We have the best medical care in the world and leaders come from all over the world for their care. It is a shame then that many of our own citizens cannot access it. Although there are variable levels of care depending on your insurance coverage, we must acknowledge that in America, we already have universal access to care, we just don't acknowledge it. Anytime anybody gets ill (mild or Serious), they go to the emergency department, if they can afford the bill, they pay for it , if they can't - they will eventually have their credit destroyed because of it. The hospital recoups its costs by jacking up rates for the insured patients. We all know this happens, yet we don't want to get Universal care because of some dreadful idea of it being socialist or communist in nature which would kill our freedom somehow. I don’t have one senior patient clamoring to get out of Medicare, in a sense; this is a single payer for all citizens above age 65!!! We haven’t become communist or socialist in the past ~40 years!!! The present reform is needed but also needs improvement.
People think that government will create tangled complex rules and tons of paperwork which will strangle healthcare. If you go into any doctors office and ask the staff if they are suffocating in juggling various insurance companies’ paperwork and rules, they will tell you they would love to deal with only one set of rules and forms instead of 5-6 sets. Never mind that there are insurance company bureaucrats creating rules and standing in the way of the doctor writing the best prescriptions you need and asking a ton of questions before allowing or DENYING access to various studies. There is no significant way to overturn these rules. At least in a public choice insurance, the public will have some mechanism to change a badly designed rule!
We don't consider insurance company denials or under coverage as rationing. There are many doctors who cannot accept low reimbursement rates the insurance companies wish to pay us, yet the insurance premiums increase yearly for all of us. This situation pulls away many of the patients who want to stay with us, the insurance companies tell them which doctor they can see. Even this is not considered rationing, but if the public option comes close to this, watch out, we have government takeover and rationing!!! By the way, healthcare is not actually rationed in any of the European single payer systems, only the money spent is. If one wishes, they don’t need to wait for a ct scan or mri or organ transplant, they simply have to pay for it privately!!! Rationing by definition means the resource is in limited supply and needs to be distributed in a planned and fair amount. Healthcare is not the limiting resource the world over, money is.
There are really only four to five big companies in any market and they somehow have very similar rules and rates. They ALLOW doctors and others to charge them only what they wish to pay for. They don't want to allow a "government plan" choice in the market as it would "TAKE OVER(Break)" their ability to manipulate the rates and rules which are becoming more complex by the day.
The same folks are the ones who so blindly created big tax breaks for the rich, and created more government spending than in our entire history, they started and couldn't finish two wars. They broke down all of the regulations of our financial industry and almost took us into bankruptcy. These folks are now crying that the plan the president proposes will cost too much. Although, this is a very expensive reform and needs much more work, the trillion we put into it now will save us from spending ~ 4-7 trillion in the next ten years. These reforms should improve the ability of docs and hospitals to get access to records to them when needed. It will enable the docs and hospitals to not have to do duplicate studies and prevent many costly readmissions to the hospital. Imagine everyone having a medical home doc, who acts not as their gatekeeper but their healthcare coach, it will encourage preventative care which may just prevent major medical bills.
We do need to pay for the reforms though and there are many options on the table the only option which should be off the table is that of doing nothing, our baby boomer population will bankrupt this country with the care they need in our current system. We need to honestly look at creating higher taxes on food/alcohol/ or high end health insurance benefits given to some executives. Let me say this unholy thought, take back some of the large tax cuts we gave to high earners over the past twenty years! In the end, it may well be a little bit of each of these ideas- the goal is worth it and demands it.
To our republican representatives, I say, GET TO THE TABLE AND CONTRIBUTE A FEW GOOD IDEAS TO MAKE THIS REFORM BETTER- WE DO NOT WANT A POLITBURO LIKE NYET,NYET, NYET.
To our democrat representatives, I say, GET THIS DONE! DON"T GET STUCK IN THE POLITICS AND POLITICAL CORRECTNESS. The mark of a good leader is one who is able to level with the country.
Here are some ideas to consider:
1)In return for never allowing denial of insurance coverage, all of us should be required to buy disaster insurance. A minimum Insurance cost policy. This ensures that all of us actually contribute into our universal access to care which as I mentioned above already exists.
- make sure all employers contribute a minimum healthcare stipend based on every hour worked. This helps everyone afford requirement #1 and it would not be a threat to any small business, instead, it would be a boon to them. If EVERYONE contributed a little, and there was a government plan competing in the market, the big insurances would not be able to keep insurance rates so high.
- Get employers out of the insurance buying business; they usually buy into plans based on their bottom line, not the needs of their employees. We could improve on the number of health plans available to each of us not just the choice of ins. company A's hmo or ppo plan. Imagine all of us having forty different plans to pick from. When something goes wrong and we complain currently, nothing actually changes at the ins. company-unless our employer is the one complaining. With each of us actually buying the plan, the insurance company will need to pay more attention to our individual needs.
- Get rid of group discounts. Today, small business owners who actually want to buy insurance for their employees or themselves find themselves actually not able to afford individual or small group policies while large corporations get huge discounts due to their size. This causes such perverse conditions as a high number of uninsured who actually would buy the insurance if it was like the premium of the larger employers. It stymies the ability of an entrepreneur in small business- if they get ill, they have to close down the shop and find a large corporation willing to use their talent only because they offer a undeniable, low priced health insurance policy. Worse yet, someone who is unhappy at their current job cannot leave if they have a medical condition as it will be a pre-existing condition.
- There should be transparent base insurance premiums with each plan, from which we are offered BEHAVIOR BASED DISCOUNTS. Behavior discounts would be in the mold of auto insurance discounts. Imagine you don't smoke –you get a discount, you maintain healthy weight- get a discount, you avoid alcohol &/or drugs-get a discount, you get preventative care, get a discount!!!!! In one fell swoop, we could incentivize all Americans to make healthier choices and allocate our health costs towards those who create the biggest risk. The discounts are based solely upon behavior and not upon disease or condition which may have been out of the individual's control.
- Malpractice reform should be part of the mix; California’s situation should be applied to the entire country.
- Pay doctors for quality healthcare, In short, pay for performance- the better the care we provide, the better we get paid.
IN SHORT, there are many good ideas which could be added into today's debate.
The scare tactics and the lies put out by the anti-reform side are in my opinion, unpatriotic; these people are trying to preserve their profit status while allowing America to die on the vine! There will NOT be a government TAKE OVER, nor will there be any EUTHANASIA, You will not be trapped into the government plan. Small business will finally get some security and not actually perish.
TO GET TO SOME ACTUAL FACTS ABOUT THIS TOPIC go to HTTP://PLEASECUTTHECRAP.COM or Healthreform.gov.
I am not a democrat or a republican, I unabashedly support healthcare reform. We have the best health care in the world with the worst delivery system in the world. If we don’t fix it, it will FIX US!
KAMLESH M. DESAI, M.D., Family medical doctor