2009 marks a very extraordinary and exciting time in the United States of America. For the time in history we are under the leadership of an African American president. His background is not one of a privileged and wealthy individual and as such he understands the needs of the average American.

His proposed Universal Health Insurance is a good thing. Far too many Americans are uninsured. This cripples the medical infrastructure and escalates the ultimate cost of keeping people healthy.

Many people use the emergency rooms as their doctor and there are consequences to this. For one, it means the system is over-utilized for trivial illnesses such as colds, minor cuts and scrapes – at a humongous cost.

At the other extreme, people may present very late in the course of their illnesses (sometimes by ambulance), which might mean that the illness has progressed to catastrophic consequences such as endstage kidney disease, diabetic end organ damage and heart failure.

If everyone had Universal health coverage, they could visit a doctor routinely, engage in preventative measures, minimize trivial visits to the emergency room and have a practitioner who is familiar with their medical history.

Some may say that insurance is currently available for the poor, namely Medicaid. Many private practitioners and centers minimize acceptance of Medicaid, if not refusing it outright. The reimbursement to private practitioners is abysmal and there are many limitations on the types of testing and medications that one may receive while on Medicaid. It also carries a stigma: it identifies one as being poor and lacking in resources. Thus some patients refuse to apply for Medicaid although they are eligible.

Private insurances limit the services their members are allowed to receive, despite members paying hefty premiums; if a practitioner chooses to write for a certain medication prescription or test outside of the acceptable boundaries of the private insurance, it may not be covered. If covered, it may require a lengthy conversation with the insurance company to achieve “pre authorization”.

Many physicians resort to not offering the medication or testing because of the challenge in getting the pre-authorization, or choose an alternative which is not first choice. Universal Health Insurance would be ideal if “pre- authorization” and stipulations are not required.

Also, since universal coverage is applicable to everyone regardless of race, creed or color, there is no stigma associated with it. The reimbursement rate will approximate that of an average private insurance coverage, thus private practitioners and medical centers will be happy to accept it.

I believe that over time, having good general insurance coverage such as the Universal Health Insurance proposed by President Obama will impact favorably on the overall longevity of our population, particularly the poor and socioeconomically deprived. They will have an equal insurance and hopefully an equal chance for receiving adequate medical care.

Perhaps, we will see that health care disparities will be eradicated with an ultimate reduction in morbidity and mortality. Life expectancy as such may equalize among the races.