09/04/2009 05:12 am ET Updated May 25, 2011

Reflections on Health Care Reform: Now or Never

By its inaction before this month's recess, Congress has actually done everyone a big favor. The politicians and electorate can read the draft legislation that has come out of the various committees. No one can complain that 31 days this month is not long enough to do this, or at least do it by reading detailed summaries provided on various websites. No doubt we will also hear much about the subject in our home states and districts by way of, for example, speeches, town-hall gatherings, and presentations at county and state fairs. We also know we will be bombarded by ads, media pieces, blogs, pundits and political types galore staking out positions. Yet if the democratic process works here, then those we put into office know that any lemons in current bills need to be turned into lemonade. We demand no less. Concomitantly, we have been given some breathing room ourselves -- to go back to the basics and ask, why do we need health care reform?

Without our health, we aren't much good to anyone -- to families, communities, the workforce, and ourselves. Others, including me, have said health care should be a right, or viewed at least like a service, i.e., akin to the heat that keeps us warm at night, or the municipal transportation that takes us to work. To be sure, we get our health from providers of healthcare. And all we want is to be cared for at a price that we can all afford. But if we cannot afford and access our doctors and nurses, then the healthcare system fails us.

While the debate about affordability and accessibility has been vigorous, certainly contentious, and, in the end, confusing, the debate and the message has morphed into reforming health care insurance coverage -- so that we all have it in order to go to our doctor or to the local hospital, and then for them to be paid a reasonable charge for their services. By necessity, reforming health care insurance now has become the sine qua non for reforming health care in our country.

As a measure of this, when main street America speaks of reform, it speaks not only of being able to afford a doctor of its own choosing and the hospital where we may go for care, but other items our personal experiences allow us to understand and appreciate. Those of us who have coverage don't want it to change nor do we want our premiums and care to reflect that for every dollar we spend or are charged, a certain percentage is intended to cover the costs of those without insurance or care. If this is so, we should all know about it, and now. We don't want insurance (including Medicare) which we have to be taken away as a quid pro quo for reform. We also don't want to be denied health care insurance coverage because of a pre-existing condition; after we pay a premium and have been treated, we don't want an insurer to deny us coverage; nor to have a "cap" placed on coverage. And we all certainly understand that if we lose a job, we don't want to lose insurance coverage as well. We want such coverage from whatever source wherever we go, regardless of employment or state of our residence. We also want premiums to be fair. If that takes the insertion of a public option into any legislation to steer competition into lowering costs, and keeping private insurance companies honest (which such an option would most definitely do), then we should have it. At the same time, we should have an ironclad assurance that a public option will not be a government takeover of health care. Such an option must not prevent our employer from tossing away all other insurance plans from which we can presently choose because it may be cheaper to pay a fine or fee for not having them than having a menu of plans in place. President Obama and those who may have to rewrite the tax code on this point, listen up. For goodness sake, we want reforms that have room not only for every single citizen, but only for others who want to become citizens in earnest.

As well, we want a system of reform that continues to encourage physicians and other health care providers to continue doing what they have been trained to do well. Equally true is that those of our young people who are thinking about becoming doctors and nurses must be similarly encouraged and motivated to enter these and similar professions.

Since reform should be a shared responsibility, then all Americans must do their part. For starters, we need to stay healthier (we are a nation of flabby folks). But telling us we need to lose body weight, or to reduce our alcohol consumption, or to forget that next cigarette, has been tried, and failed. We, too, must have incentives. Any such legislation should have built into it real ways to motivate us to lead healthier lifestyles.

In the end, all of us were given the month of August to listen to the pundits, the politicians, our friends and our colleagues about whether or not our health care system needs a makeover. Again, we can also read the proposed legislation ourselves.

Atop this piece, I said Congress gave everyone, including itself, a gift -- time -- to reflect, consider, and then reconsider. Let's use this time wisely and realize that the "sky is falling" approach (spewed forth by opponents of reform) cannot replace the merits for reform before year's end, and our sound judgment and personal experiences. If we do not use this month of August wisely, we most likely will never see health care (insurance) reform in our lifetime.