Humanitarian Government #16: Healthcare as a Human Right

Humanitarian Government #16: Healthcare as a Human Right

Good day! I got my internet back and that's why I've had issues, all. Thanks for your patience.

I'm opening up as being excited today...finally...FINALLY! I get to a topic I am intimately familiar with and can fully talk without saying ad nauseam that I'm not a specialist in isn't necessarily needed.

No, I'm not some sort of administration spot in healthcare management or business. No I'm not a doctor, surgeon, or anything like that either.

No, not mental health either, unless you count being a patient.

Nope! I may have been a low level nurse, but I was on the floors and worked geriatrics.

I stated out at five and having a doctor that must have been something because that's when I first told my parents I wanted to be a doctor. OK, you might say 'well, duh, you can be whatever you want to be'. Not so much in the early 70s. Women weren't numerous except as nurses at the time for healthcare job holders.

As I got older, that was the more often answer if asked 'What do you want to be when you grow up?'.

By High School, I was firmly in the pathway of going that way. I was on a college prep path (Advanced Placement classes, advanced sciences and maths, no fluff unless needed simply for graduation requirements because there was no other options or study halls except for one in all four years and that was only for a semester). I was planning to go to college and do a double major of pre-med and bio-chem.

But, that's also when the Recession of the mid-80s hit where I lived. At first, the bidder at the job my Dad worked at messed up and it was: 'We're either going to close the shop, or we're going to cut your hours in half'. The employees went ahead, wanted to keep their jobs and was hoping things could be recovered.

A few months later, the recession fully hit and it was 'We're going to have to cut your pay in half in addition to the hour issue to keep afloat'.

Yeah...it sucked. I couldn't get enough scholarships, my parents weren't in any financial position to get loans for me to go to school on, and we moved.

Pharmacy became a new aspect of my 'medical work history'. Then I transitioned into nursing. At that point, my life changed massively and I couldn't manage to get further licensure or education to get beyond what I was. Does that mean I didn't want that? No. Frankly, at the time and place, my licensure only allowed for pretty much one setting: geriatrics. Not that I wanted that, but still, I liked my job despite me working in such a manner that it burnt me out.

It's bad when you do 8 hrs every other day alternating with 12 to 6 hours and work 6 to 7 days a week for years. But, that's the case then and now with the shortage of healthcare workers.

This week, as of this writing, the Department of Education has made that issue worse.

What I'm going to propose will piss off several industries: Pharmacy, Healthcare (insurance), and For-Profit Education. I'll be honest: I've talked to a lot of doctors over the years and gotten their take on things. I've seen and been involved in enough branches of healthcare to see not only issues, but the aftermaths of those issues.

America is the only developed nation without a form of Universal Healthcare, has such a broken healthcare system that shortages are part of the business model to curb costs and deny care.

This is a wake-up call.

Issue: Economics

I'm starting out on the money trail simply because what is said, what is reality, and what could be are three different things in the US.

What is being touted by politicians is that 'big government' or simply 'government' shouldn't be involved in funding, regulating, or being involved in the framework of healthcare. 'Too expensive' is another term they use. Yet, we have Medicare and Medicaid: both are forms of 'socialized medicine'.

The insurance companies say that government isn't equipped to deal with something so delicate, or it would be too expensive to give out care in the way healthcare professional recommends.

People say they don't want government involvement, they don't want to pay for others healthcare, but also complain about how insurance companies pay claims (or lack of) and their business models.

In reality: Medicare and Medicaid gives very good care, has more money for that care, and works smoother than a patchwork of insurance companies and financing.

Part of that is that both Medicare and Medicaid are non-profit models. When you talk about insurance companies; swag, profits and a cost table based on what insurance company you use and even the variety of plans and care allowed are all issues. Every. Last. One. We do have a non-governmental system that proves out non-profit models work very well, too: Kaiser Permemente.

But that's an over all reality. When you get to individual reality, let me explain a few things.

Some of you might know this, but it's all good. You can skip over if you like. However, this is more for those who think that what you pay for insurance is used and allocated in certain ways. Trust me, for you in the know, you're lucky you do and probably fully on board for 'socialized medicine'. But for those who aren't let me give you the real deal.

Sub-Issue: The Way Insurance and Work are Intertwined

Say you're lucky and have a job that gives enough hours to qualify you (based on the company policy) to have health insurance.

You might have caught onto 'lucky'. It's 100% true. Business used to have that as a standard benefit. The slow (or not so slow) stagnation of pay and increases in corporate profit ties into whether or not you have healthcare. There are many companies today that will schedule a person to just under the amount of hours to qualify for that benefit just to fatten their bottom line. You see, even if you have that as a benefit, you pay into having that. The rest is paid by the employer and when you're talking capitalistic systems, that bottom line is everything and cutting that cost would be a good way of making that bottom line better.

Not only that, but if you do have healthcare insurance through a job, it's generally the lowest priced that the company can get and that generally means limited care, high deductibles, or both. Not only that, it's not full body, either. Riders for dental, hearing, and eye care are needed for those bodily systems. Prescriptions may or may not be covered and that opens up another can of worms.

Now, insurance, any insurance, is predicated on spreading out costs over a pool of people. It's not that you pay your premium and that money is just in some account under your name.

What that premium does, no matter if you need care or not, is be used for medical care (in this case) for all who are enrolled into that health insurance companies programs. So, that 'I don't want to pay for other peoples care' isn't a thing: it is what insurance is all about.

Then you have even further issues with job-tied healthcare: businesses changing insurances, care changes, and healthcare networks.

I can't tell you how often I've heard of my various jobs changing insurance companies during my time at that particular company/facility. Even healthcare settings do the same as any other business. Now, I've been lucky and I won't go into why I've been lucky. However, I've never had an issue with changing insurances no matter where I've lived although I have had issues on how to get my care at times.

How does a change in job-benefit health insurance do anything? For those of you who've lived through it, you probably know.

Changing primary care doctors or specialists, various treatment allowances can be augmented, decreased or simply not be covered and more are all involved. So, getting stable care doesn't necessarily happen with job-attached healthcare. Not to mention, if you change jobs, you may or may not even get insurance anyway.

Pre-existing conditions are a chronic condition patient's worst nightmare. Pregnancy...think about this all: pregnancy has always been a bone of contention. Before the ACA, pregnancy was considered a 'pre-existing' condition. If you ask me how that could be, I have no answer for you. Because, you see, pregnancy happens, may be planned or not, and is temporary even if it can happen multiple times. So, I'd say it's more of a thinking that women's healthcare, since it wasn't until the 1990s that it was made mandatory for female related medical research was done, forcing money into women: the very backbone and needed persons for that working pool of people business complain about not having enough.

In addition, another thought for you: business wants a bigger pool of people for the next generation of workers. People can't afford most things, to include essentials, because business doesn't want to pay for healthcare, retirement, nothing....

No, they shove all that off to government, complain they don't make enough, yet their profit margins for the most part are millions to billions.

Sub-Issue: Professionals and Scarcity

Currently, the US has had a shortage of health professionals of all stripes since before the 1970s.

For-profit schooling has driven up costs, 'weed-out' courses that are required courses that may or (and usually) may not ever be used but are required for graduation, and in some areas, required remedial courses are needed to get a health care related degree. It's not a system conducive for good care or even a good labor market.

Right now, unfortunately, people don't realize how things are in the medical care world. They are, if they are trying to figure out why their healthcare is part of the ACA and that's why their premiums doubled to quadrupled, getting a crash course.

For staffing, the amount we use is about half of what any other country uses for staffing. Canada tries and is trying to get their surgical hospital units to a one nurse for every four patient ratio. And that's just one tiny area of nursing. Going fifty miles for a specialist is damn near normal. Do you see anything?

Even when I worked as an LPN, licensed practical nurse, I worked geriatrics as a medication and treatment nurse for the most part. One LPN for anywhere between thirty to sixty depending on the amount of care needed wasn't unheard of and that was in the late 1990s and early 2000s. Pool work is and was plentiful and even with pool workers, overtime was given to those who wanted in internally and pool workers used just to give bare minimum coverage. Is this safe care? No. As stated, we as a nation uses about half the amount of staff for good care in most settings and I will say that's a huge portion of burnout for nurses: overwork.

The question is: why do we need more to do the 'same' amount of work and how about getting more people?

The partial solution will be addressed in more detail in another article, but that partial solution is education.

For one, we need to drop drastically the cost of becoming a health professional, so that's 'more people' part of the issue. The why is based in the past and what the future looks like: yes we have boomers and older gen x needing more and more medical care, yes that amount of care isn't going to be forever, but we can guesstimate the needed staffing levels and drop the amount of trained professionals only if we end up not needing as many medical personnel in some distant time. If we want to change our system to preventive from reactive, we'll still need more medical persons so regular care and follow up care, along with urgent/emergency care also being available and more may mean a small dip later, but not for the foreseeable future.

As far as the education part, one thing would be getting rid of courses that won't normally be used in the course of daily use for whatever position. I took statistics twice and didn't get far into it. When you've a baby at home, working sixty or more hours per week, and even with one evening a week for a statistics course for a BSN, bachelor of science of nursing—one that in my area allows for practicing in hospitals and not just geriatrics in long term care settings, I couldn't handle it because I couldn't get enough time to do homework, the class was too long because it was one day a week, and I was exhausted.

So, the next stop on the change train would be re-working the curriculum and using something else as a weed-out course to make sure a person is suited to the profession and absorbing needed information. So, I'm offering up a solution that might sound familiar to the older set who may read this: a mix of technical schooling and 'professional tract' schooling. I'll be getting into this further as stated in a future article.

To start even for more than CNA, certified nursing assistant, I'd start with at least partial day in classes taking the generalized and baseline courses. Get to a point so a person can get a CNA and work at least part-time for pay before the end of high school (for those overseas that's Grade/Year 9 through 12). We would also encourage those with the temperament to continue on. Now, mind you, I'm going to propose an overhaul of the education system, so don't get your mind set into 'today's' version of education.

From that CNA, the next step would be LPN and about a year to two years that can be changed to an RN with continued education, with a BSN within six to eight years after 'high-school' is started. Once that first bachelors is gotten, that's where the 'repayment' comes in.

Now, part of the time of course will be clinicals, it's there where I would put the pressure on and see how people react to a profession that literally requires perfection at all times. Otherwise, people get hurt. However, even then there are ways of giving mental health tools to handle stress as long as any 'cracking' is of being overly excitable or showing signs of taking on responsibilities for outcomes that could not be foreseen or not caused by their own negligence.

Now, from the time, and since I know nursing best, anything over an LPN has a working pay-back time. I'm still working on the economics as in funding and such, but what if we had a UBI that handles most of personal and individual needs? Picture this: you work for UBI only for a duration of one year work to one year school ratio if one works in an urban area and a nine months work payback to one year schooling if one goes into rural areas. I'll get into funding, but that's going to take a huge amount of thought further down the line, so you'll get that information/suggestions but it will be a while.

When it comes to other professionals: from Nurse Practitioners/Physician Assistants, Pharmacists, specialists in physical medicine and also mental heath workers would be much the same. I'm hoping for a doubling or even tripling of front-line medical workers that have direct patient care. MAs and CNAs are limited on what they can do and they are on the front lines, and in those settings that CNAs and MAs positions will grow, but probably with some limits. It also depends on if there would be more in-home care rather than just bigger facilities for specialized and long term care outside of a hospital.

Sub-Issue: Care Expectations

Another issue when dealing with healthcare is 'quality of care' expectations. So what kind of care am I talking about?

To start: check-ups every three months (stretched to six months with perfect health babies), vaccinations (which from a public health looking glass: when the Salk Polio Vaccine came out, there were places in high density population centers in New York and other packed cities, the area would be 80% or better within a few days. Then we've gutted education, which impacts the base knowledge and possibly even the development of curiosity but the point is: vaccines help save lives so in Erf there won't be waivers for religion or personal reasons. Not only that but for school aged children, schools would be a no-brainer site), the care from delivery to about three or four years old and then scaled down to every six months until about eight to ten, then yearly for just keeping up with a rapidly changing little human. Get a good family history and a good set of needed care {YES THIS IS BEING YELLED} AS DETERMINED WITH EDUCATED, THEORETICAL, OR HANDS-ON PRACTICE WITH LICENCED QUALIFICATIONS.

Yes, if you can't tell, I have issues with HHS and everything under that umbrella. It's unreal that people with no medical knowledge, and not all have any medical branch credentials or degrees are making medical decisions for millions.

But also think: that child will have hair-tip to toe-tip, full body/system cradle to grave care. During that early care, making sure of keeping watch on potential issues based on related history and the way other conditions can be a prelude or epilogue of various other conditions. Not only that, a 'school nurse' and even mental healthcare starting in childhood can do how much good? Am I saying parent's aren't part of the picture of raising a child? Even church? No to both. Actually, let me get very crude and very point-blank: fuck no. If you had walked in my shoes, you'd understand why I say all of that. Besides, having at least one mental-health professional around to teach good mental-health skills as a class and being a person that isn't a friend that is close but off-limits to talk to about tough things in a child's life and adults for the most part other are also off-limits because of anything between embarrassment to mortification being felt if things in that child's life needs to be addressed isn't a bad thing. It's also not indoctrination: it's honest teaching.

Now all of that is a foundation and the first children under a form of universal healthcare will end up healthier than their parents. Of course, the older the person before falling into a universal healthcare system finally instituted would more or likely be less healthier because of preventive care rather than reactive. But they will still have health issues that could have been addressed and been cheaper to do so because those folks have had to ration care or the almighty dollar amounts of profits demanded by insurance companies. All the care starting and followed through without needing to ration out care in any system of the body can cause a trail and with family history, things can be found a lot sooner and ways of either mitigating issues or avoiding them all because of catching conditions or situations early.

Not to mention, adults benefit also. Everything is the same: proactive/preventive care that allows better management of conditions, better ways of keeping people active and working (and feeling worthwhile—this one I know a bit about), and more. This means savings in time, health, and money, and that in turn keeps people from feeling like crap and ups the almighty productivity for society and business, might even allow for longer work life, and also lessens stress. All of those things are good. I hate saying 'productivity', however...because 'productivity' in today's language equals corporate work and money. Mine says 'productivity' means taking care of society in general in pretty much all ways—to include traditional type jobs. Because even a teenager being at home, doing homework but also cooking dinner provides a method of productivity that gives society a nudge, even tiny, forward.

So lets think about this: reform government funding and even the method of how people live financially; make sure food, clean air and water, housing, and essential services are available across the board, and allowing things to change enough that people are doing jobs they like rather than for survival. What can that do?

Sub-Issues: Costs

During the fights over the ACA, there was a figure of $28 billion could fund full body, all system, universal healthcare. Now, lets look at the government budget for 2026 and after the mis-named and mis-fire of a piece of legislation: One Big Beautiful Bill.

Let's throw out just one number: $112 billion. That is the just over the official ICE budget for 2026—which is a tripling of 2025 budget. However, I will say this: the OBBB was the budget bill, however with that, there is an awful lot of money going out that is not accountable in that budget. So, yet another issue that needs to be addressed.

Now, for all of the ICE budget for one year, nearly four years could have been funded for universal healthcare.

Now, Medicare and even Medicaid are generally run by the government. I say generally only because of Medicare having alternates that are also privately ran. Now: lets look at two systems. Those two is for-profit and non-profit.

We already have at least one non-profit 'insurance' or maybe you can call Kaiser Permenente (the non-profit portion) a healthcare system. Now, if you look around, even Medicare before private companies got involved had issues...but everything isn't perfect so therefore issues are going to be had.

What we didn't have, though, was government contracts that allow insurance companies profit and the leeway of refusing or cutting corners on care. This is where part of a Universal Healthcare budget would be figured on usable dollars or whatever currency Erf would have. Every dime used for stock options, golden parachutes, CEO and other C-suite bonuses and pay, and straight out profit would no longer used in those areas. That money would be used for care instead.

But I'm going to go into the programs we have now that would be consolidated both in money, services, and personnel to at least give an idea of not only a simplification of government, but also a streamlining of medical care use dollars.

To start off with, I'd break off healthcare into two sections: those who have served in military facilities both civilian and military for ten plus years and those who also served in combat. Now, this is for two reasons.

Military medicine isn't exactly the same as civilian medicine, or it shouldn't be. For one, I know bases/posts and I've already put my two cents in on those areas: they are Superfund Sites waiting for abandonment or such so they can get cleaned up. Buildings that are over 50 years old, out of code that should exceed most commercial codes, and questionable histories should be taken apart carefully and disposed of in ways that doesn't allow for further contamination. This is because we're talking about things like asbestos being used in said buildings, PCBs in various other older but still used equipment and more. In short, one nasty word: carcinogens.

Now...saying that, being in the field and exposed to who knows what on either side of battle lines and more means that those who work militarily and military-adjacent need to be watched with more care. Not to mention, military medicine needs to keep track of a variety of symptomology in regards to when and where a solider is posted and job they did so health issues can be taken care of. I'll mention two out of dozens that most people should know about just by history and news: Agent Orange Exposure and Burn-Pit Exposure. The varieties of cancers, system issues and more are not so broad as to say anything can fall into the symptomology of issues. However, both have multiple issues that show up and no explanations. So, there is one branch of medicine. That would still be a VA-type system, and personally I'd double or triple the budget on VA care. Up to and including mental-health care as a mandatory item for at least one year post service, and during that year if things come up that needs tending to in any category, it can be addressed by referrals or something...in short: help by whatever means needed beyond the basics.

For the civilian-only Universal Healthcare, I'd pull money from Medicare, Medicaid, child healthcare programs, Tri-care (a military healthcare system/insurance for dependents, retirees, and in some cases a back up to VA), and anything else that touches on healthcare, not research, so everyone gets care. At least, as of this writing, the government would need to pitch in the rest and small co-pays. I add co-pays because even in Universal Healthcare systems has some patient money come in. But I'm talking something like (in today's money type and amounts) $5 or $10 for non-specialist care, $10-$20 for specialist care, about the same for some fixed period of time for in-patient hospital care and some amounts for pharmacy or high-end or specialized testing of any sort. Still, I've heard (in person and yes I do overhear things) $150 for a primary doctor office visit and about the same as a co-pay for just one or two medications. To me, in today's economy and stagnant wages and such, is unacceptable.

As stated, cradle-to-grave, full body care. Pharmacy would be included in this and drug companies in particular will hate me: every drug on the market would be evaluated for cost-to-make and offered that plus maybe 5% profit so they can chip in on new research and development of either new drugs or better drugs than first generation drugs.

Also, let me make this clear: mental health and even drug/alcohol recovery would be part of this Universal Healthcare. Knowing what I know both personally and via profession, the thinking that both are moral failings is wrong. When you force people into a position of no hope, a looking-up that one knows would never come about no matter what you do...you create problems that are, at least still in part by various people, called moral failings. I call it a coping mechanism that is wholly unhealthy and can be dealt with in better ways. Again: a positive and over time society would improve immensely.

I've also gone into why private/corporate insurances aren't the greatest ways of funding healthcare. For medically-related insurances that want to stay in business, I'd suggest marketing for elective surgery or treatments, or to very high-end people who will end up popping up or will still be around for the same sort of care, but in whatever facilities that may or may not exist with those personnel that may or may not serve 'the general public'.

Medical personnel across the board would end up being more or less government employees. The reason is simple: make sure of living wages/UBI, and a union to make sure adequate staffing and employee input is in play.

Germany has a mandatory vacation policy, this would also be in Erf. In Germany, it's based on stress of the job, not ranking, and lets say...you don't want to get caught with what would amount to a 'new' job or temporary job when you're on vacation. Losing whatever extra you made and paying fines in addition isn't really worth it. That would up morale, lessen burn-out, and simply gives a way of getting away from whatever stress or boredom or whatever you normally would have if you worked all the time. This too, I know.

The Scandinavian countries, along with most or all of the EU/Britain have family leave, pregnancy post-birth bonding time and more. With today's population of 340 million, with the correct amount of social programs and keeping the amount of personal or business wealth at reasonable rates, we could not only ease or eliminate the status of being un-housed, medical rationing, and still have plenty of people to work even part-time whenever able and still have as much, or even more, output of whatever work.

Closing

For now, that's it. What do you think? Would you take a system that puts every dollar budgeted into patient care and education, with changes and demands of things like vacation and family-leave? Or a system that contracts with companies that use various means of cutting care, profit margins, stock holder dividends, and CEO/C-suite inflated salaries and benefits?

I know my answer. Tell me what you think.