Things to discuss in regard to single-payer universal healthcare.

[Lyric]

I am operating under the mindset that this IS going to happen, because it NEEDS to happen, and therefore it might be prudent to discuss how it should work.

Obviously, some non-necessary services aren't going to be covered--purely cosmetic breast enhancements, face lifts, etc. That makes sense, because those services are not necessary to sustain either physical or mental health. I would of course assume that breast reductions in order to alleviate back pain and cosmetic surgery to repair malformations or injuries wouldn't count as "non-necessary," and I'm sure that most people here would agree with that.

What do you think about fertility services, birth control, vasectomy, and pregnancy termination? What about sexual dysfunctions like ED and vaginismus? Should those services be completely covered, partially covered, or not at all? And if they ARE covered, should there be any age limits, situational requirements (like being married,) or denial of service due to prior criminal convictions (like a convicted rapist getting ED treatments, etc?)

What about health privacy issues? If the government is paying for our healthcare, they're obviously going to be getting itemized bills for the exact treatments that we've all received and the medications we've had filled at our pharmacies. How do we safeguard that information? Is the government going to be allowed to "share" it between agencies--like keeping all of our medical records in our FBI files, handing over itemized lists of prescriptions to the DEA, or giving health information to military recruiters without explicit consent? These government agencies already have access to this information if they can demonstrate a *need* for it (like a DEA investigation) but with all of this info in one convenient place, how can we ensure that they can't browse through it at their leisure, looking for a reason to "investigate" people?

I am 100% in favor of single-payer, universal healthcare. For the record, I believe that most of the above "non-necessary" services should be 100% covered, because I believe that most of them ARE necessary, and that we cannot use morality differences to determine individual need. Abortion is going to be the Biggie--the anti-choicers will shriek about having to "help pay" for abortions. It never seems to bother them when they help pay for murder via wars, though, does it? Grrrr. We all have to pay for things we don't approve of via our tax dollars. I don't approve of abstinence-only sex education, but I pay for it anyway. I don't approve of bailouts for rich people, but I'm going to be paying for it anyway. We need to figure out a strategy to combat the shrill voices from the right who will claim that abortion is not "necessary."

I am wavering only on the idea of paying for fertility treatments, IVF, etc. On one hand, it doesn't seem fair to help people pay to have biological children when there are so very many needy, parentless children who need adoptive families. On the other hand, a lot of infertility problems are caused by underlying medical issues, and fixing those medical issues can often restore fertility. Should we ignore legitimate medical issues just because one major effect of fixing them could be restored fertility? Also, IVF is a major, major source of excess embryos that can be donated for embryonic stem cell research--something we all could potentially benefit from. We know that Obama is going to restore the funding to this research, so this has become an important issue again. It doesn't seem quite fair to put the entire burden of payment on parents seeking to have a child, when the entire nation benefits from the extra embryos that they don't use during their IVF treatments. So should we help pay for IVF? Wholly, or partially? It's worthy of discussing, because there is a lot of grey area there.

I also firmly believe in privacy, and I want to make sure that our government cannot use our health information as yet another tool to hold us hostage and make us afraid. I think we need a clear and rock-solid privacy statute to go along with the healthcare bill, so that government agencies know from the get-go that they cannot use our health information as a tool to investigate us unless they have a prior warrant to see that information. The cynic in me can't help but feel like the FBI, the CIA, the DEA, and Homeland Security would absolutely POUNCE on this information unless we explicitly tell them that they cannot. They are always looking for reasons to justify invading our privacy. Look what they did with the Patriot Act. Ugh.

What do you all think?

[nightrain]

1. a few other issues...

Electronic records online doesn't yet seem safe and immune to hackers.

I think we need to expand the types of providers covered by Medicare, or whatever any new entity we call it. For instance, I work as a psychotherapist and am licensed as a "Professional Counselor". We are NOT yet covered by Medicare, so there are a whole slew of potential clients we cannot see and be reimbursed for, yet. I would open up the reimbursement categories. Another issue is reimbursement amounts to providers. It needs to be VERY timely and adequate or the healthcare system as a whole will not function well from the provider point of view.

I will be delighted to FINALLY have healthcare coverage for myself!

Perhaps those who don't want to pay for particular procedures due to their own stances could have a different range of services covered at another price than more complete coverage? Like, being able to have several different levels of care at various costs??