Keeping it real: Health Care Reform
As a physician who had significant administrative experiences in the past, I got to see the ins and outs of healthcare and its funding. Its a complex topic with many different players and many different agendas. Within a single office visit there are multiple different interests secretly battling it out for attention, and for money. This is why the discussions that many of the political pundits are having regarding healthcare reform are more political agendas than authentic concerns for the health and wellbeing of a nation. The system is complex and interdependent so that each intervention has reverberations throughout the system. For instance, if you continue to limit reimbursements to health facilities and providers, as has been the case for government supported plans such as medicare and medicaid, the unintended consequence is inaccessibility to care for those who are the most dependent on care (Many practices that are primarily medicaid and medicare dependent are bare-bones operations as is. Reduction of their funding results in reduction of services that are offered). The intended effect was efficiency, but the result was inaccessibility .
Former surgeon General C. Everett Koop stated simply that all healthcare systems desire three things:
1. High Quality care
2. Accessible care
3. Low cost care
Dr. Koop followed up his lecture by stating that no system on the planet can give more than 2 of the 3 things. Following his logic, because we have insisted on the highest quality care (U.S. is on the technological leading edge in medicine), and accessibility (most people do not have to wait to see a competent provider) that our cost is astronomical. President Obama is correct when he states that healthcare reform must be repaired urgently. Right now the cost of healthcare is killing businesses and leaving an estimated 20 million adults with any kind of insurance. Those uninsured are still getting sick and a rate significantly higher than those with insurance. This does not just wreck the finances of the uninsured, it wreaks havoc on the financial stability of the nation as a whole.
What President Obama is attempting is trying to closed the uninsured health care gap in order to reduce costs. He understands that the bigger issues that need to be discussed are political suicide, although I think that he has articulated them in a bolder way than have ever been discussed. Here are a couple of things that we as a nation need to wrestle with:
1. Separate but equal was not appropriate for the classroom, but it is appropriate for healthcare?
2. Is healthcare a right or a privilege?
3. Can the government develop a utilitarian approach to healthcare where resources are used where they give the biggest bang for the buck, as opposed to spending money on that which gives the least return (90% of medicaid dollars are spent in a person's terminal phase of life). Its easy to say "yes" unless the money is being used to keep your mother on life support.
4. Will America be willing to pay for its standard of healthcare?
5. Will Institutions that are profiting from shunning medicare and medicaid patients have to share in the burdens of those communities?
6. Will physician reumbursement ever consider the power of prevention, or will we always pay the most for procedures that are repairing damage as opposed to preventing it in the first place.
7. Will we have the guts to regulate the insurance industry that continues to have skyrocketing profits?
These are my thoughts about healthcare. Are we ready for the real discussion. I think that America's not ready, nor do we even have a forum for this kind of discussion. Let me know what you think,
Pastor M Traylor