As of now, there is no cure for breast cancer. Until one is found, early detection and access to care in a timely fashion offer the best chance for survival from this devastating disease. A report released last week by the Patients Association in Britain revealed shoddy care and long delays, and allegations continue to mount. While women in the UK wait for basic treatments, unbelievable stories have surfaced of convicts being given plastic surgery and the government paying for sex-change operations. Is this the model health system we want to implement in the U.S.?
Before the comments start, I’ll add that I understand that insurance companies also limit care for victims of breast cancer; however, individuals have other options for coverage and financing if they are placed in that difficult situation. Certainly changes should be made to our current health care system to address these problems. But a single-payer system is not the best way to do so. If the government runs the entire system, it is questionable if alternative care will be allowed (such is the case with Medicare, where patients freedom to spend their own money on Medicare-covered services has been severely restricted, even when Medicare has denied coverage) or if it will even exist. As doctors’ and hospitals’ fees are capped, fewer providers will remain in the system in the long run. Fewer doctors will lead to longer delays – which is precisely the situation we need to avoid.
Rather than creating a new government bureaucracy from scratch, current programs designed to help the poor and underserved should be reformed. There are many, many changes that could be made that would be better than what we have now. For starters, waste and fraud are rampant in the Medicaid system; additional oversight of this program is sorely needed so that the government’s finite dollars are wisely spent. The federal government’s dollar-for-dollar matches to states for Medicare should be given in the form of block grants, so that states are allowed to determine their own health priorities. Programs to assist cancer patients and other chronic diseases can be tested for effectiveness at the state and local level, and implemented more widely if they are successful. Private charities should be encouraged to take an active role in this process, as should doctors, hospitals, and companies. Those that truly need assistance should be helped; those that are able to obtain coverage on their own should be encouraged to do so.
Once women have been screened, diagnosed, and treated, however, the battle is not over. Survivors need access to care after they have recovered. Many states have experimented with high-risk pools to cover those citizens who have been denied coverage because of their preexisting condition. Paid for through a combination of dedicated state funds and premiums (according to the National Conference for State Legislatures, typical rates are 125 percent to 200 percent of “average medically underwritten” individual insurance rates in the state.) This shows great promise in providing a safety net for many people until they are in the clear and can reenter the private insurance market.
The current system is deeply flawed. However, changes can be made that will benefit women who need care without reducing the parts of the system that work. There are benefits to the American medical system – medical innovations developed in the U.S. have helped people around the world. We should try to preserve the good in our system as much as possible, while improving the system for everyone, including helping those who cannot provide for their own care.