Diagnosing Health Care Reform
Health Care reform is long overdue in America. It has been a system both used and abused by tangents from many avenues. While I commend President Obama for putting on the gloves and demanding passage of this bill, I am given pause by the staggering numbers of the cost. Should we rush head-long into a much needed reform, or tally the costs and allow a bi-partisan approach to legislation which can be both beneficial and less encumbering financially? I find myself agreeing with Mitch McConnell, R-KY, who stated that “rather than rush through one expensive proposal after another, we should take the time to get it right.”
This is not to say that legislation for health care reform will remain stagnant. To the contrary, given the magnitude of this proposal and the dynamics which we have seen fail in other countries, it would seem more prudent to exercise caution in the delivery of this reform. While President Obama wants to see this legislation passed in August, would it truly be detrimental to give all sides at least until September to devise a proposal which would behoove the nation?
Most of us would agree that a tax, once implemented, is rarely repealed. The issue of taxing health care benefits frightens many individuals already reeling under threats of higher taxes in states, for example, which are facing dire budgetary crises. Obama says no to taxes, but how else to forestall inflation and deliver sustainable health care?
I would agree that taxing families who earn $350,000 per year makes sense. These are people with tax loopholes the ordinary citizen will never have. There are critics who call this health care proposal Socialism. Wikipedia states under the definition of economic socialism, “A normative definition held by many socialists states that all socialist economic theories and arrangements are united by the desire to produce for use rather than profit, achieve greater equality, give the workers greater control of the means of production and to create a more effective mechanism for producing and distributing goods and services within an economy through rational scientific planning in order to direct the economy towards social goals rather than individual profit.”
It seems to me that we are not moving toward a socialist society, but rather designing a program for our citizens which encompasses equality. It is an end toward “social goals” or closing the crevasse of health care between the haves and have nots. Surely, in this great country, we can come to an agreement on quality of life for all, versus profiteering. But let us do this with measured calculations and a slower speed for such a high-impact program.
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I definitely think that more time needs to be devoted to this before anything is finalized. The government is ignoring the fact that many doctors refuse to accept medicare and even any type of private insurance that they feel is too restrictive. Making sure that everyone has health care coverage does not ensure access, especially if you want to see the best doctors.
I agree that the cost is staggering and there are too many layers in the flow chart of the proposed system that I keep seeing published. I feel that there is a push to get this through now while proponents of the plan are in the majority and they’ll worry about tackling the problems in the system after everything is passed. Of course the improving and streamlining of these systems never seems to take place.
I think that both parties are too comfortable being lifelong politicians, and it’s very easy for them to push these things through because no matter what the system is like it will not impact the access that they have to quality healthcare.
Tina,
At present many doctors refuse patients with Medicare due to the low reimbursement by the government. This afternoon Obama addessed the nation and added a proposal for an oversight body to stop such practices. I can hear people quivering at the sound of yet another oversight body, but after what happend in the collapse of the credit card systems, real estate, and banks, I am in favor of this. If done appropriately with a combination of physicians and officials who would (hopefully) give due diligence to these matters, perhaps they can be effective.
Also during this address, I did not hear the President say he wants this done by August. He seemed to leave the door open a bit and said “by the end of the year.” For all your valid concerns, that was good to hear.
Healthcare cost will increase, care will be rationed, people’s choices will be limited, spending will rage out of control, taxes will be raised that will hurt the economy, and we will suffer from the same types of problems countries like England, France, and Canada have. I am hoping it fails.
I would like to see some sort of universal healthcare program implemented, but before that can be of any great benefit to all concerned, healthcare in general in this country must greatly improve. For it is just a job to far too many doctors and nurses, and they are only interested in doing what they have to. Be assured that I have experienced this first-hand since 1993, and the quality of care that my sister-in-law has been receiving from one of the top 100 hospitals in the country has almost killed her 3 times in the past 4 months.
Of course, if we had the kind of money that Michael Jackson had, we could probably get much better care. On second thought, maybe not.
I think the republicans are just using scare tactics to have some relevance, since they don’t really have any anymore. The truth is all people who have health insurance, already pay a tax, that raises their rates to cover costs of uninsured people. I am really unsure of why that is, because in NY if you had no insurance, and did not pay the bill they sent you to collections, garnish your wages, and get judgements against you. In FL they demand you pay at least 200 dollars to be seen, if non emergent. Plus medicaid, is footed by all homeowners. The counties of each state, is who is responsible for medicaid, that means all homeowners pay higher home property taxes to pay for it. My point is we already pay for it, what Obama proposes will just make it shift a little. The biggest point being over looked is that if Obama can get this done, the health insurance companies will be forced to bring down their rates, which in my opinion they gouge us all anyway, and make it more affordable for everyone. They really need to consider tort reform as well, because that drives the costs way up beyond belief. That has to come at t he state levels, though, and I am not sure how much Obama can do about that.
Harrison,
While all the worse-case scenarios you listed are possible, I believe there is a strong push from both sides to limit these ramifications as much as possible. It is sad that you hope it fails. Obviously you have good and adequate health care coverage. Too many in our nation do not and cannot afford the average of $1000 per month to buy into it.
FishHawk,
I am sorry that your sister-in-law has had this experience. I have read reports stating that there is a drastic shortage of doctors, especially in the area of primary care physicians. The money in that field cannot compare to the specialty fields. Part of what Obama is seeking is computerized medical records which would follow a patient no matter where they were treated. That’s a good thing so that backgrounds can be utilized in the formulation of care plans. I have always thought, though, after having a similar experience in my family, that patients need family advocates. If they have no one to break up the gossip-breaks I have seen some nurses take while patients are waiting for help and red lights are flashing, they suffer. I had to be a bitch when it came to my mother’s frequent hospitalizations in one of our finest hospitals. Maybe we should put nanny cams in patient’s rooms.
Melissa,
As a former social worker I can tell you that Medicaid is paid for in part by individual states and in part is funded by the Feds. We all pay for that. Some of the money taken from our pay checks for Federal taxes is designated to help fund this program. Unfortunately there is a lot of fraud in the Medicaid program because so many cannot afford to buy into a program like the Blues or comparable insurers. Fraud, unfortunately, is built into that system. Resources such as checking accounts or savings don’t matter, but the income guidelines are extremely low. Most people receiving Unemployment benefits do not qualify for this form of Welfare. Let’s face it: desperate people do desperate deeds. If fraud were eliminated, you would be astounded by the cost savings.
During Obama’s campaign I studied his Health Care Reform proposal. Included in that was a limitation on litigation of malpratice for the very reasons you stated. This litigation is driving many physicians out of their field. When Health Care Reform is passed, I am certain it will contain a caveat on this.
It WILL fail and America will be better off:
The bill contains a pay-or-play provision that would require all but the smallest businesses to provide health insurance or else pay a fine equal to 8% of payroll.
The White House’s own internal estimates — based on a model developed by Council of Economic Advisors Chairwoman Christina Romer — say this would cost employers $300 billion and would cost workers 5 million jobs.
The bill would increase income taxes by $583 billion. The White House says only the rich would be taxed. The truth is, this would be a tax on job creation. More than half of all those taxed would be small-business owners, and the taxes would be substantial.
The White House projection that 5 million jobs would be lost doesn’t even factor in the adverse effects of this tax, but money taken from the pockets of job creators inevitably leads to pink slips for employees.
A recent poll indicates that while only 22% of Americans strongly favor the Democrats’ medical insurance plan, 38% strongly oppose it — and the number of people strongly opposed is rising.
http://www.ibdeditorials.com/IBDArticles.aspx?secid=1502&status=article&id=332725027738512&secure=1&show=1&rss=1
Harrison,
I’m not convinced that 22% of Americans oppose this, or even 38% for that matter. I do believe that the public wants a program which can best serve the needs of the country without going into extreme cost-overruns. People oppose the bill as it currently stands. We need a measured response in this legislation and due diligence in its formulation.
You and I will have the “benefit” of Medicare someday. Future generations will not. It is a moral imperative that all citizens have access to quality care, not just the wealthy. It is the wealthy who pay for subsidized programs which now exist. In fact, as I told Melissa, we all pay for that. It is not generally understood that it is the case. Eliminate fraud and abuse and the cost savings will help to enable proper programs to be implemented.
“It seems to me that we are not moving toward a socialist society, but rather designing a program for our citizens which encompasses equality. It is an end toward “social goals” or closing the crevasse of health care between the haves and have nots. Surely, in this great country, we can come to an agreement on quality of life for all, versus profiteering. But let us do this with measured calculations and a slower speed for such a high-impact program.”
If one person works, and the fruit of his labor is taken to pay for the needs of another, how can you claim that these people are equal? This is not a move towards equality. Over a century ago, when one was forced to provide labor for the profit of another, we called it slavery. Today, we call it “social goals”?
You want healthcare reform, great. Let’s talk. Let’s talk about TORT reform that would place a reasonable limit on malpractice lawsuits and cheapen the insurance that Doctors must carry. Let’s talk about deporting those who live here illegally, receiving benefits from a system into which they do not pay. But let us not take the fruits of one mans labor to provide a service for another and pretend that that makes these two men equals. It does not. It makes one man a slave to another.
Steve,
What we have now is just what you described. We are all paying for those without insurance through high insurance rates, taxes to cover Welfare benefits like Medicaid and outrageous costs in prescription drugs. It is like those who drive vehicles without auto insurance. The rest of us have rates that sky-rocket every time one of them is in an accident.
Yes, let us talk about TORT reform because it is in Obama’s proposed legislation. Why do think the AMA approves of this? That was their critical issue and it was part of Obama’s agenda going all the way back to the campaign. Done.
Those who are in those country illegally should not receive health care benefits, I agree. In my humble opinion, that is the largest part of California’s problem: illegals. Get them off Welfare. I did not declare that they should obtain benefits. The holds were removed during the Bush administration. Prior to that, people had to verify their citizenship. But then, he was from Texas. You figure it out.
One way or another, this health care reform will be enacted. No one will be completely satisfied with the entire program. That is why I suggested that the Senate and Congress slow down and not rush into this without due diligence. As you aptly pointed out, there are many issues to be addressed.
We should definitely make sure that “we get it right”. One of the problems at this point is not only the issue of health insurance and of the cost – which seem to be the only subjects being talked about – but also the quality of medical care.
The U.S. has by far the largest concentration of expensive diagnostic equipment. What seems to be lacking is the personnel, who are capable of taking advantage of such technology.
What we seem to have is basically a system, where technology replaced thinking, experience, decency and honesty.
Finding a physician who is more concerned with a patient’s well-being, rather than profit is becoming increasingly difficult. The costs are skyrocketing way beyond the actual increases in the intrinsic value of the services, even though health services should not even have value placed upon them. They should be in the priceless category.
Eliminate fraud and abuse in a Government program? Ha that’s funny. The Dems gave the trial lawyers some nice gives in thie Obamakare package. No thanks.
Politicus,
Your point is of critical importance. Physicians with the values of which you speak have been lost in the evolutionary process of technological health care. To some degree this may have to do with the litigious society in which we live. Physicians who fail to do a single test, such as an MRI, may find themselves sued if the patient is later diagnosed with a tumor. The physicians are faced with enormous costs of malpractice insurance, and I am certain that with every lawsuit faced, they have become disheartened. Hence the loss of “intrinsic value of services.” Obama’s original plan did include specifics on limiting malpractice suits. It is my fervent hope that this would then allow our society to have caring physicians, as well as physician care.
I know I’m a little late to the debate but I’ve been out of town. I have to say that my uneasiness over the whole idea of a massive reform of health care AT THIS TIME is increasing for two reasons. First, I don’t trust the Congress to get it right. Second, the country has been so focused on fixing the private economy that we lost sight of the crisis in the public economy run by State governments. Well, that is a third wave that is just now coming to shore. As a social liberal and a fiscal conservative I am torn between two competing needs: fix a truly broken health care system or stabilize a still very jittery public and private economy. We may not be able to do both.
Windroot,
I think Congress can multi-task. They have to. The states, as you pointed out, are in critical condition.
My primary issue with this package is that the public needs to be aware that states and the Feds fund Medicaid, which is a Welfare program and rife with fraud. If that fraud was thwarted, the cost savings would be enormous to all entities, thereby making passage of this legislation more feasible.
Neither the state governments nor the Feds will close this program. If it continues in its current mode, we will all pay as much, if not more, in taxes. It needs to be reigned in and the only way I see this happening is through Health Care reform.
Regarding “controlling costs”
In 1966, the Office of Management and Budget put the total taxpayer costs for Medicare at $64 million. In 2011, Medicare costs are expected to balloon to nearly $500 billion.
Medicaid cost $770 million in 1966. By 2011, that program will cost taxpayers an estimated $264 billion.
The Virginia-based Council for Affordable Health Insurance estimated that the administrative expenses of both programs last decade were 66% higher than those of private sector health insurance companies.
ADMINISTRATIVE COSTS… there’s your “government savings” for you.
Harrison,
“Administrative expenses of both programs last decade…” Well, was that not during the BUSH administration?
You may want to take my information as one who does know matters regarding Medicaid, that this program is filled with people who actually do not qualify for the benefits. Bush eased off gleaning them out for political reasons. This was bad judgement. The costs to every state, as well as the Fed money contributed, had a blind eye toward fraud and exponentially a cost to all of us through taxes. A program which is appropriately monitored for compliance with have huge cost savings.
Would you rather have programs implemented for those desperate enough to defraud the government because they NEED health care, or legislation in which all will be covered and monitored? Your answer, I believe, will be no to both.
The numbers I provided were from the 1960s. That was before the Bush Admin. And the fact that it costs the government (read taxpayers) 66% more than it costs private companies to do the same thing should give you pause.
It does give me pause that you would use stats from the 1960′s. It’s totally irrelevant. Enjoy your good health care insurance, Harrison. May it serve you well. May you not be denied access to payment should you get cancer. May you not have to face debt if you have a pre-existing condition. May you have plenty of personal funds available to cover the prescriptions you may one day need. No, I doubt these issues will impact you. It is the millions of other American I am concerned about.
Quite a comfortable bubble you live in. How sad that you seem to lack empathy for those less fortunate. And apparently you earn more than $350,000 or one million dollars, both figures now in play for this reform. Do you not realize that even now your tax dollars are being eaten up by insurance companies who are getting fatter by the day? Live long and prosper, Harrison.
I cite states because the estimated costs THEN were nowhere near what they really are. Do you think the estimates NOW will be different? Of course not!
Under the government plan about 500% more of my tax dollars will be eaten up and nothing will really be better as I showed you that the private sector has costs that are 66% less than what the government’s are.
I don’t know why you would think I earn more than 350k per year. And, btw, Obama promised not to tax healthcare benefits but now says he will… that will affect almost everybody who earns any income.
No thanks!
And I have “empathy” but not under this plan.
Great post. We have seen the impact of “We must do something now!” I would love to see our representatives slow down and do something with forethought and take responsibility for their actions. I want them to read the legislation they sign, as well.
Erik,
I agree with you about slowing down and actually reading the legislation before they sign it. With such a sweeping reform, any missteps along the way could have serious consequences.