Reading the Washington Post this morning I came across this opinion piece
Dear Democrats: I’ll vote for any of you. But please nominate someone who can actually win.
The article and related comments highlighted two areas that seem to grate whenever I hear them - "Medicare for All" and "Free College Tuition".
Here are some of my thoughts on these two issues.
On Universal Health Care
Over and over candidates talk about “insurance coverage”. Insurance coverage often bears no relationship to access to health care. There are many ways to create universal access which have little or nothing to do with insurance coverage.
Early access to health care is known to prevent minor problems or chronic diseases from becoming major issues requiring emergency room visits or hospitalization. Early access is enhanced by
- Eliminating copays and deductibles.
- Access to health clinics, especially in areas with underserved populations. Staffing with NP”s and PA’s as independent practitioners when MD’s are not available to serve an area.
- Providing medications for chronic diseases such as diabetes and hypertension at no cost.
- Reimburse all medical school costs for students, including pre-med studies, in return for providing primary medical care in underserved areas.
- NP’s (nurse practitioners) and PA’s (Physician Assistants) agreeing to serve as primary care practitioners should also be reimbursed.
- Nurse practitioners (NP’s) and Physician Assistants (PA’s) often complete their higher education in steps. Supporting registered nurses and paramedics in obtaining advanced training and degrees takes advantage of their existing clinical experience - something physicians often don’t encounter until toward the end of their training.
Reimbursing primary care practitioners - MD’s, FNP’s, PA’s - at levels which recognize their professional status helps to avoid drain off to more lucrative specialties.
People are scared of the "unknown" and the possibility of losing something that already works for them. A public option available nation wide could be a good start. We should probably remind people that currently Medicare Part B is an option and is not free, nor are so-called “advantage” plans free. Without Medicare Part B and either a supplemental or advantage plan, seniors may still face overwhelming medical costs that Part A doesn't cover. Purchasing these options may consume over twenty percent of an already limited retirement income.
Of course this isnt "free" health care but the cost of not providing access to quality health care for all is much greater.
Of course this isnt "free" health care but the cost of not providing access to quality health care for all is much greater.
On Free College Tuition
Nothing is ever “free” and people are less apt to take something they’ve earned for granted. The meaning and need for college or university education is also up for discussion. The current discussions of “free college tuition” often fail to take into account the difference between job preparation or training and education.
Society has and needs a mix of people - laborers, philosophers, nurses, astronauts, soldiers, welders, farmers, bankers. Not everyone is suited for every task, and the work that suits someone at twenty may be totally different from what one should be doing at sixty. What ties all these differences together is that each job or vocation is as important as any other. The philosopher values and respects the laborers who contribute to their life running smoothly. The astronaut recognizes the importance of the technician who ensured all the parts were assembled correctly. The farmer appreciates the veterinarian who helps keep his animals healthy. When any of these jobs is viewed with disrespect as too menial, too elite or too mundane to be worthy of our notice or that the people performing them are considered not as valuable as ourselves, the fabric of our social cohesion begins to unravel.
Traditionally new immigrants to our country embarked in somewhat menial work. They encourage their children to achieve and work to support their children’s efforts. Their children’s successes are not always in terms of a professional degree but may be in other areas such as law enforcement, assembly work, construction, sales or other vocations which provide them with the means to meet their goals. But as modern life requires more and more technical skills even these “non-professional” vocations require a level of advanced training and expertise.
Is “free college” the answer? Why not, instead, provide life opportunities through mandatory National Service?
National Service can be a way for college bound students to earn and prepay their tuition. Making this a required stop between high school and college allows teens to take stock of their lives and the rest of the world. For kids from less advantaged areas it can provide opportunities and insight into things they’ve never been aware of before. Whether it’s military, health care, or a union sponsored apprenticeship, with no exemptions, there can be meaningful work for everyone - from high school drop out to entitled prep school grad. I’ve often wondered how many young men involved in the CCC went on to become forest or climate scientists or park rangers.
Full link to story:
https://www.washingtonpost.com/opinions/dear-democrats-ill-vote-for-any-of-you-but-please-nominate-someone-who-can-actually-win/2019/07/04/4d9550c4-9dd9-11e9-9ed4-c9089972ad5a_story.html?utm_term=.357889fada1c&wpisrc=nl_most&wpmm=1
