Educate yourself on health care

This is must reading for anyone in the midst of the argument over the current health care debate. http://www.washingtonpost.com/wp-dyn/content/article/2009/08/21/AR2009082101778_3.html?referrer=facebook

Bottom line: we need to pick a method of delivery for health care and we need to change the motivation in the system to health and not profit.

Comments are gladly accepted.

The President is coming to town! (to talk health care)

Sounds like a new song, doesn't it?

Ok, since no one answered any of my questions, here's where I cast all fear of repercussions to the side and offer my solutions to this acrimonious health care debate. This is with a particular sense of disgust that I post this because the media and talking heads are working the nation up into a froth with misinformation and half-truths, at best, and outright lies, at worst.

So, at the risk of offending all my friends and acquaintances, here is my idea. Wouldn't it be cool if someone from the White House read this before Obama comes to Grand Junction this Saturday? I'm not holding my breath.

You have two major issues in healthcare: delivery and cost. So here goes nuthin'!

1. First, preventive medicine. Studies have shown that $1 of preventive medicine saves $1.68 or so. Why is it that we can't shift the inordinate amount of money being spent on emergency room care by sponsoring wellness programs for all? This should be a no-brainer. So the answer is to design a plan that is (horror of horrors) government-run, where everyone has basic preventive coverage. Cover annual physicals, dental checkups, mammograms, pap smears, basic blood tests, colonoscopies, pre-natal care and other tests designed to catch things before they get out of hand. Wouldn't we all want that? If we save money by making this shift, that's less money that needs to come out of the citizens' collective pockets (read: lower insurance premiums to offset by maybe slightly higher taxes). I really like that the docs in England are incentivized to keep their patients healthy (but only if you can't be dropped by a cherry-picking doctor).
   
2. Second, supplemental insurance policies. With the basics being covered, that leaves the insurance companies to sell supplemental health insurance policies to those that can afford it. You want plastic surgery insurance, you got it. You're living an unhealthy lifestyle by your own choice and need more than the basic coverage, you get to pay for it. I personally think that if you smoke, drink, have weight problems, heart problems or are diabetic due to lifestyle choices, then you should be paying more into the system. Why should healthy people subsidize the unhealthy ones? You don't get that same treatment when buying life insurance. If you don't like it, guess what, you can make a change or live with it and pay your own way.
3. Third, pharma companies. Guess what you get to do under this plan? You still get to sell your overpriced legal drugs to consumers. But, we're sick and tired of you using us to cover all of your R&D and marketing costs when the same pills end up in other countries at a fraction of our cost. Also, all drugs ads are gone in my world. You can spend that money on R&D. With the internet, we all have plenty of opportunity to find information if we want to search for it. At home, we don't need to be bombarded with TV and radio ads, warning us of side affects while selling us on the fabulous results we'll all have with better bladder control or sexual function. And generic drugs are price controlled, period.
   
4. I'm tempted to take away the health care premium deduction for businesses, but I'm not convinced of this one yet. I think that it's outrageous that I would have to spend 20-25% of my takehome pay to cover a health insurance premium when I have actually used maybe 1-2% over my entire life! You want to create some competition for premiums - quit expecting that huge premium increases can be saddled by business. Many Americans don't have insurance because their employers can't afford it either. You on the right - with the cushy jobs with choking benefit packages, imagine if you had to buy your own insurance. You'd be screaming for reform too! That includes members of Congress too - in my world, you all join the rest of us in having to deal with this burden.
   
5. Tort reform - Lawyers are going to hate me. I think we need strict caps on medical lawsuits. I don't know what the number should be, but someone needs to be bold. Since when do we think we are worth so much? Since when is it possible that we think that because we are injured that we can't do anything else? Seen that video of the guy with no arms or legs? Seen his attitude about life? There's no way we should allow the injured to win the lottery on a malpractice suit. Yes, as my grandmother, the RN, used to say, "They all didn't get A's.", we also need to have better review and disciplinary actions against the medical profession. AMA - if you don't like it, too bad. It's our health and our children's health that you're messing with. But guess what? Now you won't have to order up the store in tests to cover your ass.
   
6. Medical records - Like I've suggested before, put the software companies in a room and tell them they can't come out until they have standards for data structure and ease of use. This is also a no-brainer and please don't tell me it can't be done. If Larry Ellison of Oracle fame can build a multi-million dollar boat for a yacht race, he can have passion enough to be the hero of medical information.

So who's going to pay for all this? We are. But guess what? It should be cheaper. We should have less total medical expenses because we're preventing major issues before they need emergency care. We'd be saving time and money in staff in managing the mountain of data. Insurance companies wouldn't be making a profit on basic care. Marketing funds spent by pharma companies would be passed on to consumers (or at least spent on R&D where it needs to be spent). Multi-million dollar settlements simply don't happen. And guess what? It would probably all behoove us to pay a little bit more into our taxes (since we should save a bundle on insurance premiums) since we're all going to benefit from this new delivery system.

Bottom line: everyone pays into the system of basic care because we all would benefit from it. And I mean everyone! If you work, you pay through Medicare taxes. If you own a business, you pay through Medicare taxes. If you're unemployed, no co-pays for six months. After that, you pay a sliding scale - the longer you are unemployed or not paying Medicare or self-employment tax, the higher your co-pay. If you're illegal in this country, you pay too. It seems that some illegals can get jobs and avoid many opportunities to pay but this is where you need to pay too. We are already subsidizing their care since they are not paying for emergency room care, so why can't we make them pay even a small amount for preventative care? Again, it would save us all so much.

Universal means all of us benefit, but all of us pay. The Hippocratic oath compels medical professionals to treat the sick. Our system should have the basics available to all and all of us should pay for that benefit.

Yes, this is a complicated issue and I'm willing to have that conversation with anyone.