Friday, June 22, 2007

Health Care Reform--UPDATE

Supposedly, after Iraq, health care reform is the most important issue to voters. I'm not sure I buy that premise, but for the sake of this post, I'll go with it. Todd Zwillich over at WebMD enthuses about the reform possibilities:

Observers are hoping that the debate -- along with pressure from voters -- leads lawmakers and the next president to get serious about reforming the health care system.

Because, you know, it's accepted fact that this president and congress don't take health care seriously because observers like Todd say so. This kind of journalism irritates the stuffing out of me. But I digress.

Here is the mandate on health care reform:
Nearly four in 10 of those surveyed said they want to hear candidates talk about coverage shortages and the uninsured. Close to three in 10 said health costs were their No. 1 concern.
There is no question that health care needs to be addressed in the United States just like there's no question education should be fixed. President Bush's plan to get health care back into the hands of the individual by pushing for medical savings accounts was a good start. But like Education, there are so many interests attached to maintaining the status quo, most "solutions" will be bureaucratic and cause more problems.

My evidence for that premise is all our other state run health care "solutions".

UPDATE: I went and looked at what Dr. Helen had to say, thanks Anon. Here's a video she linked to. It's worth taking the ten minutes to watch.


Anonymous said...

What drives me nuts is the utter lack of clarity in framing the issue. For the record, my "health care" has been splendid, through numerous operations, cancer scares, bugs and whatnot. I hear people I know complain about Health Care when theirs, too, has been fine. It's always someone else that is having a terrible time, we think, and Something Must Be Done.

Are we really talking about lack of health insurance ? or the health care dispensed by overworked ER units wherever there are masses of illegals depending on it for primary care? So far that is not happening where I live, though it may be only a matter of time.

Then you find out how many people could pay for insurance but choose not to. Or how many carelessly threw away coverage by giving up job to chase some home-based business scheme that was never really thought out. Gotta follow your dream, right?

If we can't frame the issue properly, how can we come up with a solution. It's enough to make you suspect that the *solution* has been written and it just needs to be fit to current problems to sell it to us.

Anonymous said...

I think anyon 10:54's comment above is something to consider.Those with good and solid jobs seem to have good healthcare. Our health care is also excellent. It has always taken care of most of our medical expenses including my husbands jaw surgery and braces...even though some would have argued that it is cosmetic.

Dr. Helen has a great post on this very subject. It was interesting to watch a clip that shows just exaclty who the people are that are without health care coverage.

I also find anony statement about the home based business interesting. We know a number of people who have given up good jobs to follow some ideal of a home-based business. They give up their insurance and often experience complete disillusionment.

What really can be done for the small group of people that are left without healthcare coverage due to no fault of their own?

MaxedOutMama said...

I agree with you and the other posters, Dr. M. In GA, we have made matters worse by trying to expand coverage greatly. The state programs are good, but what they pay is too little to sustain providers in many communities. Medicare reimbursements are also a joke. The real crisis in healthcare is that we are pretending to offer coverage but requiring providers to accept payments under those programs that really don't even cover 70% of their expenses. This shifts the burden to the ever-smaller number of people covered under private health insurance.

If we want good healthcare we are going to need good doctors and good medical facilities, and I think the problem is that everyone doesn't want to address how to pay for that level of care. OK, if we are not willing to pay for it, it won't be there. And rolling the whole thing into a governmental program isn't going to change a thing; if anything it will make it worse. Because every state I know of who has done this has created a worse problem.

Melissa Clouthier said...

I guess it depends on the definition of "good". I'm self-employed, use a MSA (medical savings account) and pay cash for the first $6,000 of care--after that, it's paid 100%. Well, if we have a bad year (or a bad decade) that money is spent every year. Plus, our premiums. And they're not cheap at $850/month. Before the insurance company pays a dime, we pay nearly $15 thousand. Is it any wonder they're making great money?

To add insult to injury, we had our patient reimbursement drop the same month we had our personal premiums increased. We got the letters the same day. The money we got from the company was so bad, we dropped them for our patients. It cost more trying to get paid, then we got paid. Insane.

Even will all that, the worst part of the medical system is Medicaid/Medicare. We take neither. Our patients pay cash if they're old. Period. The government's reimbursement rates are insulting. They're paperwork demands onerus and it's nearly impossible not to run afoul of some arcane rule or regulation. And the Federal Government does not play nice when Joe Blow Doc makes a mistake. They presume guilt.

Nope. Cash is better. If people can afford only a little, they pay a little, but it's cash and it costs nothing to get paid. Paperwork is easier. And best of all, people who pay cash heal faster.

The government needs to get out of healthcare. They artificially prop up the industry by setting pay amounts. Some services are ridiculous and would fall into disuse. Some are highly prized and would fetch more money. There are no free market controls in health care. That's the problem.