For the past three years I’ve been doing health policy research with the hope of helping to inform our elected officials about both the issues in our health care system and potential solutions. With the all of the news coverage of townhalls, speeches and protests regarding health reform, it has occurred to me that many people are horribly misinformed about many of aspects of our current health care system and the reforms being debated. I am always open to discussing these and other potential policies, so let me know if you want to chat. But before a more in depth conversation, I think there are some key aspects of the debate that need to be addressed.
What is health care reform?
There are many different aspects to health care reform, which include reforming the way we use the doctor, how the doctor diagnoses and treats us, and how it is all paid for. The items being discussed in the Senate and House are less about reforming health care (the way we use the doctor and how he/she diagnoses and treats us) and more about reforming the health insurance industry and market (how is the doctor paid for the visit and how do we pay for insurance).
Why is health care reform even needed?
There are about 50 million Americans who don’t have health insurance and thus don’t have the ability to go to the doctor like you and I do. They are unable to make an appointment with a regular private physician and often either delay care or end up in the emergency room to receive care which could have easily been done by a regular doctor. This is important not just because I believe that everyone should have access to health care, but also because the emergency room costs more than going to visit a doctor in his or her office. These costs, if they are not covered by insurance or the government, are passed on to the rest of us in the form of higher health care costs.
While the costs of health care are high for each of us, they are even higher for the government. Medicare, which is the government run health insurance program for those over 65 years old (and certain other key groups), is a huge cost to our federal government. Medicare is one on the fastest growing costs to the federal government. We need to do something now to lower health care costs to ensure that Medicare is available for all of us when we retire. The longer we wait the higher health care costs will become.
What are the goals of health care reform?
The main goals are to insure those who currently lack health insurance and to reduce overall health care costs.
So what does a public health insurance option do?
The public health insurance option is a way to reign in health care costs by creating competition with the private health insurance companies. This will force the private health insurance companies to have competitive pricing and benefits for all of us, because if they don’t people will choose to purchase health insurance through the government.
This public health insurance option is a government takeover of health care, right? It means that we are going to have a system like the UK or Canada, right?
Absolutely not. Think of the public health insurance option as a Medicare type program that the rest of us can buy into, if we want to. So if I am 61 and want to retire, but am too young for Medicare but can’t buy health insurance from the private market, I’ll be able to choose to purchase it from the government. It does not mean that private health insurance companies are going to go away or out of business. Trust me, they are doing just fine. In fact, the CEO of United Health Group made more than $125 million last year. Not to mention a recent report by the nonpartisan Congressional Budget Office found that adding a public option will not force the private insurance companies out of business. For those of us with health insurance that we are happy with, we likely won’t see any changes, expect lower prices in the future.
I heard that the health insurance reforms will allow a bureaucrat decide who gets health care and who doesn’t, is this true?
No, that is exactly what these reforms are trying to stop. There are thousands of us, each day who receive a letter from the insurance company saying that the treatment or health care that was provided will not be covered and we are not required to pay tens of thousands of dollars for the care we received or our loved ones received. Not to mention, our doctors currently will only provide a treatment if they know it will be paid for by the insurance. These are examples of a bureaucrat between you and your doctor making treatment decisions. The government is trying to remove that bureaucrat with these reforms. Currently, health insurance companies can drop coverage when you get sick (after paying premiums for years) because of some undisclosed ailment you had when you signed up. The proposals being debated in the House and Senate are trying to stop this practice and trying to ensure that we all receive the health care that we need.
There have been several rumors about death panels and euthanasia in the recent days. These are completely false. They stem from an inclusion in one of the proposed bills stating that doctors can be reimbursed by Medicare for having discussions with their patients about living wills and other end of life decisions. So if you are enrolled in Medicare and you want to talk to your doctor about those decisions and seek his or her insight into the matters, the doctor will receive payment. This simply creates a financial incentive for doctors to encourage their patients to create living wills and have end of life conversations with our families. The government will not place a value on people’s lives and grant care accordingly.
Are these health care bills going to fix everything?
Unfortunately, no. The health care system in not an efficient system. Ultimately, we need to examine the way we reimburse doctors to ensure we are reimbursing quality and not simply the quantity of services provided. We need to provide financial incentives for doctors that provide high quality care at a lower cost, like the Mayo Clinic in Minnesota does. They provide amazing health care at a fraction of the cost of some doctors and hospitals around the country. In the United States we are paying about twice as much for health care than any other country in the world but receive far worse outcomes than most developed nations. This reform is not going to fix everything, but it is an important step in moving towards lower costs and higher quality care.
As always, feel free to spread the word.