Comments on: Support Universal Health Care http://actlocallysf.org/blog/takingaction/2007/09/20/support-universal-health-care/ Just another actlocallysf.org weblog Sat, 17 May 2008 01:09:58 +0000 http://wordpress.org/?v=wordpress-mu-1.0 by: Susan Ross http://actlocallysf.org/blog/takingaction/2007/09/20/support-universal-health-care/#comment-1236 Sun, 07 Oct 2007 21:12:13 +0000 http://actlocallysf.org/blog/takingaction/2007/09/20/support-universal-health-care/#comment-1236 Dear Mayor Newsom: I applaud your efforts to improve access to health care for everyone, regardless of their income. Unfortunately in the US many view health care as a privilege based on the size of your wallet-rather than a basic human right- which is the premise of the international treaties the US signs As a nurse, who has worked in many hospitals in the US and has spent 15+ years designing, implementing and evaluating international health and development in over 30 countries I am very concerned about the crumbling US health care system. While it is horrible for people with no/little insurance, health care costs for people with insurance has become a increasing reason that individuals file for bankruptcy While financial support/insurance is an important issue; it is not the only issue. Personally I am not sure how sustainable the insurance business model is since it selectively pays for preventive services but pay for treatment which is much more costly. Health care is a system. In the US the health care system is decentralized and fragmented with unclear lines of accountability; often slow to adapt to changes, and has received limited investment over the pas few decades. This implies that to address the root causes of the current health care situation a systematic approach is required and insurance alone will fall over the overall aim Key three factors that also limit access to quality services include: 1) personnel; 2) facilitates/infrastructure; 3) medical mindset. First, there needs to be adequate numbers and appropriate types of personnel. According to the workforce study, the nursing shortage in California is estimated to be 20,000-30,000 by 2015. This begs the question of who would take care of people, even if they have insurance. In addition, specialists (MDs) greatly outnumber general/family parishioners and most providers reside in urban areas living rural areas far from services. Second, there also needs to be equtibale distribution of well-maintained facilities. Since many of the hospitals in the Bay are rebuilding to meet the seismic code this is a great opportunity to upgrade the facilities. However, many hospitals have closed limiting access and hospital beds. For example, Richmond only has one hospital that will have to manage growing numbers of chronic illnesses and an aging population. They often have to divert pts to Walnut creek and Fremont because they are full. Third, there also needs to be a huge shift in medical and client thinking. As the former CEO of Pfizer said, we have a sick care system not a health care system. The high number of specialists, number of hospitals compared to clinics, and curative focus is what the US health care system has evolved into. The AMA has been lobbying against universal health care (socialized medicine) since the 1930s. One of there arguments is that they feel they won’t be on the cutting edge of research. From a consumer perspective, most Americans due not like to wait for services ( e.g., in Britain it may take 3 months to get elective knee surgery. All these factors (financing, staff, and facilities) need to be addressed to ensure that the system can provide high quality services. I know that these issues are concerns for Mitch Katz and Tangerine. I also know that many of these issues are beyond the scope of SF and the lack of federal leadership is appalling. I think that what you are doing is a great first step. I also know that many of these efforts have to be implemented at a larger scale to have any real impact, requiring complex partnerships among many stakeholders. It doesn’t seem that the press is covering these broader issues. I think that because SF is being looked at as a model you are uniquely positioned to raise some of these issues at the state and national. Thanks for listening susan<ul><li><label>Overall Rating</label>: 1</li> </ul> Dear Mayor Newsom:

I applaud your efforts to improve access to health care for everyone, regardless of their income. Unfortunately in the US many view health care as a privilege based on the size of your wallet-rather than a basic human right- which is the premise of the international treaties the US signs

As a nurse, who has worked in many hospitals in the US and has spent 15+ years designing, implementing and evaluating international health and development in over 30 countries I am very concerned about the crumbling US health care system. While it is horrible for people with no/little insurance, health care costs for people with insurance has become a increasing reason that individuals file for bankruptcy

While financial support/insurance is an important issue; it is not the only issue. Personally I am not sure how sustainable the insurance business model is since it selectively pays for preventive services but pay for treatment which is much more costly.

Health care is a system. In the US the health care system is decentralized and fragmented with unclear lines of accountability; often slow to adapt to changes, and has received limited investment over the pas few decades. This implies that to address the root causes of the current health care situation a systematic approach is required and insurance alone will fall over the overall aim

Key three factors that also limit access to quality services include: 1) personnel; 2) facilitates/infrastructure; 3) medical mindset. First, there needs to be adequate numbers and appropriate types of personnel. According to the workforce study, the nursing shortage in California is estimated to be 20,000-30,000 by 2015. This begs the question of who would take care of people, even if they have insurance. In addition, specialists (MDs) greatly outnumber general/family parishioners and most providers reside in urban areas living rural areas far from services.

Second, there also needs to be equtibale distribution of well-maintained facilities. Since many of the hospitals in the Bay are rebuilding to meet the seismic code this is a great opportunity to upgrade the facilities. However, many hospitals have closed limiting access and hospital beds. For example, Richmond only has one hospital that will have to manage growing numbers of chronic illnesses and an aging population. They often have to divert pts to Walnut creek and Fremont because they are full.

Third, there also needs to be a huge shift in medical and client thinking. As the former CEO of Pfizer said, we have a sick care system not a health care system. The high number of specialists, number of hospitals compared to clinics, and curative focus is what the US health care system has evolved into. The AMA has been lobbying against universal health care (socialized medicine) since the 1930s. One of there arguments is that they feel they won’t be on the cutting edge of research. From a consumer perspective, most Americans due not like to wait for services ( e.g., in Britain it may take 3 months to get elective knee surgery.

All these factors (financing, staff, and facilities) need to be addressed to ensure that the system can provide high quality services. I know that these issues are concerns for Mitch Katz and Tangerine. I also know that many of these issues are beyond the scope of SF and the lack of federal leadership is appalling.

I think that what you are doing is a great first step. I also know that many of these efforts have to be implemented at a larger scale to have any real impact, requiring complex partnerships among many stakeholders. It doesn’t seem that the press is covering these broader issues. I think that because SF is being looked at as a model you are uniquely positioned to raise some of these issues at the state and national.

Thanks for listening

susan

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