Monday, March 22, 2010

Health Care Reform

It is Monday morning, March 22, 2010. I have read my daily newspaper which featured multiple articles on the historic health care reform bill passed last night in the House. I have watched taped bits of the debate on C-SPAN wherein the Republican speakers decried the bill in the most horrific tones while the Democratic speakers lauded its many accomplishments. I have spent the last six months talking to my neighbors, friends and family who also reflected this split in opinion. And I have spent the first 2 months of this year struggling to pay for healthcare while on COBRA due to the loss of my primary job on January 4th of this year. So, which is it? Financial doom and the beginning of the end of our freedoms or a step towards utopia?

My hope is that the majority of us who are too busy making a living, driving their kids to soccer games and swimming practice and working 2 or more jobs to pay their bills will join me in the understanding that it is neither the best legislation ever nor the end of America as we know it. My hope is that we will demand that the rancorous debate that we have seen in Congress and in the streets, debate which seemed more like professional wrestling than serious discussion, will be replaced by civil discourse based on the issues, not fear. And finally, I hope that we will all take a good look in the mirror and remember that our founders gave us the basis for the greatest governance in history but that it requires an incredible individual and personal responsibility to make it work.

The baseline debate, to me, is; should all Americans have access to affordable health care? I believe that if you asked that question, a large majority of people in this country would answer yes. But let's take it a step further. Should all SICK Americans have access to affordable health care? Sounds like a no brainer; if you are sick you should be able to get treated and not go bankrupt or lose your home. Yet, think about it folks, that is precisely what we are debating. Insurance companies take everyone's premiums and wager that they will pay out less than they take in. When you are healthy, they win and when you are sick they lose. To offset their losses, they give better rates to large companies where the risk is spread out. Individuals or small companies that don't have this advantage, are the first to lose their coverage or have to drop it because it is too expensive. In other words, the sicker you are (or the people you work with), the more likely you will lose coverage. Now, don't get me wrong, I understand why insurance companies do this; they are trying to make a profit just like any other company. The problem is that their making a profit can and does cause Americans to lose health care coverage. When it was recently discovered that Toyota may have ignored problems with their accelerators because it would have cost more to fix the issue than to address it, and that upwards of 50 people in the last few years may have died because of it, there was some outrage and immediate congressional hearings. Yet, isn't it obvious that in the name of profit, health care insurance companies deny benefits and coverage? Some say up to 40,000 Americans die each year for lack of health care coverage. Even if it is only 10,000, shouldn't we be just as irate?

So clearly, it seems to be about money. Yes, we think everyone should have health care coverage and yes, certainly anyone who is sick should be provided health care services and coverage but who should pay for it? Obviously, healthy people need to contribute premiums to help pay for the sick. Healthy people should accept this burden because some day they could be in need. I sometimes hear people complain that they never get sick so why should they pay for health insurance. I usually ask them if they would rather be sick so they were getting their money's worth. Or if they plan to die early so they don't waste all those years of life insurance premiums.

Speaking of money, why do we spend almost twice as much per person as any other county for health care but have poorer outcomes? Undeniably, our health care system provides tremendous care. But is seems that the care is accessible in proportion to one's income. When you see certain pundits claim that America has the greatest health care system in the world because they just got treated or all these famous people always come here, focus on the fact that the main thing in common is money and resources. But what about all the people without those advantages? Are we really comfortable with the provision that like any other product in a free market system, access to quality health care should be based on one's ability to pay?

While I am no economist, I do know that my recent loss of my full time job resulted in a COBRA payment that was unaffordable. Luckily, the stimulus package included a 65% subsidy for those who lost their jobs since Dec 2008 and even more fortunate, I was able to secure a job this month that provides health coverage. So again, if we accept the premise of universal access, then we must face the real life question of cost. Should we cap the profit of insurance companies or mandate that they be non-profit? Should we cap the salary of doctors? Should we cap the cost of technology such as X-ray machines? Should we cap the cost of services such as heart bypass surgery? Should we cap the cost of liability insurance for health care providers and lawsuit payouts when medical negligence occurs? Should we do all of those things so that we can truly say that America has the best health care system and have actual facts and statistics to prove it?

And what about you and me? Should we pay better attention to what we eat so we don't need to take so much medication? Should we exercise a little more and watch TV a little less? Should we change our unhealthy behaviors rather than asking for a drug to counteract our poor choices?

We have major issues to discuss concerning health care in America and those issues have not been decided with the recent passage of the health care reform bill. I trust that Americans will continue the debate at work and at home and I look forward to that debate on this blog. You know my thoughts; what are yours?

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