Thursday, July 23, 2009

Thoughts On Health Care

I've been following the healthcare debate. I'll say one thing, it's complicated. Everyone - drug and device makers, insurance companies, physicians, lawmakers, economists, consumers - has a stake. And those stakes don't easily align. It's messy. It reminds me of the 2003 Medicare Prescription Drug debacle that ended with the awful "donut hole," a gap in coverage placed strategically at a level that benefitted drug companies and providers at the expense of consumers. It gave the appearance of care and compromise. Morally and effectually awful.

The healthcare debate is central to almost every concern in the nation at the moment. It affects our economy, it addresses the ominous spending-down of entitlement programs, it affects GDP, the deficit, personal income, small and large business success (e.g. healthcare premium pay-outs), and of course public health. It has threads in food production, agriculture subsidies, and culture (perks for exercising, not smoking, and other preventative strategies). What doesn't this debate address? I can see why it's such a bear to tackle, why the House Bill is over 1000 pages, why the men and women we've elected to Congress, ordinary people with an extraordinary task, are missing deadlines.

Those of us with health insurance are right now paying upwards of $1000/year to cover those who receive care but don't pay for it. That number is unnecessarily inflated. Treating head lice and poison ivy in emergency rooms is a logistical and financial nightmare.

While I was glad for the reassurance the President gave last night:
"This debate is not a game for these Americans, and they cannot afford to wait for reform any longer. They are counting on us to get this done. They are looking to us for leadership. And we must not let them down. We will pass reform that lowers cost, promotes choice, and provides coverage that every American can count on. And we will do it this year."
I'm hoping that any legislation which gets passed doesn't look like the labyrinthine Medicare Act of 2003.

Here's the President's press conference from last night:


Here's the text of his remarks before he took questions:
Obama Makes Fresh Appeal on Health Care at Prime-time News Conference, PBS
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2 comments:

Jim Purdy said...

You said:
"I've been following the healthcare debate. I'll say one thing, it's complicated."

I suppose that's the one thing we all can agree upon.

In an earlier post, you raised the issue of rationing health care. I know this is a very emotional topic, especially for senior citizens like me, with health issues.

However, I am solidly in favor of rationing. It makes no sense to me for society to spend tens of thousands or even hundred of thousands of dollars to prolong the life of an ailing senior citizen, when many younger people could be treated more effectively for much less money.

And people like me, whose health problems were caused by poor lifestyle decisions, shouldn't be a burden on others.

Needless to say, my senior friends get very angry with me. This will be a very tough political fight.

Bix said...

Not a comment I expected to hear. Thanks, Jim.

I don't understand a lot of the policy issues, but I can see that we're spending a lot. And it isn't sustainable.

Getting more basic services to more people, protecting people when they change jobs or retire, removing the stigma of pre-existing conditions - these will cost. If we don't want to borrow to pay for them, we have to take money from other places.

Or make the system more efficient, I don't know, scale back unnecessary tests, unnecessary surgery (I feel for Obama's "comparative effectiveness" researchers.) I heard of a group of physicians who were salaried, instead of receiving fee for service. The commentator said they ordered fewer tests.