Tuesday, August 11, 2009

Healthy, wealthy and wise

I honestly tried to read the House healthcare reform bill. It is huge and written in such legalese that I couldn't understand the bit I was reading. (Maybe once the current financial crisis and healthcare reform are taken care of, we can work on simplification of more legal documents, including legislation, into plain English.) So, I found a video on "Healthcare for Dummies" from FOX News (not my most trusted source, but this was actually pretty straightforward.)
Here are my thoughts on this whole debacle:
1) Things aren't working now. Costs are increasing way faster than the rate of inflation. A lot of people are losing insurance coverage because costs keep going up and it is unaffordable. People without insurance or with poor insurance tend not to be able to afford preventive care and end up in the ER with a major health issue, often not being able to pay those bills and declaring bankruptcy, which leads to whole other issues. So we all pay more to cover the losses.
2) We are so lucky to have pretty good health insurance. If we didn't, we would be in big trouble. We paid roughly $2000 for each pregnancy/delivery for me, plus about $500 per child for pediatric care within the first few months. The hospital and doctor bills added up to well over $20,000. Yeah, not pocket change.
3) Market forces are obviously not the solution since they haven't worked so far. The current bill may not be perfect, but we need to do something.
4) There are many functioning government run programs around the world. Those countries have better healthcare at less expense than we do. Can we look at what works there and try to implement it? Why is everyone so against "socialized" medicine? Seriously, if we did have a single-payer, government solution like Canada or the UK, all doctors would accept payment so your doctor wouldn't change. They actually seem to get pretty good results, despite the few bad stories you hear. There will always be someone who has problems. Can we determine if something works for 99% of the population? Because that would be a heck of a lot better than the current system.
5) The current bill doesn't have socialized medicine. It doesn't change anything for people who currently have employer-provided coverage. What it does is provide an option for people who don't have coverage. I'm no economist, so I can't explain how this is supposed to make healthcare overall less expensive other than surmising that by more people having insurance and getting primary, preventive care, there will hopefully be fewer expenses for catastrophic illnesses. And by the government getting into the game with a healthier population than just Medicare recipients (generally the elderly who generally have more health issues), the government can maybe provide a little competition to drive down costs. And the bill actually makes it harder for companies to stop providing insurance if they currently do, so maybe fewer people would suddenly lose their coverage.
Things I'd like to see:
1) Incentives for more med students to choose primary care and ways to reduce med school debt so that isn't an excuse for the huge bills. (I'm not saying that is the only reason for a large salary for a doctor, just that it shouldn't be part of the equation.)
2) Less restrictions on who can provide primary care - PA's, CNP's, midwives. I really think that would help reduce expenses because a lot of things do not require a doctor and doctors are more expensive than other practitioners.
3) Figure out a way to cut the cost of medical malpractice insurance. I really think this is a HUGE part of why some care is so expensive. Our lawsuit-happy society has kind of done this to ourselves, but can we cut the lawsuits to when they are really needed? Bob Cringely actually had an interesting idea regarding malpractice insurance.
4) Maybe there needs to be some sort of health insurance co-op, like a credit union where the insured are the owners. That way, they have say over CEO pay (no multimillion dollar bonuses!) and no stockholders to be beholden to so any profits go back into making premiums smaller. Hey, that might have actually been a brilliant idea! Now if only someone can figure out how to make it work...
On that note, I will close by saying I hope something gets done because not to act is worse than to act right now. And may we all end up, yes, healthy, wealthy (however you define wealth) and wise.

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