Health Care Reform: Some Optimism Please

"The hope arises anew, and the dream lives on." -- Ted Kennedy

Interspersed with the news of the death of Ted Kennedy are the comments from Senate members and pundits that the health care bill is now on a last leg. I am as totally baffled by this diagnosis as I am about the lies, distortions, and misunderstanding concerning Obama's plan that have taken firm root.

I had just read about the guy at the town meeting who went berserk screaming that the Government was not going to touch his Medicare, when my husband came home to share parallel confusion. His barber. whom he has known and trusted longer than he has known and trusted me (which is almost 30 years) told him that a health care bill would raise his taxes, ration and compromise his care, and that government bureaucrats would take away his doctor and decide his medical fate. This from a guy who voted for Obama!

I had thought that Hillary Clinton exaggerated when she talked of a right ring conspiracy that destroyed her attempts at heath care reform in 1993. I thought that if she had communicated and planned openly, instead of behind closed doors, involving dedicated health care professionals in her planning, common sense and success would have prevailed. I was wrong. Rationality is no match for concentrated hate and fear tactics, strengthened today in a world of 24 hour cable, and thriving technology.

The only match for lies and distortions are leaders with the maturity to come together and act for the good of their constituents, addressing this truth: We cannot afford not to move forward because our current system is financially unsustainable! Health care costs are consuming our national output, rising faster than inflation. They are the largest cause of personal bankruptcies and are rendering our industries noncompetitive in the world market. And what are we, American citizens, getting for this? Our life expectancy is lower than most industrialized countries, and our health care costs are considerably more than any of them.

Buried in the unnecessary turmoil and rancor, is a solid degree of consensus achieved in both the House and Senate bills which will benefit us all. For instance, there will be a requirement for all Americans to have health insurance, either through their employer, through government programs, or personally purchased. Those who cannot afford insurance will have either tax credits or subsidies for purchasing. The choices of benefit programs and their costs will be more easily understood through state based "exchanges" with specific transparency of information and rules as well as appropriate explanations of what is available. Insurance will no longer be denied because of "pre-existing" medical conditions.

There is even agreement about how to make the system less costly and of higher quality, with more money devoted to patient care. Doctors and hospitals offering efficient, high quality, evidenced based care (such as aspirin right after a heart attack, appropriate blood thinner for types of irregular heart beat, ordering only necessary tests... the list goes on and on) will be financially rewarded. There will be financial penalties for less than quality care and efficiency. There will be encouragement and funding for more primary care physicians and greater emphasis on prevention and maintaining good health, rather than emphasis on payments made during illness. In other words, doctors and hospital systems will be rewarded for keeping patients well!

Further, efficiency will be achieved through simplification of record keeping, communications with insurance companies, and by standardization of insurance forms. Electronic health records will be encouraged and finally mandated, improving communication among health care professionals, leading to less test duplication, waste, confusion, and error. There will also be a crackdown of fraud and abuse within the system, such as charging Medicare for equipment that patients never receive or doctors charging fees for patients they have never seen.

How are we going to pay for all of this? It is estimated that about 30% of the $2.5 trillion yearly spent on health care goes to overhead, which will be reduced greatly by addressing the above. Other funding will come from payment reform of Medicare and Medicaid, such as bundling of payments for physicians and hospitals for an episode of medical care. Funding will also come from employer payments to a general fund. Any new taxes that may be required will apply only to the wealthiest among us.

As for the distorted fear regarding "rationing of service," we have that now as insurance companies deny coverage and specify services. In the Obama plan there is no rationing; there is payment for treatment that evidence shows will truly work. And there is nothing in any bill that will take away one's doctor.

The major roadblock to health care reform is whether or not to include a "public option" plan, which would force insurance companies to lower their costs to remain competitive. Currently "for profit" insurance companies use the expression, the "medical loss ratio" to describe the percentage of the insurance dollar that goes to patient care. It has moved from the low 70s to the low 80's. The rest is overhead and profit. Medicare has an overhead expense ratio of 3%, which means that $0.97 cents of every dollar goes for health care.

Successful, beloved politicians are principled pragmatists who know that inflexibility is the enemy of progress. When our nation lost President Kennedy, grief was soothed when a divided Congress faced down hatred, insisted on compassion and united to pass the 1964 Civil Rights Act. Senator Ted Kennedy deserves this quality of recognition for his life work. The Health Care Bill need not be perfect. But it must be passed.

Comments

[miggie1]

I have a pretty good job with supposedly excellent health care, family coverage. Or this is what I was promised when I was hired some 6 years ago. Well this excellent health care insurance coverage affords me the following: rising costs for services rendered, copay newly added in addition to the rising costs, reduction in overall coverage and type of coverage, confusion with every aspect of the billing, and the list goes on. It has come to a point where I think twice about scheduling a simple doctor's visit or delay lab or dental work...nothing unusual mind you, all routine visits....because I never know what it will cost me at the end. We must press on with Senator Kennedy's plan. Unless we unite, stop the bickering and bureocracy, we'll all end up in the same boat - on the losing side. I agree with Ms. Smullens...let's get this bill out, get it out quickly and iron out the details later or as issues and flaws may arise. Our country needs a reformed health care system, and our citizens need and deserve a reformed health care system.

[taniacaa]

Independent of whatever model of healthcare insurance Congress decides on (public, co-ops, private only) their will have to be some reduction in the for-profit structure that currently exists. This may include regulation of premiums private insurers can charge and basically what services these premiums must cover. Also we will have to invest in more primary and preventative care.

[DEJM]

A lot of what she hopes will be is already happening, like electronic records.

Things like "necessary tests" is subjective. Will the doctor and patient decide what is necessary or will there be a one-fits-all standard?

In the end, people want and deserve a better health care system.

I still believe we should all get the health care plan used by members of Congress.

Use our tax dollars for our growing health care needs. How come no one ever complains that
foreign aid is too costly? It is....cut it way back and use that money for health care.

[JEngdahlJ]

Are we building a health IT Tower of Babel?

Overlooked in most of the electronic health records discussion is the potential for population-level analysis -- finding healthcare patterns and measuring quality and improvement over time. Only if systems work together via data exchanges or other data pooling can we get the most out of our EHR investment. More insights -- http://www.healthcaretownhall.com/?cat=3

[SaraKay Smullens - Huffpost Blogger]

Thank you all for writing. I know the suffering that goes on in our communities all over our country because of lack of health care for families. I am sickened by it. I will never forget the years that I was a single parent of two little girls, and how terrified I was that I would become ill and unable to afford care. It is inconceivable to me that this suffering goes on and on in our country. Yes, I would also prefer a single payer system, and I applaud all working so hard for it. But I also am a realist, and my life has taught me that perfect can be the enemy of good. There is room for give and take and compromise in order to get a bill out, but I do not think that even Senator Kennedy could have achieved a single payer system. Perhaps I am wrong. I have been wrong before so often. But to me that important thing is to get a bill out, and then, as public confidence grows, continue to build on it and correct any flaws.. And, of course, my hope is that such a bill will bear the name of our late Senator who kept the torch alive and glowing for so many years.

[N1512]

The writer appropriately talks about all the real agreements that have been reached in Congress by taking away the false issues and preconceived ideas about what is happening with healthcare reform. It's time to end the 70 year struggle to get healthcare coverage for our citizens and improve the care that they do receive. Isolating those that can afford healthcare from those that cannot only weakens our country in the long run, both domestically and internationally. It's time to end the bombast and political posturing and create a just healthcare for all our citizens.

[creolechild]

If you are concerned about receiving "real" health care reform in this country, please take the time to watch a video on our current system. The video was created by Oregon physicians who are advocating for the single-payer option. The video is very informative and helped me to gain a better understanding of various aspect of health care, as we know now it.

https://www.madashelldoctorstour.com/Mad_as_Hell_Video.html

These Oregon physicians are in the process of organizing a caravan designed to inform the public about the benefits of the single-payer option. At last count they will be stopping in approximately 23 states, on their way to demonstrate in Washington. They need volunteers and our support. Please spread the word.

[Frank Johnson]

America was first, a dream by those who wanted less government i.e. less taxes, religious freedom. She prospered as she attracted honest, hardworking God fearing people from all over the world. She attracted these people who wanted to partake of what capitalism and good healthcare ( to name a couple )could provide them.
It amazes me that so many stand behind a president who is on a path to destroy both. If America was built on small government, free capitalism and good healthcare, how can we be great if they are destroyed? I find it impossible.
Without a doubt, we are becoming a fascist and the revolution to stop it has apparently begun.

[NordicSci]

Try living in a third world country for a while where communicable diseases are rampant. Then you will understand what it means to have a personal interest in the health of your neighbors. Without violating our constitutional principles we have managed to socialize education in the interest of “promoting the general welfare.” Can you even have a viable democracy without an educated citizenry? The same goes for many other public goods (e.g., public safety and health). A health care system that covers everyone is essential to our individual and collective well-being and cheaper for everyone in the long run. Ironically the counties with socialized coverage (I use “socialized” to refer to the widespread capitalist practice of pooling financial risks) are not the ones on the verge of collapse from out-of-control health care spending. No its America, the one industrialized nation without universal access.