Thursday, September 10, 2009

Is This The Cure For Health Care in America?

Oh Health Care Debate, is there anything you can't do? You stir up patriotic and religious fervor, you help the public and the elected communicate and/or curse each other face to face, you show off how brilliant and how dim we can be, you shape the nation's economic and physical health, you cause our imaginations to sparkle with dazzling illusions of nightmares or lush dreamscapes of unicorns and rainbows, you take the money from so many and disperse it to so many more as you loom large above us like a fierce king bestowing boons and banes to the worthy and unworthy. Oh Health Care Debate, how can we hate you?

Oh Health Care Debate - where do we go from here?

Last night President Obama pointed out some pointed facts which tend to blunt most of the current back and forth howls heard in the public squares (which now also exist as binary code). Such as the fact that he asked 5 committees to draft legislation and so far 4 have complied and another will soon. So there is no one bill, no one plan, at this point which is being scrutinized and none of them, not one, has been made law by Congress.

I do like it when Obama calls out his critics - "
I will not waste time with those who have made the calculation that it's better politics to kill this plan than improve it. I will not stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what's in the plan, we will call you out. And I will not accept the status quo as a solution. Not this time. Not now."

Much of the key issues being promoted seem quite valuable to me: no exclusions from insurance because of pre-existing conditions, no elimination or dilution of insurance due to illness; no caps on coverage while yet creating a limit on out-of-pocket expenses of the sick.

But what I hear from all of these current proposals are reforms for insurance itself and not really for reforming Health Care itself. I suppose I am part of a small minority of folks because it seems to me the best way to approach the problems are to re-invent the way we see Health Care: I do not think such care should be operated as a for-profit business. But I know such an idea is far, far away from what most people think.

And I did not like hearing from Obama that he thinks Americans should be required to carry health insurance - "
... individuals will be required to carry basic health insurance – just as most states require you to carry auto insurance. " Although he immediately added in something I do think is worth considering - "There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements."

And here is something from the speech which sounds quite good:

"Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance. It's how everyone in this Congress gets affordable insurance. And it's time to give every American the same opportunity that we've given ourselves. ... "But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up."

I suppose I would fall into that 5% crowd.

Maybe the result of all this debate and proposed legislation will be that health insurance costs will be more affordable for more people, that some of the fraud will be ended, and that we'll start to see health care in a different way. Maybe. If that does happen, then maybe we can actually begin work on changing Health Care from a for-profit business to an inexpensive system anyone can access at any time without worry of going broke or being turned away. Of course, maybe I just need treatment for my own delusions.

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