Health is a right. It is personal and essential to maintain the quality of life from birth to death. We can all agree on that, and it is similar to our basic rights such as the food we eat and the air we breathe.
But some of us confuse ‘health’ with ‘healthcare.’
We have private healthcare companies looking to maximize profits at any cost — just like mainstream companies like Apple seems to do — and it isn’t a good thing. iPhones can be a matter of privilege. Healthcare isn’t.
Healthcare is just the means we use to fulfil our right to stay healthy. It is just like establishing the source of food or creating a pollution free environment. It is a mistake to consider them to be the same. Many people also use the terms interchangeably to achieve their means and personal objectives.
But we have to remember that a right can never be brought against the expense of other citizens, their rights or other human endeavours- especially when it comes to healthcare coverage.
The Nuances of Healthcare Coverage
Healthcare coverage is one of the many tools one case use in the healthcare setting to get access to medical service. Some of us think healthcare coverage equates to healthcare, and in turn, represents health. This is a big mistake!
Now let’s explore a bit about universal coverage and government program. My discussion will focus on pharmacy and medication to keep things within the scope of this article.
Medicare for all is a form of universal coverage which looks to expand the spectrum of the population covered through the already established governmental system of payer for senior citizens. We have been dealing with Medicare for quite some time now, and we have seen the challenges especially when it revolves around medication coverage.
Still, now it hasn’t been able to implement a solid policy of medication coverage without roping in private pharmaceutical companies, FDA and private insurance provider’s monopoly. The pro-Medicare politicians believe that the government should regulate the pricing of medications in a bid to lower them. They also think the government is in a better position to implement such changes.
As I have already said many times, healthcare for all, universal healthcare, Medicare for all, national health plan, single-payer system — all needs one thing for its implementation- that is a complete takeover by the government with full authority to pass transparency. In countries with low pricing of medication, the government has the authority by the constitution to implement caps on costs and regulate the market.
Until the government does the same in the USA, it is going to be a long drawn battle with medication cost and coverage. The consequences will reflect themselves on the legitimacy of Medicare and other government run programs at the federal level.
The government should Never Negotiate with Private Entities
The government shouldn’t engage itself in negotiations with private profit-seeking parties. We need to get rid of all double standards that surround human health, government and politics. The government must pass mandates and laws in order to secure the interests of the citizens, and not of corporates. If the government has to ever get into a private negotiation, it should be conducted at the private enterprise level based on the concept of free market and fair chance promulgated by government policies.
We cannot expect the government negotiations to be effective until pharmaceutical and Pharmacy Benefit Management (PBM) becomes transparent with a proper cap on pricing for the benefit of the citizens. Can the US become like other countries?
Some of us do believe it can, but that gives rise to another important question- can the transformation be made without changing the constitution? If yes, then what is the process?
No law prohibits the buying of insurance coverage across the state lines. However, it is not available, no one can buy it.
If the government has the ability to ensure the limit on drug pricing then what is stopping them?
Until we have a proper answer to the questions, all we are doing is throwing rocks at a dark room. The things that we expect Medicare for all to bring is only going to open another can of worms as I talked about in one of my last publications. The best way to implement the changes is to adopt a bottom-up approach beginning with improving the doctor-patient relationship and empowering both physicians and patients.
It really doesn’t matter who pays for healthcare coverage or how it is paid. We can use any form — cash, insurance, direct pay — all options should be freely available through fair and competitive means. We need to eliminate limitations and borders and remove bureaucracy and monopoly in healthcare. This can only be done with a bottom-up approach because we can never expect to secure the help of the politicians if we don’t help individual citizens ourselves in our communities.
Empowered patients can demand what is right and just. Public demand will force politicians to align their mission with that of constituent patients to secure their position which will lead to favorable laws. The government can ensure free and fair competition by upholding the constitution and ensuring consumerism and the free market. It also needs to be stringent with public safety and fairness.
In a social democratic state, the government should have limited control over the market based on the utilitarian model with full authority to place price caps. Choices should be made according to the time, era, social circumstances and expectations of the society for them to be effective. Like I have already said in one of my earlier publications, the grass is not greener on the other side of the wall, it is just tended differently!