2010-02-24 / Opinion

5 issues with health reform

Dear Editor:

Did you read the recent issue of National Geographic? It reported that the US spends more on medical care than any country - about $7,290 per person, which factors in the lack of health insurance for an estimated 45,000 deaths a year.

#1 Status quo - Are you satisfied with those numbers? Our nation’s life expectancy at birth is about 78 years, which ranks us 20th among the industrialized nations, just about the Czech and Slovak Republics. Other indexes, e.g., 6.69 deaths per 1,000 live births, are also inferior to most industrialized countries. Our health expenditures for 2008, according the Department of Health and Human Services, topped $2.3 trillion or 16.2 % of GDP. As the world’s wealthiest nation, we can do better.

HCR improves the quality of health care by eliminating perexisting conditions, e.g., pregnancy, mental illness, etc., contains costs and delivers better care. Look at the economic implications of not providing better health care. (Think automotive.) We can’t afford to maintain the status quo for the sake of our children’s children.

#2 Accessibility - HCR would increase, not decrease, health insurance for those who get it through work or buy it from private companies. That’s not a government takeover of health care. (The Veterans Administration is government - run, where ‘government’ owns the hospital, employs the physicians and finances the care.) Medicaid, ‘aid’ for those who lost private, employer -sponsored health insurance as well as meeting federally established means tests, would be extended by increasing eligibility. You still choose your own physician.

#3 Rationing - We don’t have ‘hard-rationing,’ when a person with money is prevented from getting health care. We do accept ‘soft-rationing,’ that is, if you can’t afford it you can’t have it.

Also, employers and private insurance companies ration heath care by deciding what’s included in their benefit packages. HCR would reduce ‘soft-rationing’ in terms of ‘price-rationing.’ Again, accessibility would be increased.

#4 Costs - Elements of cost-containment are within HCR. Significant pilot programs and payment reforms make serious attempts to rein in unnecessary procedures and to correct over priced procedures. The challenge is to eliminate the estimated onethird of medical spending that’s wasted each year and doesn’t improve a person’s health - admittedly a tough task. Electronic medical records would be a great step in cost-containment.

#5 Private insurance - If you like your health insurance you can keep it, but employers may decide to change or drop coverage - as they can do now. The House bill contains penalties for employers who don’t provide coverage, which are more severe than in the Senate bill. Given the escalating costs of health care and the imposed penalties for not providing health insurance, it’s impossible to predict what employers will do - “pay or not play.” It’s still up to the employers, not the employees, but the intent of the legislation is to increase accessibility to health care.

What are your fab five issues? Thanks for listening.
Bill Moldwin
Past CEO, SW Detroit Mental Health Services

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