Good day, family and friends!
When last we met, we established that everyone, from the most indigent to the wealthiest among us, has access to healthcare. I am not yet dealing with physician choice or the cost of private physicians or the number of specialists per capita in a given area of the country or any other questions or issues. All of that comes later. All the last post was meant to do was answer the question, "How accessible is healthcare to the citizens of America?" The answer is, "Anyone within 250 yards of an American emergency room or department, whether or not they are a U.S. citizen, whether or not they are actually within the borders of the U.S., have access to all the medical care necessary to treat and stabilize an emergency condition to the point where they can reasonably be expected to care for themselves, or until they can be discharged into the care of a qualified caregiver, whether or not they are able or are willing to pay for such medical service."
But many people believe that isn't enough...that they shouldn't be 'forced' to go to an emergency room if they want to see a doctor. According to the Bureau of the Census, the American Medical Association, and the Centers for Disease Control, in 2006 (the last year this statistic was available for all three organizations), between 91% and 92% of the population of the U.S. lives less than thirty minutes from either a primary-care physician or a non-emergency clinic that is still accepting new patients. Of the remainder, just under 6% of the population chooses to live in remote areas more than thirty minutes from any sort of population center, no matter how small. This means that only 2% to 3% of the U.S. population lives in what are called 'under-serviced' areas.
While I do acknowledge that there are areas in which the American Healthcare system can be improved, I have to applaud our nation on accessibility to medical care. Of the twenty most populous nations in the world, Japan comes the closest to offering the level of healthcare available to Americans. There are nations that seem to be doing a better job of delivering healthcare to their citizens than America...Cuba and Sweden are the two countries most often used as examples...and for their population, they very well may be doing a good job. But comparing the logistics of delivering medical care in the third most populous nation on Earth to the logistics of delivering it in the seventy-fifth and the eighty-eighth most populace nations is like comparing the logistics of traffic management in Greensboro, NC and Chesapeake, VA to that of Chicago. It isn't even an 'apples-to-apples' comparison; rather, its more like 'apples-to-eggplant'. Basically, such a comparison is spurious and completely without merit. The bottom line is that, of the twenty nations that make up just over 79% of the world's population, none provide better access to healthcare than the United States of America.
Next time, I start looking at the cost and affordability of healthcare in America.
Until then, best regards...
© James P. Rice 2009
10 September 2009
20 August 2009
Healthcare in America: How Accessible is It?
Good day, family and friends!
I start today with the question, "Does everyone have access to healthcare in America?" The short answer is, "Statistically speaking, yes."
In 1986, the Emergency Medical Treatment and Active Labor Act (42 U.S.C., Chapter 7, Subchapter XVIII, Part E, § 1395dd, EMTALA) was passed as part of the Consolidated Omnibus Budget Reconciliation Act. This act mandates:
"In the case of a hospital that has a hospital emergency department, if any individual (or a person acting on the individual’s behalf, whether or not the individual is eligible for benefits) comes to the emergency department and a request is made on the individual’s behalf for examination or treatment for a medical condition, the hospital must provide for an appropriate medical screening examination within the capability of the hospital’s emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition exists."
It further goes on to define an "emergency medical condition" as either:
"(A) a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in—
(i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy,
(ii) serious impairment to bodily functions, or
(iii) serious dysfunction of any bodily organ or part; or
(B) with respect to a pregnant woman who is having contractions—
(i) that there is inadequate time to effect a safe transfer to another hospital before delivery, or
(ii) that transfer may pose a threat to the health or safety of the woman or the unborn child."
This EMTALA goes on to make it illegal for a hospital to have any sort of financially-based conversation with the individual until such time as the patient's condition has been stabilized and the conversation will not interfere with the diagnosis and treatment of the condition. Later amendments from Congress defined "individual" as "any person within 250 yards of the emergency room/department, regardless of the person's citizenship or legal status," and made it illegal for different levels of care to be provided, based on the definitions in the Act. In other words, whether you're a Mexican citizen living just across the border from a hospital in Texas, or the wealthiest American citizen in El Paso, TX with the greatest medical insurance in the world, you will both receive the same level of care if you have the same emergency medical condition and go to the same border hospital in El Paso.
Next time, we continue our look at how accessible medical care is in America. Until then, best regards...
© James P. Rice 2009
I start today with the question, "Does everyone have access to healthcare in America?" The short answer is, "Statistically speaking, yes."
In 1986, the Emergency Medical Treatment and Active Labor Act (42 U.S.C., Chapter 7, Subchapter XVIII, Part E, § 1395dd, EMTALA) was passed as part of the Consolidated Omnibus Budget Reconciliation Act. This act mandates:
"In the case of a hospital that has a hospital emergency department, if any individual (or a person acting on the individual’s behalf, whether or not the individual is eligible for benefits) comes to the emergency department and a request is made on the individual’s behalf for examination or treatment for a medical condition, the hospital must provide for an appropriate medical screening examination within the capability of the hospital’s emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition exists."
It further goes on to define an "emergency medical condition" as either:
"(A) a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in—
(i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy,
(ii) serious impairment to bodily functions, or
(iii) serious dysfunction of any bodily organ or part; or
(B) with respect to a pregnant woman who is having contractions—
(i) that there is inadequate time to effect a safe transfer to another hospital before delivery, or
(ii) that transfer may pose a threat to the health or safety of the woman or the unborn child."
This EMTALA goes on to make it illegal for a hospital to have any sort of financially-based conversation with the individual until such time as the patient's condition has been stabilized and the conversation will not interfere with the diagnosis and treatment of the condition. Later amendments from Congress defined "individual" as "any person within 250 yards of the emergency room/department, regardless of the person's citizenship or legal status," and made it illegal for different levels of care to be provided, based on the definitions in the Act. In other words, whether you're a Mexican citizen living just across the border from a hospital in Texas, or the wealthiest American citizen in El Paso, TX with the greatest medical insurance in the world, you will both receive the same level of care if you have the same emergency medical condition and go to the same border hospital in El Paso.
Next time, we continue our look at how accessible medical care is in America. Until then, best regards...
© James P. Rice 2009
19 August 2009
Intermezzo
WARNING! Today's post is a bit longer than normal.
Good day, family and friends!
Since my last post on the 13th, I've been doing some serious soul searching. I have to admit to being more than a little surprised and shocked by the response I received from the definitions I provided, not only from my friends and family, but from others outside my Facebook 'Friends' list who read my blog. While the responses from my 'Friends' list were considered, reasonable, and in the spirit of open debate and discussion, the others were considerably more vitriolic. These less than intelligent individuals also chose to expose their true cowardly nature by sending their comments to me via e-mail rather than posting them in either of the open forums available. Both sets of comments, however, did serve to underscore the most fundamental problem with most political debates these days, and in particular the Healthcare debate: how can we have a rational, reasoned, intelligent debate about anything when we can't even agree on the most basic parameters of the debate?
I could become redundant right now and once again go into excruciating detail of how I went out of my way to make certain I did not get the definitions I used from any source that was even remotely "Conservative" on the political pendulum, but I won't. What has happened, though, is that I now understand what the main protagonist in two novels I recently read was put through as I am experiencing now it myself.
In Terry Goodkind's novels, Soul of the Fire and Faith of the Fallen, Richard Rahl believes that he can convince the citizens of a small country to join his empire by simply sharing the truth with them. The truth is that Richard's empire is dedicated to justice, to protecting individual rights, to ending corruption and cronyism, and to allowing everyone the freedom to strive to be their best free from the fear that it will arbitrarily be taken away from them. The Order (Richard's opposition), on the other hand, believes that Man is a base creature whose only purpose in life is to help others with no thought for himself. The Order preaches social justice and entitlement, mandates charity, condemns personal excellence, and justifies murder, rape, and pillage as tools necessary to bringing 'true equality' to the masses. Unlike Richard, though, The Order doesn't bother with the truth. They instead use propaganda, misinformation, and outright lies to manipulate the masses. They demonize business owners as wealthy elitists who just want to side with Richard so they can continue to keep all the money earned for them by the common workers. They promise a new era of prosperity for the common man while punishing the 'greedy.' They use whisper campaigns to blame Richard's faction for everything that goes wrong...even natural disasters. They spread rumors that Richard doesn't care about the unemployed and would rather see impoverished children die. In short, they stoke the fire of fear in the common people.
In the end, 70% of the people vote to side with The Order. Richard withdraws his entourage and leaves the people to their fate. The Order moves in and the people discover the truth...that they have voluntarily enslaved themselves to a culture of death. From this, Richard finally realizes that truth does not automatically win every time and you can't force people to be free. He learned that no amount of logical, reasoned, factual discourse will ever change an opinion based on feelings. In fact, more often than not, the attempt to change such an opinion will lead only to animosity, derision, and outright hostility. This is where the response to my blog has left me.
As I read comments that called me things like "hatemonger", "racist", "Republican stooge", and "ignorant inbred hick", I decided I was done. Why should I even bother if just the definitions I provided were eliciting this sort of response from the effete thugs who are only interested in promoting their own agenda? It became very clear that no amount of rational, logical analysis and discussion would dent the shell of partisan intolerance in which these 'enlightened' individuals had wrapped themselves. I was done trying to be a rallying point for the vision of personal freedom and personal responsibility laid out by our forefathers. I would no longer bear that standard as long as I was viewed as nothing but a 'hick in a flyover state' by the snobs living in the elitist bastions of Los Angeles, San Francisco, Seattle, Chicago, Central Austin, and the East Coast. I had decided to drop my analysis on Healthcare in America.
This is where my brilliant youngest daughter comes in. I was discussing with her the frustration (and to an extent, depression) I was experiencing as I tried to have an intelligent discussion when she cut to the chase and asked me a single question: "Why did you start your blog in the first place?" That one question was like a lightning bolt. She made me realize that I had wandered far off track. As stated in my very first post, I started blogging "as a way to work out my thoughts on everything that is happening to our Nation and around the world." I didn't start this blog to educate or enlighten anyone else. If that happened along the way, it was gravy. But the meat of my blog is my own thoughts.
Therefore, thanks to my daughter, I have decided to continue my analysis of the Healthcare issue. I will continue to write about the facts, experiences, and opinions I deem relevant. I will continue to document my sources for my own use. I invite you to continue reading and to comment on what I post. I will probably answer questions, respond to requests for clarification, and thank you for your comments. I will not, however, debate anything in the 'comments' section of either my blog or my Facebook account until I have completed the entire series on Healthcare. Then, if you want to debate, I will do so only if you come ready with facts from verifiable sources. If you choose to try to debate anything in this series with 'feelings', I will at best ignore you, and at worst verbally shred you.
Next time, I will finally continue the series on Healthcare in America. Really! Until then...
Best regards...
© James P. Rice 2009
Good day, family and friends!
Since my last post on the 13th, I've been doing some serious soul searching. I have to admit to being more than a little surprised and shocked by the response I received from the definitions I provided, not only from my friends and family, but from others outside my Facebook 'Friends' list who read my blog. While the responses from my 'Friends' list were considered, reasonable, and in the spirit of open debate and discussion, the others were considerably more vitriolic. These less than intelligent individuals also chose to expose their true cowardly nature by sending their comments to me via e-mail rather than posting them in either of the open forums available. Both sets of comments, however, did serve to underscore the most fundamental problem with most political debates these days, and in particular the Healthcare debate: how can we have a rational, reasoned, intelligent debate about anything when we can't even agree on the most basic parameters of the debate?
I could become redundant right now and once again go into excruciating detail of how I went out of my way to make certain I did not get the definitions I used from any source that was even remotely "Conservative" on the political pendulum, but I won't. What has happened, though, is that I now understand what the main protagonist in two novels I recently read was put through as I am experiencing now it myself.
In Terry Goodkind's novels, Soul of the Fire and Faith of the Fallen, Richard Rahl believes that he can convince the citizens of a small country to join his empire by simply sharing the truth with them. The truth is that Richard's empire is dedicated to justice, to protecting individual rights, to ending corruption and cronyism, and to allowing everyone the freedom to strive to be their best free from the fear that it will arbitrarily be taken away from them. The Order (Richard's opposition), on the other hand, believes that Man is a base creature whose only purpose in life is to help others with no thought for himself. The Order preaches social justice and entitlement, mandates charity, condemns personal excellence, and justifies murder, rape, and pillage as tools necessary to bringing 'true equality' to the masses. Unlike Richard, though, The Order doesn't bother with the truth. They instead use propaganda, misinformation, and outright lies to manipulate the masses. They demonize business owners as wealthy elitists who just want to side with Richard so they can continue to keep all the money earned for them by the common workers. They promise a new era of prosperity for the common man while punishing the 'greedy.' They use whisper campaigns to blame Richard's faction for everything that goes wrong...even natural disasters. They spread rumors that Richard doesn't care about the unemployed and would rather see impoverished children die. In short, they stoke the fire of fear in the common people.
In the end, 70% of the people vote to side with The Order. Richard withdraws his entourage and leaves the people to their fate. The Order moves in and the people discover the truth...that they have voluntarily enslaved themselves to a culture of death. From this, Richard finally realizes that truth does not automatically win every time and you can't force people to be free. He learned that no amount of logical, reasoned, factual discourse will ever change an opinion based on feelings. In fact, more often than not, the attempt to change such an opinion will lead only to animosity, derision, and outright hostility. This is where the response to my blog has left me.
As I read comments that called me things like "hatemonger", "racist", "Republican stooge", and "ignorant inbred hick", I decided I was done. Why should I even bother if just the definitions I provided were eliciting this sort of response from the effete thugs who are only interested in promoting their own agenda? It became very clear that no amount of rational, logical analysis and discussion would dent the shell of partisan intolerance in which these 'enlightened' individuals had wrapped themselves. I was done trying to be a rallying point for the vision of personal freedom and personal responsibility laid out by our forefathers. I would no longer bear that standard as long as I was viewed as nothing but a 'hick in a flyover state' by the snobs living in the elitist bastions of Los Angeles, San Francisco, Seattle, Chicago, Central Austin, and the East Coast. I had decided to drop my analysis on Healthcare in America.
This is where my brilliant youngest daughter comes in. I was discussing with her the frustration (and to an extent, depression) I was experiencing as I tried to have an intelligent discussion when she cut to the chase and asked me a single question: "Why did you start your blog in the first place?" That one question was like a lightning bolt. She made me realize that I had wandered far off track. As stated in my very first post, I started blogging "as a way to work out my thoughts on everything that is happening to our Nation and around the world." I didn't start this blog to educate or enlighten anyone else. If that happened along the way, it was gravy. But the meat of my blog is my own thoughts.
Therefore, thanks to my daughter, I have decided to continue my analysis of the Healthcare issue. I will continue to write about the facts, experiences, and opinions I deem relevant. I will continue to document my sources for my own use. I invite you to continue reading and to comment on what I post. I will probably answer questions, respond to requests for clarification, and thank you for your comments. I will not, however, debate anything in the 'comments' section of either my blog or my Facebook account until I have completed the entire series on Healthcare. Then, if you want to debate, I will do so only if you come ready with facts from verifiable sources. If you choose to try to debate anything in this series with 'feelings', I will at best ignore you, and at worst verbally shred you.
Next time, I will finally continue the series on Healthcare in America. Really! Until then...
Best regards...
© James P. Rice 2009
13 August 2009
Healthcare in America: A Clarification
Good day, family and friends!
Well, it appears that I'm on the right track. The definition I provided for American Progressivism alone generated quite a debate in Facebook...so much so that I decided I needed to clarify a few points from what I've posted so far before I go any further.
First point: the definitions I provided, specifically those for the political philosophies, are not mine. Those are the definitions provided by universally recognized experts in their fields; experts such as:
> The editors of The American Heritage® Dictionary of the English Language, Fourth Edition;
> Ronald J. Pestritto, Shipley Professor of the American Constitution at Hillsdale College;
> William J. Atto, Ph.D., American Historian and Researcher specializing in the 19th Century and Assistant Professor of History at the University of Dallas;
> Herbert Croly, founder and first editor of The New Republic.
Second point: the only personal opinion I have so far presented in this series is that the debate on healthcare in America "is rapidly devolving into shrill screaming matches split along the lines of political philosophies." As this series continues, I will make a point to indicate when I am expressing an opinion. I will also be providing a complete bibliography of my sources at the end.
Third point: I am not making this a contest between Good and Evil. I provided the definitions of the various political philosophies in order to provide a foundation for the various proposals that have been made to fix, improve, and/or change healthcare in our nation. I firmly believe it to be of the utmost importance that we understand the philosophies and motives behind the various suggestions so that an informed decision can be made.
Finally, please keep the input coming. I really do love any and all thoughtful questions, comments, and criticisms about my blog. Keep in mind, though, that if you take exception to data that I quote from a documented source, please take it out on the source and not the messenger.
Next time, how accessible is Healthcare in America?
Until then, best regards...
© James P. Rice 2009
Well, it appears that I'm on the right track. The definition I provided for American Progressivism alone generated quite a debate in Facebook...so much so that I decided I needed to clarify a few points from what I've posted so far before I go any further.
First point: the definitions I provided, specifically those for the political philosophies, are not mine. Those are the definitions provided by universally recognized experts in their fields; experts such as:
> The editors of The American Heritage® Dictionary of the English Language, Fourth Edition;
> Ronald J. Pestritto, Shipley Professor of the American Constitution at Hillsdale College;
> William J. Atto, Ph.D., American Historian and Researcher specializing in the 19th Century and Assistant Professor of History at the University of Dallas;
> Herbert Croly, founder and first editor of The New Republic.
Second point: the only personal opinion I have so far presented in this series is that the debate on healthcare in America "is rapidly devolving into shrill screaming matches split along the lines of political philosophies." As this series continues, I will make a point to indicate when I am expressing an opinion. I will also be providing a complete bibliography of my sources at the end.
Third point: I am not making this a contest between Good and Evil. I provided the definitions of the various political philosophies in order to provide a foundation for the various proposals that have been made to fix, improve, and/or change healthcare in our nation. I firmly believe it to be of the utmost importance that we understand the philosophies and motives behind the various suggestions so that an informed decision can be made.
Finally, please keep the input coming. I really do love any and all thoughtful questions, comments, and criticisms about my blog. Keep in mind, though, that if you take exception to data that I quote from a documented source, please take it out on the source and not the messenger.
Next time, how accessible is Healthcare in America?
Until then, best regards...
© James P. Rice 2009
12 August 2009
Healthcare in America: The Issues
Good day, family and friends!
As promised last time, I have one more term to define...
A-mer-i-can Pro-gres-siv-ism - noun
The political philosophy that blends socialism and fascism, originally outlined and defined by John Dewey and Herbert Croly at the end of the 19th/beginning of the 20th Centuries, and embraced by Theodore Roosevelt, Woodrow Wilson, and Franklin Roosevelt. Progressivism is a system of government marked by centralization of authority under an elite administrative class, stringent socioeconomic controls, marginalization of individual rights, limited private ownership of property, moral relativism, suppression of the opposition through terror and censorship, and typically a policy of belligerent elitist nationalism. The progressive philosophy views the common citizen as rabble incapable of self-determination and in need of guidance by the intellectual elite. Since its inception, this movement has been known as Progressivism, New Nationalism, Social Progressivism, Intellectualism, The New Deal, Liberalism, and American Progressivism.*
Some of you may be wondering why, if I'm trying to take a completely logical, scientific look at the state of healthcare in America, I'm defining so many terms that most people deem to be political. Its because one must understand the source of a problem before one can focus on a solution that actually resolves the problem and does not make it worse in the long run. The definitions of these political philosophies are important so that we can understand the source of many of the ideas being thrown around as 'solutions,' and by extension, the motive behind many of these ideas.
But the true starting point lies with the first three definitions I provided: healthcare, healthcare system, and insurance. I'm starting here because, when most people speak of 'healthcare in America,' they are actually lumping together two different issues...Access to Healthcare in America, and The Affordability of Medical Insurance (a.k.a Healthcare Coverage) in America. Therefore, my analysis and accompanying suggestions of solutions will be split into these two categories. starting with Access to Healthcare in America.
Until next time, best regards...
* Summarized definition consolidated from The American Heritage® Dictionary of the English Language, Fourth Edition and American Progressivism by R.J. Pestritto and William J. Atto.
© James P. Rice 2009
As promised last time, I have one more term to define...
A-mer-i-can Pro-gres-siv-ism - noun
The political philosophy that blends socialism and fascism, originally outlined and defined by John Dewey and Herbert Croly at the end of the 19th/beginning of the 20th Centuries, and embraced by Theodore Roosevelt, Woodrow Wilson, and Franklin Roosevelt. Progressivism is a system of government marked by centralization of authority under an elite administrative class, stringent socioeconomic controls, marginalization of individual rights, limited private ownership of property, moral relativism, suppression of the opposition through terror and censorship, and typically a policy of belligerent elitist nationalism. The progressive philosophy views the common citizen as rabble incapable of self-determination and in need of guidance by the intellectual elite. Since its inception, this movement has been known as Progressivism, New Nationalism, Social Progressivism, Intellectualism, The New Deal, Liberalism, and American Progressivism.*
Some of you may be wondering why, if I'm trying to take a completely logical, scientific look at the state of healthcare in America, I'm defining so many terms that most people deem to be political. Its because one must understand the source of a problem before one can focus on a solution that actually resolves the problem and does not make it worse in the long run. The definitions of these political philosophies are important so that we can understand the source of many of the ideas being thrown around as 'solutions,' and by extension, the motive behind many of these ideas.
But the true starting point lies with the first three definitions I provided: healthcare, healthcare system, and insurance. I'm starting here because, when most people speak of 'healthcare in America,' they are actually lumping together two different issues...Access to Healthcare in America, and The Affordability of Medical Insurance (a.k.a Healthcare Coverage) in America. Therefore, my analysis and accompanying suggestions of solutions will be split into these two categories. starting with Access to Healthcare in America.
Until next time, best regards...
* Summarized definition consolidated from The American Heritage® Dictionary of the English Language, Fourth Edition and American Progressivism by R.J. Pestritto and William J. Atto.
© James P. Rice 2009
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