Reason and common sense are losing
in the debate over health care reform
Maybe it’s the name. Health care reform has sparked passionate debate but we seem to have lost track of what the real objective was. The issue of the uninsured and the under insured is now known as health care reform. Perhaps we could stay more focused if it had been called: health insurance reform. Health insurance and health care are NOT the same thing. They are linked, but they are different.
The nastiness that has surfaced over the issue was horribly brought into the open when Georgia Democrat, Rep. David Scott arrived at his office in Smyrna and found a swastika painted on his office sign. Scott said he also has received mail in recent days that used N-word references to him, and that characterized President Barack Obama as a Marxist.
What are the real facts? The most important fact is that some 45+ million Americans do not have health insurance. Every American should have health insurance! There is nothing more frustrating than to have to tell a client that you cannot enroll them in a health insurance plan because they have some medical risk that the insurance company chooses not to insure. Often it is as simple of being outside the height and weight requirements of the company.
Many clients are both willing and able to pay for coverage, but because they are individuals outside the protection of group sponsored plans, they just can’t get it. Access is the biggest problem.
Does Congress really need to create an entirely new health system to fix this biggest problem? Why not just mandate that insurance companies must take every applicant regardless of health? Insurance companies are getting a bit nervous (less as the days go by, but a little) and this would have been an excellent time to mandate coverage regardless of health.
If applicants are below a certain income level, then let the government subsidize the premium on a sliding scale. This fix would cost a whole lot less than any of the cost estimates for any of the three major proposed plans.
This solution would also calm the fears of the 80+ million Americans who do have health insurance, most through employer group plans, and who do not want their plans or doctors to change. It’s the push back from this group, as well as current Medicare recipients, that is fueling much of the inflammatory rhetoric. 80 million people don't want a whole new system and the resentment that is building with the fear that they will lose what they have is the catalyst for some of the crazy rumors circulating on all sides.
There are other problems including the under insured, unrealistic lifetime caps, denials of claims for silly reasons and we will address these in future columns. But for now, why not just fix the access issue. We don’t need thousands of pages of proposals which will result in months of debate.
Focus would be helpful and likely be much more productive. It’s a very clear problem, with a very clear fix. Fix access and the rest of the problems will be much easier to manage.
Comments
Somebody in Washington needs to be reading your column, Shelia. You nailed it with this one!
As someone who lives in a country (UK) with a nationalised health care service this debate seems strange to me. I'm well aware that the US is fiercly against 'Socialism' but there should be certain national services that are classifed as a human right. The US is not as Capitalist as it thinks, it has 'socialised' police forces and fire departments. Imagine asking a woman who has been raped whether she has police insurance. Certain human rights transcend people's ability to pay for them. I have the right to be treated in a hospital whether I have the money to pay for it or not. I also have the right to pay more money for better service if I so choose. While I dont trust the goverment here, there are degrees, and I certainly trust them to act in my intrest more than insurance companies. Perhaps the insurance companies are different in the States, over here they try to avoid paying out on technicalites, and refuse insurance to high risk people.
While I agree with your statement that health coverage should be extended to every citizen of this country, I disagree with your suggestion that insurance companies need nothing but a mandate to accomplish this. The only reason insurance companies exist is to make a profit. (That, unfortunately, is a basic tenet of corporations.) Insurance companies do not care about their insureds; only the bottom line. Governments are not there to make a profit and are eminently more qualified to act as a central insurer for health care. I have looked closely at countries with universal health care and the results demonstrate that their systems cover more people for less money than ours. To add insult to injury, the top ten health care systems in the world are all less expensive than ours, provide better care and are all universal plans. We, on the other hand, spend more on health care than any other country in the world and rank only 37th in quality. Insurance companies need to go.
I think Robert hits the nail when he says this is a question about human rights and government services, or, the roll of government. Unfortunately, Robert is assigning a humanistic understanding and not a Constitutional understanding to this debate. The first question is "Is health care or health insurance a moral right?". The second questions is "Is health care provision to every citizen a part of its role". I like Sheila' articlebecause it addresses the role of government as setting law and standards. I think Robert misses the point because he has assigne a moral right to citizens that may not exist.
Thanks to everyone for reading and for your comments. However, to CDEC,please go back and read my 2 columns about the French health care system which is ranked number 1 in the world. It is a combination of government and private insurance. Their system is so much more like ours then Canada or England, for instance, but it works and for half the price of ours. My suggestions is that we look at how the French government worked WITH the private insurance company and now they have both universal health care and insurance companies who are happy making profits.
The model is right in front of us. Can't we learn from others?
Sheila, This is just excellent. I actually do use the words health insurance reform when speaking with my senior patients - and, man, do they want to talk about this. I would disagree that the only reason insurance companies exist is for profit. Any business model originates when a need is identified, and you cannot just remove that aspect of why any business exists. They are entitled to a profit. The question is one of waste and greed. We are seeing people die. They are not getting their care, yet so many want to say health care will become worse. It is a broken system. Right now only the loudest screamers are being heard.
Excellent article. I wrote a similar one you might be interested in talking about the need for insurance reform. You can find it under my name at associated content.
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