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Health Care: What issues interest social workers?

Currently, the United States spends more on health care than any other country even though we are ranked 47th in life expectancy and 43rd in child mortality. In addition, over 40 million people are without coverage, including millions of children. Eight out of ten of those uninsured are members of working families and the number continues to grow at an alarming rate.

NASW supports a national health care policy that ensures the rights to universal access to a continuum of health and mental health.” (Social Work Speaks, 7th Edition 2006-2009). Both presidential candidates have proposed enhanced health care plans. In each health care proposal there are issues of interest to social workers. These include mental health, veterans’ health, women’s health, HIV/AIDS, long term care and Medicaid and Medicare among others.

What health care related issues interest you as a social worker?

16 comments

  1. I support the bill before Congress, HR6528/S2706, that increases the cap on health insurance benefits for those enrolled in large group plans It is only a partial step toward good health care coverage, but it is a good step.

  2. I absolutely support a national health care policy that offers assess for everyone to receive care. No one should be without access to health insurance. My question is, how will this effect those os us who are providers of mental health care? I have some concerns about that. Wonder if there has been much discussion about this in conversations?

  3. All health care related issues interest me as a social worker, and not just for my clients either. As a person who has had to deal with personal medical bills (even though there have not been any pre-existing conditions), and as a person who has had to work with clients who have no choice but to go to the local emergency room because they are uninsured, anything related to health care interests me.

  4. It is interesting I wrote this for my Social Work in Health Care Settings Course: I will share this with my fellow social workers.

    Healthcare for all is a wonderful and glorious idea, but realistically we as taxpayers do not have the funds to support the estimated 45 to 50 million people that are without healthcare (Morris & McGann, 2008). If the United States starting in January of 2009 were to provide free healthcare for everyone in the United States to these estimated millions of people, this would create a dramatic increase in the demand for services at hospitals and offices without increasing the nursing staff, medical staff, technical staff, doctors, physician’s assistants, social workers that need to be employed at these facilities. This would mean a great shortage in medical staff, a shortage that is already in occurrence! With the Obama ticket he is proposing cost controls, which would lower the salaries of doctors so severely that who knows who would want to go to medical school (Morris & McGann, 2008). With this notion goes the quality of care, which would diminish as a result of unsatisfied and overworked staff.

    In economics courses I learned that as supply stays the same or decreases while demand is increasing sharply this will cause a dramatic increase in prices. The same applies to the notion of universal health care, you see if the supply of hospitals, doctors, nurses, etc stays the same and the demand for health care increases with universal health care, then this will cause a great increase in the price of healthcare. So who pays? We do as taxpayers (Morris & McGann, 2008). Even if lets say universal health care does pass, Obama is elected into office and it is implemented it does not mean that everyone will even take advantage of those services. In the Clinton administration, the president convinced Congress to pas the State Children’s Health Insurance Program which offers health insurance to children with no health coverage (Morris & McGann, 2008). One third of the parents of those children, never even signed up for services (Morris & McGann, 2008)!

    The United States spends an estimated 16 percent of its national wealth on health care, more than any other nation even France who has universal health care (Morris & McGann, 2008)! Clearly, the administrators would have to find way of cutting costs which means rationing health care. This means that bureaucrats will have the power to veto on any medical procedure we want even if we are willing to pay for it (Morris & McGann, 2008). This notion of rationing health care will be especially harsh on our elderly population, whose lives would rest solely on this new cost-benefit analysis (Morris & McGann, 2008). Therefore, universal health care should not rest on our federal bureaucrats to make a decision for us, it is a privilege as citizens of a free nation to set our own standards, rules and regulations as decided by our health care providers NOT by our national government.

    See the truth is that if we lived in a nation with universal health care, it would decrease the quality of services for everyone; it would increase the price of health care and force rationing for the very first time in history (Morris & McGann, 2008). Being Healthy is a positive thing that comes from feeling good physically, emotionally, psychologically. Insurance for all is a great idea, but realistically this nation does not have the funding to support those 45 to 50 million people without healthcare. Extensive efforts to encourage health should be taken before we try to impose on the pockets of every taxpaying citizen.

    How much as taxpayers are you WILLING to pay for universal health care?

    Works Cited
    Morris, D., & McGann, E. (2008). Fleeced. New York: HarperCollns .

  5. In response to Rosemary Nova, I have not heard any politician discuss providing FREE health care to anyone. We (taxpayers) currently already pay for the uninsured and their health care costs everytime they are admitted to a hospital or get care through a clinic providing services to the uninsured and of course through Medicaid.

    There is not a perfect answer to our health care problems in the US, however, WE can do better. Health care is already rationed and will continue to be so, overtly and covertly. We can do a better job providing access to preventive care, health education, as well as, ensuring that we assume some responsibility for our health care status, ie, through a healthy lifestyle, etc.

    The bitter pill for me is how any of us can say that we deserve quality health care and yet not be concerned for those identified as the “undeserving.” We will probably all fit into that category at some point. Many people already have the attitude that the elderly and disabled use a disproportionate amount of our health care resources and we should “limit” this use in the future. I pray for those of us who may become disabled and/or live until old age and wonder if we will be cared for or forgotten.

  6. I support health care for everyone; I am in favor of the way they do it in Europe.

  7. Ms Nova’s comments are right on. universal health care is socialism. Ask the Russians how well that works. The cost of health care needs to be reduced in order to increase it’s affordability. Tort reform would help. In addition-increased competetion amoung heallth care providers will also help. In conclusion we should not trust the government to manage our health care system. This is innefecient and discourages competition.

  8. I really enjoy reading all of the thoughts posted here. It’s information that makes you think. My comment about health care is that tax payers already foot the bill via higher ins. prems and payments to ER’s when an uninsured person gets sick and goes to the ER to get well. In many cases, if that person was ins. they could see a dr. not in er doc. I beleive that preventative treatment, focusing on health instead of waiting for a sickness
    would be a hugh step in the right direction. As far as salaries go, dr.’s could be given tax breaks or some thtsype of loans from med school repayment, etc. Just my thoughts. I just think that it’s disgraceful that this country does not take care of the citizens, the very people who they claim to work for.

  9. My concern is the misunderstanding about the U.S. health care “system”
    ( We don’t really have any sensible or systematic approach to health care in the U.S.) Most Americans are quite ignorant about how our approach to providing health services compares with those of other industrialized countries. What we should do is extend Medicare to cover all Americans, as it was intended to cover whan introduced to Congress in the mid-sixties. As a “single payer” system, Medicare is not paying for the multi-million dollar salaries of the CEO’s of all the multiple health insurance companies in the U.S. For more information, see my textbook: “Social Work in the Health Field: A Care Perspective” (2003) Also, see >www.pnhp.org<

  10. Lois ( #9) is correct. Most people in the US do not have a clue how the health system really works in this country. Revamping our system is paramount to getting anything that is close to workable. Just like 12 years of education is a basic right for everyone in the US, health care should be also. That does not mean that you would be entitled to any and all care available if you don’t have the means, but basic healthcare should be afforded to everyone. Preventative care and lifestyle changes need to be at the core of making a system that works for the majority of our citizens. Difficult , disciplined decisions would need to be made so that is unlikely to ever happen in our lifetime.

  11. In response to: “Ms Nova’s comments are right on. universal health care is socialism. Ask the Russians how well that works. by ‘Doug P’. Universal Healthcare is Socialism, it works great for Canada, Great Britain, Holland, Netherlands, France, Spain, Israel, Germany, and Old Folks in the US (Medicare)and the US Military. I don’t think anyone would seriously consider Russia’s health care system Universal or Good. A little more research on your part would go a long way.
    Rosemary is correct about the apparent cost, But it is a small amount to pay for a stronger country. One thing is clear. Our current system does not work well and will eventually collapse. My portion of my family coverage for private insurance is almost $12,000 per year. I would love socialized medicine.

  12. Do you really want to wait 6 months for an appointment to see your doctor? How about waiting months for a mammogram, then several more months to get a biopsy? Or, how do you like the thought of the government “managing” your care more stringently than your insurance company?

    Another view: your current insurance premiums are paying for a select few unhealthy members in your risk pool. The highest health care dollars go toward treatments for diseases related to obesity, smoking and alcohol/drug abuse. Do you really want your income taxed to cover those diseases on a national risk pool?

    One of the best ways to cut down insurance premiums is to get rid of employer-paid insurance plans. That would open competition between the insurance companies to woo us with smarter health plans (including choices of covered services). A tax credit for people to use toward their health plan of choice is better than being robbed of income to pay for a risk pool not of my choice.

    Opening the market is good for the people, or at least people who want to control their own health care.

  13. I worry about continuing trends in high rates of medical errors. Social Workers are uniquely qualified to help prevent errors through educating and empowering patients and their families to become knowledgeable, active consumers. A hospitalized patient should always designate one primary advocate to help him/her:
    –ensure positive identification before receiving any medication and any procedure
    –ask health care providers to wash their hands before and after every patient encounter
    –writing down questions in advance (who can ever remember everything they wanted to ask the doctor when they’re in with the doctor)
    –keeping an updated medication list and carrying that list with them, including vitamins and herbal supplements
    –completing an Advanced Directive, keeping it in an accessible location (like your car’s glovebox)
    –informing your family of your health care wishes NOW (remember Terri Schiavo?)

    Social Workers are wonderful health care advocates who can also educate other health care professionals regarding the diverse ways different people cope and how they approach medical care. Social Workers can also advocate to end inequity in health care (such as the different presentations for AMI in men and women).

  14. In response Mr. Norris in #11 I was not referring to Russia’s health care system but it’s past experience with Socialism in general.
    I have heard negative things about the health care systems in Canada, Great Britain, Germany etc. And besides productivity has gone down in those countries due to their movement toward socialism.

  15. I don’t understand why the NASW continues to endorse candidates that do not promise to develop a Federal single payer system — essentially an expansion of Meidcare to all cistizens.

    Again, and again, we don’t make a move in his direction for fear that “it will be just like Canada”. Is the alternative no healthcare at all for millions of Americans? Shall the CEOs of major health insurance companies just continue to walk away with huge compensation packages as rewards for keeping the shareholders happy? That money can go into treatment.

    More than 44% of us are uninsured or underinsured. Is no treament at all better than “socialized medicine”? I have relatives in Canada who do not have th complaints I’ve heard described over and over again by scared Americans who need to hold on to the broken system we already have.
    With regard to giving healthcare to all — Obama’s proposal is complicated and still does not get for profit insurance companies out of the equation.

  16. There are so many things wrong with what Ms. Nova says above that I scarcely know where to begin (but I’ll try).
    (1) “Who will want to go to medical school if salaries are lowered?” Men and women who want to be healers and are dedicated to providing quality care to patients are the ones who will want to go to medical school. The notion that absent the profit motive “the best” or “most qualified” individuals will avoid choosing a particular profession is plain wrong. The World Health Organization ranks Italy, Germany, France, the Britt’s and other European countries (not to mention Canada, New Zealand and Australia) as having health care systems superior to the United States. Physicians in these “socialized” systems do not make the kind of money that physicians in the US make but my question is how much money do you need? Physicians in these countries make a good living. Tort reform?…it isn’t necessary. If a physician is accepting payment for their services from the government, the law says they can’t be sued. Any claim for damages is settled by an arbitration board. No courts are involved. Also, if the profit motive is the measure of qualified and talented people choosing a profession what does that say about social workers?
    Another point, citizens of these European countries pay less for their medical care than we do in the US. Do people have to wait if using the national health services for NON-emergent procedures?…yes, but nothing prevents any citizen from purchasing private health insurance that would enable them to go “straight to the head of the line” if that is what they want. Private health insurance is alive and well in socialized health care systems. Are wait times exaggerated by opponents to universal health care?…yes. I’ve worked in Michigan and interviewed many beneficiaries of the Canadian system. They don’t wait long. But let’s concede that there will be some wait time added. Isn’t this because everybody will be included, isn’t inclusiveness a social work value, won’t there finally be a sense of justice for all citizens (please see social work code of ethics and core values of social workers for further details).
    (2) “The laws of supply and demand will cause a dramatic increase in prices.” I too enrolled in an economics class in college and what I learned about the law of supply and demand is that in order for his law to apply it must have two elements (a) an individual who does NOT have to buy and (b) and individual who does NOT have to sell. One doesn’t have to know too much about being sick to know why this law doesn’t apply.
    (3) “Rationing will take place.” Rationing of health care is taking place now. Anybody that is my age and has developed chronic health conditions knows that their insurance company is highly adept at rationing health care. In fact, just yesterday the citizens in the 9th congressional district of Missouri elected an insurance salesman to the US House of Representatives who was nearly successful in passing a law enabling insurance companies to deny women coverage for mammograms. If it were not for the federal government, our US (Republican) Congressman from the 9th District would have been successful.

    I’d like to close by sharing a brief account of my encounter with the British Health Service. I am not widely traveled but I once had the opportunity to travel to England with my family for three weeks. When we arrived at Heathrow, I had the worst sore throat I had ever had in my life. When I got to the hotel, I said to the desk clerk I was sick and needed to go to the nearest medical clinic. The hotel clerk said “Stay here, we’ll summon the doctor.”
    I want to be clear that the doctor summoned was NOT a doctor what was associated with the hotel. The doctor was simply the doctor assigned to the medical district in which the hotel was located. It would have made no difference if I were a hotel guest or an intoxicated homeless man leaning up against the side of the hotel with unstable vital signs.
    Fifteen minutes later in walks the doctor. This isn’t just any doctor, he’s the first-born son of an English Lord. I’m examined by the doctor who diagnoses me with strep throat, he prescribes penicillin and the exam concludes. I ask the doctor what I owe him and he says “nothing.” I protest saying that I had taken him abruptly away from his other duties and should pay him something to which he replied, “It’s on the British Health Service.”
    So, I’m not tolerant of those who malign the British Health Service. As far as I’m concerned if you go to Britain and become ill and the British government decides to send a member of the British aristocracy to your door and provide you with medical treatment free of charge then I’d say there’s something right with that system.
    Thank you Ms. Nova, but I’ll take socialized medicine.

    PS – George Bush has done more to socialize this country than any President in this country’s history. Under George Bush the United States government now owns Wall Street, the banks, large sectors of the insurance industry and is about to get into the automobile business. Thanks to George Bush, we’re all socialists in this county like it or not!

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