Opening Thoughts
As many observers of the Healthcare Reform debate may be experiencing, we are getting lost in the shuffle of political rhetoric, infectious innuendo, direct attacks and a general, overall, lack of substance. We are also getting drowned in non-specifics on what this debate is really about versus what reform really does, or should mean.
Over the course of this issue’s primary life during the current administration and congress, we have downgraded our discussions to describe all aspects as Healthcare Reform; but is “Healthcare Reform” really what is being said, or is needed and desired by “we, the people”.
There are really two points that need be accepted prior to continuing:
1. Healthcare Services is the provisioning of care, of and for a patient, by a qualified medical doctor, nurse, technician, etc.
2. Healthcare Insurance is the management of payment of healthcare services from a pool of money collected by insurance agencies to those who delivered the healthcare services.
With these points in mind, is “Healthcare Reform” really about transforming Healthcare Services, or the Healthcare Insurance business. I put forth here that it should be the later.
I heard it said recently (and I tend to agree) that the United States has excellent, world class comparable healthcare services and has been outstanding in providing advancements in treatments and diagnoses of many diseases. The only problem we have is access to those services. Those with the monetary means to afford either the best insurance or, in extreme cases, to pay directly for healthcare services, have access to the best quality of care. Those without the monetary means, through choosing a life-path or circumstances beyond their control, may be unable to elect insurance coverage or simply cannot afford it, resulting in the use of the hospital emergency room as their only method of access.
Worst of all, are the cases where the “pre-existing condition” raises its ugly head resulting in a denial of initial coverage or a drop of existing coverage. This is the insurance industry’s way of “reducing their risk”, a prime method for improving their financial and “value” position to investors, shareholders and they’re employed profit takers (CEOs, bonus collecting upper management). Insurance companies today are reaching harder and farther into our physiology and biology to find the way to get out of covering us. The natural long term outcome of this approach to healthcare service denial is best shown in the movie “Gattaca” in which your life, and what you do in it, is predetermined based on your genetic makeup at birth.
Changing Thoughts
I’ve discussed a reformation of our mindset on this debate before in “Healthcare Reform”, however, we also need to change our way of thinking about the debate…we should not be debating or legislating change on the delivery of Healthcare Service, but should be solely focused on legislating change in the Healthcare Insurance industry.
Throughout these last few months, “we the people”, our elected representatives and our media have degenerated into discussions of “Government Death Panels”, “The Government between you and your doctor”, and other nonsensical blathering. When, with simple thoughtfulness, we can all see that without legislation forcing the moral and ethical high-ground, insurance companies, left to their own devices, are chiefly motivated by profit for themselves and the list of profit takers mentioned earlier.
Which brings me to the crux of the matter: The “government option” (sometimes called a single payer option – not so, or sometimes, incorrectly). Since the private sector of our economy has as its chief motivator money, the public sector can, through provisioning of a better option, provide the motivation for private industry to make change to save itself and improve our access to care. The current “government employee” plan does not deny coverage or remove coverage for “pre-existing condition”, it provides choice in coverage and the freedom to change. It negotiates better rates than the private sector for the same quality of care, and has the added advantage of an immense pool of partakers funding its coffers, resulting in nearly (if not wholly) undetectable impact to individual cost when one individual in the pool develops an expensive disease.
So, why not make the “government option” (the option your congressional representative has) available to all. The next time you go through a “benefits enrollment” at work, you could have a choice of one or more private sector options and the government option. If the insurance companies know this is to happen, they will find a way to adapt very quickly, or go the way of the dodo.
On a “smaller” front, small-business in America is quickly finding itself simply unable to afford to provide healthcare insurance options to its employees. I’ve seen the impact of a single patient with cancer one year, drastically increasing the costs the next year for the other 80-plus employees, almost to the point of making it unaffordable. However, if we had a “government option” the small business could offer by utilizing and contributing lower cost premiums to that very large pool, small business would be able to hire talent at a more equitable rate to the big dogs. This would increase competition in the market place - something all “free-market economists” would agree is a very good thing as competition breads innovation.
Final Thoughts
The simple resolution to this debate is for us, our representatives and the media to stop focusing on nonsensical misdirection and focus on the task at hand: making the great healthcare services of this country equitably accessible to all. This task obviates the necessity for legislating regulation of the insurance companies to force equitable competition with a government option in the areas of exclusion, “pre-existing conditions”, and coverage drop prevention. What it also means is that the insurance companies will then be motivate to find ways to become more efficient – the result of which will likely be the vast implementations of data management and exchange technologies that past legislative activities have attempted to mandate.
As the current bill being bandied about is around 3000 pages, it makes sense that embedded in those reams of paper are a lot of appeasements for the insurance companies and other special interest with their hand out. Let’s change that: the provisions I’ve called for should be simple enough to write, after all, we managed to write a 6 page bill granting the ability to invade another country to the unchecked decision of but a few.