people on Medicare and 57 million on Medicaid (these groups overlap as it is possible to be eligible for Medicare as the primary coverage and Medicaid as the secondary - 9.2 million are dual enrolled according to CMS). The net is that there are 97.8 million Americans who receive health care that is paid for by the taxpayer. To provide care for this large group of people, the Federal Government collects 2.9% of every working employee's pay off the top (The employer and employee split this equally while self-employed people pay the full 2.9% themselves. This figure has steadily risen since it began in 1966 at 0.7%. There are approximately 120 million workers in the US who are tasked with funding these social programs. The 2013 submitted budget for CMS is $898 billion. This comes out to an average total cost of $9,238 per enrollee at the federal level - this does not include the amounts that the states spend on Medicaid. The administrative cost of CMS averages $121,000 per CMS employee. The point is that these programs are incredibly expensive, extremely wasteful and naively administered. While it sounds nice to provide free health care for all, nothing is free - someone must pay. Every dollar the federal government collects comes from someone who earned that dollar.

Since WWII, many employers have provided either no cost or subsidized health insurance for their employees. This has put distance between the employee and the actual cost of care. Folks just don't realize how much health care actually costs. Many people would think that paying $1,000 per month for health insurance is too high, but when you consider that the total claims for their family greatly exceed that amount, the cost of coverage is justified. What isn't justified is the cost of care. However, arbitrarily determining how much CMS will pay for a specific service will not actually reduce the cost of care. Instead, this will result in the access to health care problem that your post mentioned - If CMS will reimburse a doctor $50 for a service that costs him $60 to perform and for which he charges a privately insured patient $120, the doctor will do one of two things. He will either charge the privately insured patient more (subject to contractual limitations) or he will stop seeing Medicare/Medicaid patients...and then the issue will actually be an access to health care problem.

Well, you didn't answer my questions, but that's ok.

[cdsga]

Well in a way I did-but then again after all the available programs (county, state, and charity/indigent care are ruled out-just how many people are you talking about? Is it a huge proportion?

[NayRN]

So, devil's advocate here,

As many have mentioned, Americans have a right to life, liberty, pursuit of happiness

also right to bear arms, speak freely, gather peacefully, etc.

So, lets say we amend the constitution to include the right to have access to health care. Fine, now it's a constitutional right.

There are limits on these other rights. If they are abused, they are taken away.

A criminal can have their freedom or even their life taken away. They can also lose their right to bear arms.

In certain cases, such as in public forums, the right to free speech may be censored to protect certain audiences.

But these guys still get health care? How can they lose access to the most fundamental of human rights but still obtain health care services?

Sooooo...

What kind of limit could we place on the "right" to health care. Could we begin to call things what they are and cut off abusers of the system? The habitual, weekly ER visitor with vague abdominal pain who is allergic to all but dilaudid (fast push, please)?

The repeat drunk driver in with their third car wreck this year, this time with liver lacs and TBI due to an accident that killed a family of four? The violent ETOH abuser, in at family's request for detox, who, last time they were here spit in a nurse's face and broke another one's nose? The diabetic who, despite excellent access to needed supplies, repeated attempts at education, and declined offers of home health services continues to be readmitted to the hospital in DKA because they "didn't have time" to check their blood sugar and treat it?

I mean, can't we place these guys who don't follow the rules on health care probation or something? I understand that some may lack the mental capacity to understand their health condition and treatments. Yes, we should be compassionate and do everything we can to help. But for the ones who simply will not follow the rules or decline every attempt we make to help them, shouldn't we re-distribute scarce resources to help those who are willing to accept it?

[cdsga]

It's pretty interesting that you say these things NayRN there is such a thing as a contract that physicians use for narcotic use/prescriptions. There are very stringent guidelines that people have to follow if they want their pain medications. If they don't follow the guidelines-they are immediately discharged and not allowed to be seen by that physician's practice again. They leave it up to the patient to follow and be responsible for their compliance with the rules.

I wonder if the same type of contract could apply to other types of things? If patients refuse to be compliant with their medical treatment plan then all the access to medical care in the world won't help them.

[CountyRat]

The arguments people offer to support the view that healthcare is a basic human right inevitably requires conflation of "rights" with "needs." I have a right to practice a religion or not practice one, as I choose (to offer one example). But needs are different. I need food. My family will die sooner without food than they will without healthcare. So, why do I have to go to work, earn money, and spend it in a grocery store to feed my family? If my needing it makes it a right, why are we not demanding "free" food?

The answer is very simple: we do not demand free food because we understand that food is not free. Every bite of food that you or I have eaten today had to be grown, harvested, processed, transported, displayed in a store (with employees that need to be paid so that they can meet their needs) before we could eat it. This involves a lot of people doing a lot of work, and, since that time, work, and those resources have value, they must be reimbursed for the value of their labor. There must be a balanced exchange of value.

No law, no congress, no president can make anything that we need free by passing a law.

What about the poor? We must provide for the poor, but we will not help the poor by pretending that we live in a fantasy world where valuable services can be rendered free by government decree. These are stark realities, but they are realities nevertheless. Real help for the poor must be based on reality, not wishful thinking.

I offer these observations in the spirit of respectful, collegial interaction. I respect those who hold different views and have no hostility toward anyone. I hope that we can continue to interact within this forum calmly and thoughtfully.

[realmaninuniform]

I agree CountyRat, far too many these days are economically illiterate and calling for "free this" and "free that". What they don't realize is that - "There ain't no such thing as a free lunch". Nothing on this earth is truly "free". Someone somewhere along the lines paid for it in some form or another.

[realmaninuniform]

"The "choice" variable doesn't exist to begin with."

Oh really? Is that why I CHOOSE to decline my employers health insurance plan? Is that why pts and POA's can CHOOSE the course of tx or lack thereof? Is that not the purpose of living wills, and advanced directives? Need I really further destroy this futile point?

"The Constitution contains the enumeration clause, which counts slaves as 3/5's of a person, the entire reason for needing this definition was that the Federal government did not allow slaves to vote. The Constitution also contained the Fugitive Slave Clause which protected one state's right enslave someone emancipated in another state, protecting the existence of slavery at the Federal level."

Article and section number's please! No wiki copy and paste. You do know anyone can edit wikipedia, right?