11/09/2009 05:12 am ET | Updated Nov 17, 2011

Health Care Debate: "Death Panels," Health Insurance Reform, and the Truth

Amidst all the hysteria surrounding the health care debate, there is a shameless lack of clear thinking. I've had the unfortunate experience of seeing our health care system up close twice this past year, and let me explain what's really going on. I think I found the smoking gun on the death panel accusation, and it's not the doctors or the hospitals. And it's not about socialism either. It's about insurance companies who are profiting from deliberately misleading their customers, and the real need for health-insurance reform.

Here are two stories relating to the health care debate that illustrate my point.

The first case involves the self-employed husband of a friend. They thought they were insured, but after a slip on the ice the day before Christmas, they found out they were wrong. He broke his pelvis, then had terrible blood clots throughout his whole body. He spent days in intensive care. While being treated for his injuries, the doctors found out he had heart problems. They fixed those. While there may have been times when the doctors could have been reluctant to treat him, knowing they probably weren't going to get paid, both the doctors and the hospital were under moral and ethical obligations to treat him anyway. And frankly, most doctors are going to find it hard to withhold treatment from a patient if they think it will help, whatever the financial implications. I mean, isn't that part of the Hippocratic oath or something?

Unfortunately, the insurance company (which, remember, they thought they had been paying to cover this kind of thing) felt no such moral or ethical obligation. Nor will they ever, if health-insurance reform doesn't become a reality. The hospital reduced my friend's bills as much as possible, but he is still obligated to pay the insurance company--which he will probably do for the rest of his life. He's not young, but he's not retired, either. And now he and his wife have to give up a lifetime of savings because of fine print on an insurance document.

The second story involves my 80-year-old mother. She is well insured because our company has insured her, and we have a team of experts to defend her from being taken advantage of. But she's also suffering from her fourth round of metastasized breast cancer. This past December she had a heart attack and spent about a week in the hospital. In full disclosure, I had just joined the board of this hospital--the Lehigh Valley Health Network--so I was paying extra-close attention.

Here is what I learned: As a nonprofit organization, they are legally bound to provide care for people, even those who can't pay for it. (My friend who broke his pelvis was in the same hospital.) But more important, doctors don't ever want to give up on a patient--it's in their nature to want to cure, heal, or fix somebody. So even though my mother was expected to die from cancer in the near future, the cancer doctors wanted to give her chemotherapy, and the heart doctors wanted to operate and give her the most powerful medicines. Yes, the doctors get paid for doing those things. But they also get paid to give patients options and choices.

My mother chose not to get further treatment. The doctors were a little bit surprised, and nervous, but they respected her decision. And not only has she outlasted their predictions for her survival, she's done so with a quality of life that would have been totally lacking if she'd chosen the treatments they offered. She's been able to enjoy her grandkids, eat whatever she wants, and decide for herself how she wants to spend the inevitable last days of her life. Sure, she is mad as hell that we won't let her drive. But if we'd pushed her to get further treatment, I'm sure she'd be dead by now.

What do these stories show? Whatever side you take in the health care debate, we can all agree there are many things we can do as individuals and as a country to improve our health outcomes. Taking self-responsibility seriously, focusing on prevention, and making the right choices for ourselves and our families are key. These things lower the odds of a life-threatening health problem.

But even healthy people can slip on the ice, and people who think they are doing all the right things can still get a diagnosis of cancer. And until we have serious health-insurance reform, that's where having the wrong health insurance--or no health insurance--makes a huge difference. If you're like my mother, you get to choose what options to accept and which to reject (even if the system pressures you to take treatments that may lower your quality of life). If you're caught without coverage--perhaps because an insurance company was deliberately unclear about what exactly they were covering--you hope you'll get treated anyway. And it's likely you'll end up with debts you'll never be able to pay off.

Let's be clear that nobody's proposing a death panel to decide who should or shouldn't be treated. But there currently are "death panels" deciding who should and shouldn't get paid: insurance companies whose lack of accountability and focus on profits leads them to knowingly and willingly destroy a family's financial future. That's why we need health-insurance reform. That's what needs to be fixed. Fixing that is not socialism; it's our democratic responsibility to make sure everyone is treated equally, and fairly.

It's a matter of true family values. And if dozens of other democratic countries around the world can do it, and do it better than we do, we should be ashamed of ourselves if we don't do it too.

Tonight President Obama will address Congress, and the nation, on his plans to overhaul the health care system. Come to during the speech to see live comments by me and various Rodale editors and observers. Check Thursday morning for more commentary. And, as always, I invite you to post your comments right here on Maria's Farm Country Kitchen.

For more from Maria Rodale, go to Maria's Farm Country Kitchen.