Brazil's "Public Option" Health Care a Model for USA
Cross-posted at the Public Option Health Care Now blog.
Pardon me for sounding confused, but I just cannot understand the talk about requirements that individual Americans purchase health insurance. Here in Brazil, there is a "public option" that consists of community health centers in each neighborhood as well as at least two public hospitals in cities under 100,000 population, with more public hospitals in larger cities. Anyone, even an international tourist, can go to these clinics and hospitals and it is unlawful to request or accept payment from patients, regardless of the ability or inability to pay. THIS is public option health care.
In addition, common medications are given out for free at these clinics if they are available, with the only requirement being a prescription from a doctor, public or private.
No one is required to purchase this assurance that their medical needs will be taken care of. Instead, the program is paid for through various government taxes. It's worth pointing out that in Brazil people are tax-exempt until their income reaches three times the minimum wage, so it's fair to say that many of those receiving the benefits of the service are being entirely subsidized by other wealthier people who may use the public system or may prefer to use private doctors.
In light of my experience with this system, it seems rather absurd to me that we should require people in the US who are sleeping under a bridge to buy health insurance when they cannot even afford a cup of coffee. Government promises to provide such people with subsidies just make me think of a tidal wave of new bureaucracy to determine who needs what level of subsidy and who has paid their premiums and who hasn't. A public option designed this way may have all of the expensive bureaucracy of a welfare department, with an equal likelihood that many people will fall through the cracks when the need the care the most.
In Brazil, there are also private hospitals and doctors which sometimes have less wait times, more attentive visits and other benefits that come with flying first class. But a friend who is a doctor in Brazil tells me that ALL of the private health insurers often refuse to pay for expensive treatments when paying insured people need them the most. So, if you don't have cold hard cash, you may well find yourself relying on the public option, which is actually quite effective in many cases.
What the United States needs is what Brazil has: a system of public clinics and hospitals where anyone and everyone, regardless of their ability to pay, can come and receive treatment with no discussion whatever of their financial circumstances. In such a system, Bill Gates might lie in a hospital bed alongside Bill, the streetsweeper, each receiving from their Government the care they need without the bureaucracy they would abhor.
Francis L. Holland is an US-trained attorney who has lived in Brazil since 2004, accessing public option clinics and hospitals far more often than private ones.