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EDITORIAL Watching the elected officials in Washington toss around the pros and cons of health care reform is like watching a study in total confusion. It might do these so-called learned men some good if they were to stop and look backward to the hard-scrabble years in the 1930s. There was no health insurance as we know it today. There were only two forms of medical care. Either a family had the money and could visit their family doctor when they were ill, or those without financial means went to the local health clinic for medical treatment. Agencies like the Department of Health in New York City dealt with illnesses that were more contagious and deadly than anything experienced today. Tuberculosis, diphtheria, typhoid and syphilis, to name a few, were commonplace and were dealt with case-by-case in various health clinics set up throughout each city in each state. And each disease was brought under control. Funding came from a variety of sources: municipal, state, federal and private contributions. One of the most influential not-for-profit home health care programs established was the Visiting Nurse Service of New York. It was founded by a Lillian Wald, a young nurse who saw the need for medical treatment for those who could not afford to visit a private physician. In 1909, she persuaded the Metropolitan Insurance Company to hire visiting nurses to care for policy holders during illness. Within two years, the insurance company had extended its nursing service across the country. Over the next 20 years, the Henry Street Settlement, which provided multiple health services to the poor, received 30 to 40 percent of its income from insurance payments. This was apparently the forerunner of the health plans in effect today. At that time, the insurance company was not cast as the big, bad wolf and the simplicity of the program was its greatest asset to everyone. However, in today’s world, the buzz-word is confusion. Is there a plan for the government to take over the health system? Or does the government just want to compete with the private insurers in an effort to lower the cost of having health insurance? And why does the answer as to what it will cost change daily? In New York City, there is a free clinic (NYCFC) that began as a partnership between New York University School of Medicine and the Institute for Urban Family Health that caters exclusively to those who are uninsured. It provides all services at no cost to the patient and provides prescription drugs at a greatly reduced cost. For uninsured New Yorkers, NYCFC also serves as a portal to existing government insurance programs such as Medicare, Medicaid and Family and Child Health Plus. There are workable programs already in place that can be expanded, but legislators and the present administration seem to enjoy creating chaos instead of just doing the right and simple thing.
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