I am disappointed by an under-reported quote in Reuters from incoming Health and Human Services Secretary Tom Daschle.
I supported Barack Obama because I want the health care system to be changed. I have Crohn's Disease. I've been through the mess that is the modern American health care system, and I have the scars to prove it. I've personally experienced, or seen other patients in similar positions experience, everything that is wrong with modern American medicine. I've talked with first-rate doctors who tire of the bureaucratic mess that is the HMO system.
I want change. Now. I want there to be a plan where anybody, regardless of pre-existing conditions, can purchase affordable health insurance and access the treatments they need to be a productive member of society. I want an end to the practice of the chronically ill person being the first one laid off or the last one hired because their insurance premiums are so high. I want the chronically ill to be able to be free to move wherever they'd like to live in this country, and not have to consider whether a state's chronically ill plan is any good. I want a level playing field for the chronically ill and the disabled.
I think Tom Daschle really cares about passing health care reforms. I think he has interesting ideas on how to fix the system, and though I do not agree with all of his ideas, I believe they come from the right place. I praised his nomination when it became news. I was excited, as I believe that his nomination indicates a level of seriousness about the issue.
But I was pretty disappointed when I read Secretary-designate Daschle's remarks to a health insurance industry gathering. Reuters reports on Daschle's latest comments:
"Speaking at a meeting of healthcare industry experts in Denver, Daschle said he would like to "allow the states to be workshops and laboratories of innovation."
I know that the Secretary-designate is aware that there are already vast differences between states on health care. The chronically ill, who often can't find employment where insurance is carried due to high insurance premiums and cannot afford insurance on the private market, have to deal with a patchwork of state high risk pools. Some states are better than others, but common problems remain.
I took Secretary-designate Daschle's comments as, "We may not be in the position to do anything, so it'd be nice if state governments could act on this issue." We'd get an even bigger patchwork of systems if the state laboratory idea was implemented. Patients who are in all respects similar--same profession, same age, same disease--would still be treated differently based upon the state they live in. Because 49 of 50 states are broke, state governments would have little incentive to act in a way that includes patients with serious illnesses (many of us end up on disability and Medicaid). In short, nothing would change. We'd have the same problems of people neglecting the care they need because they can't afford it, only to be bankrupted by the emergency care that is needed after a life-threatening (and completely preventable) complication develops.
I have detailed what I'd like to see as reforms before. I will not repeat that now. I will say that any reforms that are being considered must be federal. There must be a minimum national standard of insurance that applies/is available to everyone at an affordable price.
And to keep health care affordable, we need to have a serious discussion about end-of-life care. We must reduce expensive care that carries little benefit--feeding tubes in dementia patients, life support, etc. Part of the reason that we're 37th in efficiency is that we spend too much money on end of life management.
Update: Partially Impaired, and others, point out that the Reuters article that triggered my disappointment has a quote that is in poor context. I'm not sure what the context actually was. It could be what I'm describing above, or it could be a universal health care plan that, while far from perfect, would be a national standard. Hopefully, someone can find a transcript of what Secretary-Daschle actually said, and the context it was said in.