Health care reform needs to pass now, and here’s why

There are certain actions we take even though we know that ultimately we will not be successful. Sometimes we do this out of hope for a better tomorrow (like playing the lottery) or because we are taking a moral stand (like supporting a candidate that has no chance of winning).

Supporting health care reform is probably a little of both.

Even if any of the currently proposed health care reform plans pass, it will make little impact on our crumbling health care system. That said, you MUST support health care reform now.

Why?

1. The current system is worse then broken. You probably know about the over 40 million Americans that lack health care coverage, and the fact that we pay more than any other country for health care, but have poorer health than most other countries. However, non-health related facts may be even more important.

The most common reason for bankruptcy in the US is medical bills. In addition, our nation’s industries can not compete in a global market because of health care costs. GM spends more on health care for its employees then the metal in the cars they make. The health care system is not only broken, it is crippling our entire company.

2. If we don’t act now, reform may never happen. Congress goes into recess at the end of the month. By mid-April, our representatives will start to focus on the mid-term elections. Thus, it is likely that nothing substantial will get done this spring, summer and fall until after November, 2010. If this is the case, regardless of the outcomes of the upcoming elections, no politician will want to tackle health care any time soon.

3. We are so close. We have never before had health care bills that have been passed in both the House and Senate. This is historic. We can’t stop now, because we may never get this close again.

4. There are actually some good things that will happen if reform is passed. Even if we don’t cover all the uninsured, any bill that covers millions more has to be worthwhile. Both side also seen to agree on eliminating pre-existing conditions and closing the Medicare Part D donut hole will be a major help to many of our seniors.

But the current health care reform proposals aren’t perfect.  Here’s why.

1. Coverage is not enough. There are four major problems with our current health care system: lack of coverage (uninsured, underinsured, pre-existing conditions), escalating health care costs, a poor delivery system including a primary care shortage, and an unhealthy population.

The other issue, of course, is how to pay for any fixes. Current proposals pay lip service to all four, but really only address coverage. All are inter-related, so without addressing the others, your can’t fix the system. Massachusetts is a perfect example. After expanding coverage to all residents, the state found that there weren’t enough primary care doctors to see everyone. These newly insured patients ended up going to the ER, leading to dramatically increased costs for the state.

I believe we should have first addressed rising costs and our delivery system. Fixes include malpractice reform and restructuring our payment system which pays for tests and procedures over prevention and counselling.

2. You are probably not affected. If you are reading this, you are doing so a work (you have a job) or at home (you probably have a job if you can afford shelter with a computer and Internet connection). This means that you likely have health insurance that is provided by your employer, like most Americans between 21-65. Similarly, you are likely not happy about your escalating health insurance premiums and possibly frustrated by longer and longer waits for shorter and shorter appointments with your doctor.

However, you likely want to keep your doctor, are thankful you have coverage, and though you feel bad for the uninsured, you are more fearful of what substantial reform might mean for you. The good news is that whatever passes will likely not affect you. The bad news is that we will likely not get any real change until things get so bad that most Americans demand change.

3. Things are bound to get worse. Though our dysfunctional system and plans for reform may not affect you now, things will get worse. Without addressing costs, premiums will continue to go up and even more patients will lack the ability to afford health care coverage. Without addressing the bureaucracy of insurance paperwork and they pay disparity between specialists and primary care physicians, students will continue to go into non-primary care fields and current primary care doctors will retire. In addition, our nation is only getting older and fatter, and thus sicker and more expensive.

Bottom Line: Our health care system needs massive changes. This can’t be done quickly, so one piece of legislation will not fix it. It will take many years and many pieces of legislation just to start moving in the right direction. However, we have to start somewhere. Though the current proposals will not work, they are a first step. In addition, a millions of Americans will get coverage and we may get a few needed fixes. Yet, if we fail to take this first step, and don’t pass something soon, it may be a decade before health care reform is discussed again.

Matthew Mintz is an internal medicine physician and blogs at Dr. Mintz’ Blog.

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  • http://www.twitter.com/matthewbowdish MatthewBowdish

    The idea that we physicians should support a bill that the majority of Americans opposes just for the sake of “passing something” is bad policy and bad medicine. Just because there may be some good features doesn’t mean this bill will not make matters worse. It will. It has LOTS of bad features that will make health care coverage more expensive and make medical decision-making more bureaucratic. The public wants reform. We doctors want reform. This bill isn’t real reform. They need to start from scratch and come up with a bipartisan agreement that can gain wide support from the public and medical professionals. To suggest we need to “pass this now” is public policy malpractice.

  • lazza11

    Dr Mintz is exactly right, and some of the other commenters seem to have slightly lost touch with reality (which seems to be a common denominator with all opponents of this reform bill)! You cannot just say that this bill will make everything worse without giving reasons?

    Two reasons to support this bill:
    1) As Dr Mintz points out, quite apart from the fact that the bill provides coverage for 30 million Americans, if it fails under a congress that had a senate supermajority and has an incredibly popular and motivated new president, then no future congress or president will dare to touch the issue until it is too late for the countries budget!

    2) This is a really great bill! It is probably not ambitious enough, especially in cost control measures, but it does all that can be done today given the political realities. Look how hard it has been to pass this incredibly moderate bill! It would never have passed if it were more ambitious. The bill makes a great start on many cost control fronts and builds a competitive framework (the exchanges) to build a private health insurance SYSTEM for the US. Even more ambitious changes will be needed but we need this bill first! It has an independent medicare commission which will have the power to start redressing the broken incentives for primary care and investigate bundling of services rather than fee for service (in short to start fixing the US payment system) and it has innumerable other pilot programs in cost control. It also bans recision and discrimination based on pre-existing conditions and allows college students to stay on their parents insurance up to 25.

    The bottom line is it is a very modest but sensible reform bill that covers 30 million Americans and yet the CBO (which routinely UNDER-estimates savings) says it will REDUCE total government expenditures by 2019. It probably does not reduce them ENOUGH to save the country from bankruptcy – but it starts us on the right path. All physicians and all Americans should absolutely support the bill.

  • Doc99

    Obamacare is a Statist’s wet dream, more about control than about care and crafted in the back rooms of the sausage factory. This isn’t reform. This is a hostile takeover.

  • http://www.blog.greatzs.com ZMD

    You’re dreaming if you think passing this bill will lower the cost of health care for American industries. This bill does not create a single payer system like other countries. It is more of an insurance reform bill with the government giving money away to people to buy insurance. Group insurance from employers will not change. Obama has said that and you can be sure the unions will not allow any changes to occur. GM, Ford, and other American companies will still be at a cost disadvantage compared to Japan or European countries.

  • Frank Drackman

    Only 40 million Americans lack health coverage?!?!?!?!?
    Thats like 20 million better than when the President(Peace be upon Him) started talkin about it last year.
    So just keep doin whatever he’s been doing, in 2 more years, everyone will be covered.
    And I think I’ve seen most of the 40 million in the last year, most more than once, in away I’d sort of LIKE to see them have insurance, and find out it sucks just about as much…
    and I think this is just a scheme of yours to be the only remaining physician in Primary Care…

    Good Day Sir!

    Frank, M.D.

  • ninguem

    The healthcare proposal before the Legislature is a monstrosity that will take the current system and make it orders of magnitude worse.

    To say “do something, no matter how stupid, just so we can say we’ve done something”, as Mintz does, is so ignorant it is beneath contempt. Like Pelosi’s “pass the bill so we can see what’s in it”.

  • Mike Blackmer

    Great response Dr. Bowdish! The current ideology seems to support the argument that if it looks like a turd and smells like a turd, we should just call it health care reform and squeeze it through.

    Health care can and will get worse if price transparency is not addressed. This bill only really addresses coverage. It is a recipe for disaster. Our politicians should be looking for ways to improve the system as an ongoing project; not pack it all into a bill oozing with earmarks/bribes.

  • rezmed09

    The assumption above seems to be that we cannot make the situation worse than it already is. I can only reply with: “Medicare Part D”. Where is cost control? Where is control of over-utilization? Where is the control of anything? Give everybody everything they want and you get nothing.

    “We’re just a country who cain’t say no…”

  • http://www.drmintz.com Dr. Matthew Mintz

    I am not saying “do something, no matter how stupid, just so we can say we’ve done something”, but rather, “do something, even if it does only a little bit of good, just so we can say we’ve done something which will allow the process to continue.”
    I agree that matters will get worse with or without the proposed legistlation, but I am not aware of anything in the bill that will do more harm compared to doing nothing.
    I too would like them to start over with something everyone can agree on. Politically, this will never happen.

  • BobBapaso

    We need to DO something! If it makes things worse, at least we’ve set a precedent for doing something and maybe it will be easier to do something again and make things better. No one really knows what the current bill will do, overall. You are sure it will make things worse only if you believe the insurance companies.

    If we create a mega-disaster, that might be the best thing we could do. Our culture only seems to do something effective at times of crisis.

  • SLDF

    So the logic is this: We should do something –> this is something —>therefore we should do it.
    This article is a classic example of smart people being extremely short sighted outside their field. Please stick to doctoring and leave logic/critical thinking to those more capable.

  • http://www.twitter.com/matthewbowdish MatthewBowdish

    Dr Mintz says:
    “I agree that matters will get worse with or without the proposed legistlation, but I am not aware of anything in the bill that will do more harm compared to doing nothing.”

    Actually, there is plenty of evidence to suggest that we can make matters worse with this bill. Just read Megan’s piece about the loss of flexibility in reforming Medicare that will happen if this bill becomes law.

    http://www.theatlantic.com/business/archive/2010/03/the-unkindest-cut/37288/

    Money quotes,
    “Proponents of reform have been acting as if the fact that various Democrat plans have been scored by the Congressional Budget Office as “deficit neutral” somehow means that they couldn’t possibly be worse than the status quo. This is extraordinarily wishful thinking. For one thing, as Greg Mankiw points out today (and I have previously argued), even a success will leave us worse off in one key respect: we’ll have used up the easiest, most obvious cuts that otherwise would have been used to deal with our rapidly growing Medicare problem.”

    And,
    “”The fierce urgency of now” is obviously totally compelling to those who think nothing can go wrong, but for the rest of us, it’s not a good reason to commit ourselves to a very risky course of action.”

    And Mike-I agree with you 100% on cost transparency, which is why I would argue that we need to make a more patient-centered reform package that would allow such transparencies to be useful for encouraging greater competition, especially with routine care.

  • http://www.drmintz.com Matthew Mintz, mD

    @ZMD- sorry if my juxtaposition of health care bankrupcies and what GM spends on health care implied that I believe the current proposals will decrease health care costs for American industries. It will help the former, but does nothing to help the latter. However, I believe that in order to make the very necessary steps to decrease health care costs for everyone, we must first pass this bill, so that we can address costs in future bills. In my opinion, if this bill doesn’t pass, there will be no future bills.
    @rezmed09- though Medicare Part D could have been so much better, I do not believe it made things worse. Even though many seniors are stuck in the donut hole, part D provided many seniors with medications that they could not have otherwise afforded. Prescription benefits for seniors must be fixed (and part of the proposed legistlation calls for pharma to fill the donut hole), but Part D was similarly a first step.
    @SLDF: My logic is this: We should do something –> this is is not perfect, but it’s better than nothing, and without it it is very unlikely that anything else will get done in the near future —>therefore we should do it
    @Dr. Bowdish- thanks for the link to the article. I believe we are in agreement that addressing costs are important and this bill does nothing to address costs. I also agree that this bill is far from neutral. SGR, which still needs to be addressed, is not even counted in this bill. It sounds like you are making the case that since the bill is not fiscally responsible, it would be better to do nothing. While I am not going to defend the fiscal side of the bill (as mentioned, I would have preferred that decreasing health care costs be addressed before focusing on coverage), I would rather have a bill that ends up not paying for itself than doing nothing. Nothing will definitely lead to increased spending/costs. Something, may in the short term cause costs to go up, but will allow further discussion/legislation to address costs.

    • http://www.twitter.com/matthewbowdish MatthewBowdish

      I am not quite sure how one could read my first reply and conclude that I don’t want reform. Seems like the strawmen are out in force. But to say you would “rather have a bill that ends up not paying for itself than doing nothing. Nothing will definitely lead to increased spending/costs” neglects several issues. We already have runaway entitlement spending that is bankrupting the country. To add to this another $2.5T entitlement programs makes the already required entitlement reforms that much more difficult, unless you are trying to crash the system. If anything, doing nothing in the short run (if by “doing nothing” you mean not passing this top-down, hyper-partisan bill) may actually be better than passing it. But we need good reforms, not 1970s Nixon-era price controls that have been shown to raise prices and crease choice in the end.

      Furthermore, I am not only opposed to this bill because it will add trillions to the already bloated debt. This bill will fundamentally change the relationship between citizen and government. Instead of encouraging more accessibility through cheapening the costs, it creates a new entitlement that will politicize and bureacratize just about every medical decision we make. It’s strange that democrats make a big deal about ‘getting govt out of our wombs’ and then favor the feds turning private insurers into public utilities, and thus dictating what can and cannot be covered through such mechanisms as the Medicare advisory board, community rating, price-controls, etc. The day this bill passes is the day that American exceptionism dies.

      What we need is real reform that encourages patients to have a greater stake in their healthcare decision-making, that encourages real competition, that plays to what makes American great and not some Euro-style, govt-backed giveaway to big insurance companies that removes patients even further from the freedom to choose what kind of health care is important to them.

      Again, passing bad legislation will give you bad outcomes in the short-term as well as the long-term.

  • http://bit.ly/7NzmlS Dyck Dewid

    Many of your points are well taken. Yet, this is teaching all of us that we ARE CONNECTED (your children will affect my world, you affect my environment, health care affects the economy and confidence in this country). It is not about those w/o health care insurance. to me it is about greed & self. it is about thinking if I’m secure– that’s most important. It’s not only Congress doing this.

    We must suffer together until we learn about sharing (our pain, health, our frustration, our air and water, our time & money, our caring). The lesson seems big, so the suffering must be big.. and it would be worth it if we will learn what we need to learn. Suffering is the great teacher, even if some have great capacity for it, she has all the time in the world.

  • http://bit.ly/7NzmlS Dyck Dewid

    = = = = = = = = = = = = = = == = = =
    What single thing would bring this home (for me)? Health Care Reform. But…

    1. It must be FAIR and equitable to all (no mandatory or punishments) and yet provide a safety net to those in trouble.
    2. It must apply to ALL Citizens, including all government.
    3. It must not favor big business or any special benefactor interest.
    4. It must honor the patient first and push toward non-assembly line medicine.
    5. It must allow complete choice of all citizens to have their lifestyles and care for their own health.
    6. It must not interfere with consequences of imprudent lifestyle or unsatisfactory choices or lack of personal responsibility.
    7. It must have a short implementation and not be mired down w rules.

    ps, ‘Dyck’s 5 Steps to HCR’ maybe not polished, but it fits these criteria. http://bit.ly/9GwRLL

  • Mike Blackmer

    Dr. Mintz, I agree that doing nothing may be just as bad as passing this bill (but definitely not worse). However, I disagree with you that these are the only two options on the table. This needs to be on ongoing project and it possibly could be once the political olympics are over and out of the public spotlight.

    In effect, you are saying that we should pass this bill with no regard to cost. So I ask you this, would/did you build a house with no regard to how much it would cost you? Would you sign your mortgage documents without knowing the terms?

    I liken your logic and this whole bill to the lending fiasco that is crippling our country. Uncle Sam wanted to keep the economy growing so Pres. Clinton and Fed Chairman Greenspan pushed banks to introduce “exotic loans” so that more people could have the american dream. Banks glady responded. Option Arms and Interest-only Arms swept the country.

    Educated people were signing these mortgage documents, while not knowing that they were negative amortizing. They were also buying homes without regard to cost. All of this was under the assumption that everything was going to keep getting better.

    In the end, millions more people were able to reach their god-given right to have the american dream. I think it is wonderful; everyone should have their dream home without any worries of how much it costs. As for the details of the loans, who cares? These things will all get worked out, right? This is all great until the logistics are addressed and its realized that this type of thinking is an economic nuclear bomb.

    So lets just pass this bill. Its better than nothing. What harm could be done? Who cares what the repurcussions could be. Lets get it past to keep healthcare reform on the table…I am baffled by this logic. No matter if this bill passes or not, healthcare reform is going to be a major topic for many years to come.

  • http://www.drmintz.com Dr. Matthew Mintz

    Mike,
    I also agree that “this needs to be on ongoing project and it possibly could be once the political olympics are over and out of the public spotlight.” However, politically, any ongoing dialogue that gets at some of the real issues, like cost and how to pay for reform, will never occur if a bill does not get passed. Several administrations over the past few decades have tried and failed at healthcare reform. The Clinton attempt was a huge disaster. President Obama got elected with more votes than Ronald Reagan on the promise of health care reform. In addition, he arrived in Washington with a Democratic House and Senate. He should have been able to get anything passed, especially health care. If health care reform does not get passed before the spring recess, despite the fact that “healthcare reform is going to be a major topic for many years to come, ” no politician will touch it for at least another decade or until the entire system crashes (whichever comes first).
    I wouldn’t say that we should pass the bill with “no regard to cost,” but rather we should pass the bill despite potential costs issues, with hopes that this can be addressed in subsequent bills. Though I agree fiscal responsibility is important, the same rules that apply to people (like mortgages) can’t always apply to government. Governments needs to spend money even if they know they can’t pay for it under certain emergent situations, such as war or our recent stimulus package. I believe our failing health care system would qualify as one of these emergencies.

    • Mike Blackmer

      I understand what you are saying. Maybe I am too naive, politically, to believe that it is D-day for healthcare reform. I still think we can work out a lot of the kinks at the state level.

  • Evinx

    So pass this bill – even though no one really knows what is in it – you have the House bill, the Senate bill + some “fix” that may or may not happen.

    So your real point is pass something bcs something is better than nothing + we can then hope Congress will want to fix some of the problems down the road.

    It took nearly 100 years to get rid of the Rural Electrication subsidies even though electricity was everywhere in the country. Where is all the discussion about ethanol bcs that surely isn’t working out as intended. And gee, pet care costs have been rising the same percentages as human healthcare costs. How about Medicare for All Pets?

    Mike Blackmer’s comparison to the real estate crisis is apt. Dr Mintz – you should read it .

    Your attitude is what got us into the terrible mess we are in. When I read articles such as yours – pass something and we can worry about fixes later — makes me wonder about some physicians clinical abilities. Shall we order 100 Pet + CT scans and worry about the radiation later?

  • Joe

    “Shall we order 100 Pet + CT scans and worry about the radiation later?”

    I’d say if its a choice between 100 PET scans or 0, and the PET scan is very clearly needed (as health care reform clearly is), then yes, the benefits outweigh the consequences.

    The argument is tat its now or never to pass a bill, and never is horrible, so now, while still bad, is better.

  • http://www.drmintz.com Matthew Mintz, mD

    Evinx,
    If you want to use the prescription analogy, physicians do this all the time. It’s called empiric therapy. Patient comes in with a high fever and cough, no other signs and symptoms and other preliminary tests like a urine analysis are negative. We know we need to treat the patient with something, even though we don’t know exactly what the infection is (pneumonia, bronchitis, sinusitis) or what bug might be causing it (strep, staph, etc.). So we empirically treat the patient with a broad enough antibiotic to cover as many bases as possible with the hope that the medication will work and we aren’t doing any harm. We do this because even though the diagnosis may not be precise (could even be wrong), and we could wait a little longer for further testing, symptoms, etc. to get a more accurate diagnosis; doing nothing is more likely to harm the patient. In my opinion, doing nothing right now is more likely to harm the chance of true health care reform. The proposed legistlation might not be exactly right, and might even do some harm, but health care reform could die without it.

    • Healthcare Observer

      Not the same – the first is more likely a placebo (and in any case you shouldn’t be prescribing antibiotics for passing viral infections). The healthcare reform, while missing the key public option (for now), has obvious causal good.

  • ninguem

    “…..President Obama got elected with more votes than Ronald Reagan…..”

    ….which means absolutely nothing. I suppose Obama got more votes than Abraham Lincoln, so should we carve him into Mount Rushmore? A dumb throwaway phrase, comparing elections from a generation past, it’s dumb when either side does it.

    “……..on the promise of health care reform……”

    and I think just a few more things as well. Iraq, Afghanistan, the economy, a weak Republican candidate, on and on.

    “……In addition, he arrived in Washington with a Democratic House and Senate. He should have been able to get anything passed, especially health care. If health care reform does not get passed before the spring recess, despite the fact that “healthcare reform is going to be a major topic for many years to come, ” no politician will touch it for at least another decade or until the entire system crashes (whichever comes first)……”

    Did it ever occur to you that maybe, just maybe, the reason he’s not getting a healthcare bill passed is the bill as crafted is such a monstrosity that the public is strongly against it.

    Or haven’t you noticed the polls?

  • Evinx

    Just about everyone agrees HCR is needed — it is simply that THIS version of HCR is what is not wanted.

    Passing HCR simply for the sake of passing something — anything — makes no sense.

    How many write a script just bcs the patient is asking for a pill — any pill — to “solve” his problem?

  • http://www.drmintz.com Matthew Mintz, mD

    ninguem,
    That Obama won with so many Americans voting for him is significant. Of course he won on more than one issue, but health care reform was central to his campaign. You may disagree with my opinions on health care reform, but I am not sure how you can argue against these two facts.
    The public is not strongly against health reform. According to a very recent Kaiser Family Foundation poll, though Americans are split, most (regardless of politics) find something they like in the proposed legislation.

    Kaiser Health Tracking Poll — February 2010

    The February Kaiser Health Tracking Poll finds the public still split on health care reform legislation, with 43 percent in favor and 43 percent opposed. However, the poll also finds that majorities of Americans of all political leanings support several provisions in the health reform proposals in Congress and most attribute delays in passing the legislation to political gamesmanship rather than policy disagreements.
    http://www.kff.org/kaiserpolls/8051.cfm

    • http://www.twitter.com/matthewbowdish MatthewBowdish

      The Kaiser Health tracking poll is the only one of many polls, most of which show somewhere around 52-55% against the bill and 43% in favor. See Rasmussen, CNN, WashingtonPost, etc. If you are going to argue that the percentage that voted for Obama is significant, it’s difficult to downplay that roughly the same percentage of Americans is opposed to this HCR bill.

      http://www.washingtonpost.com/wp-dyn/content/article/2010/03/11/AR2010031102904.html

  • onesider

    It it just me or is the fact that you make a grammatical error in the very first point the beginning of the end of your argument?

    Seriously? This bill is nothing more than the largest, most expensive insurance subsidy in history. Just “giving” insurance to the 12-25 million uninsured would be significantly cheaper than this bill… so why spend the extra billions?

    It makes no sense. None whatsoever….

  • T Steadmon

    Is anyone here aware of the reduced payments primary care physicians will get if they refer too much under the new bill? From a recent Washington Times article:

    “As one example, consider the implications of Obamacare’s financial penalty aimed at your doctor if he seeks the expert care he has determined you need. If your doctor is in the top 10 percent of primary care physicians who refer patients to specialists most frequently – no matter how valid the reasons – he will face a 5 percent penalty on all their Medicare reimbursements for the entire year. This scheme is specifically designed to deny you the chance to see a specialist. Each year, the insidious nature of that arbitrary 10 percent rule will make things even worse as 100 percent of doctors try to stay off that list. Many doctors will try to avoid the sickest patients, and others will simply refuse to accept Medicare. Already, 42 percent of doctors have chosen that route, and it will get worse. Your mother’s shiny government-issued Medicare health card is meaningless without doctors who will accept it.”

    -source:
    http://washingtontimes.com/news/2010/mar/11/obama-family-health-care-fracas/

    • http://www.twitter.com/matthewbowdish MatthewBowdish

      Get used to it…The patient will not be making the decisions under the new system.

  • http://www.mcgath.com GaryM

    Your argument amounts to “Things are broken, we’ve got to do something!” But this kind of reasoning generally makes things worse.
    The reason things are broken is not a “free market,” but the opposite: Too much government. Tax pressures and, in Massachusetts, explicit legal requirements, have pushed people into dependency on insurance companies. The patient is not the customer, and the doctor has to be primarily concerned with keeping the customer — the insurance company — happy. This isn’t the way insurance works in a free market. You don’t get oil changes from car insurance, or plumbing maintenance from home insurance.

    But progressives campaign for more and more mandated coverage and requirements to purchase insurance, driving costs higher and increasing the economic wedge between doctor and patient.

    The cure which you offer is to further increase the separation between doctor and patient. More of the disease doesn’t cure the condition.

    We do indeed need “reform” in the way people get medical treatment, but not in the way progressives have hijacked the word. The government should be re-opening ways for people to pay for their own medical care and bypass both insurance companies and government. Congress won’t do this, of course; it would decrease their hold over us.

  • ninguem

    “The public is not strongly against health [financing] reform.” You always leave that word out.

    But hey, no kidding genius. Of course they want health financing reform. So do I. I’d like to see interstate purchase of health insurance. Shadegg bill. I’d like to see more entities use HSA’s the way the State of Indiana does. Given that HSA’s have five years data showing they do work, given they have five years data showing they help rein in cost, they “bend the cost curve” as the policy wonks like to say, and given that the “reforms” contemplated so often try to kill them off, it’s clear that the goal of this Congress is control, not reform, not improvement.

    To say polling shows “Americans want reform” is as insipid as saying Obama got more votes than a politician from a generation ago. What’s the significance of Obama getting more votes than Lincoln?

    What the public doesn’t want is to do something stupid, just for the sake of doing something. That does not seem to slow you down.

  • BobBapaso

    Ah, finally, someone mentioned (in passing) the solution:
    HSA’s.

  • ninguem

    BobBapaso it’s what the current Administration and Congress don’t want to hear. The one thing that has five years supportive data, is the one thing they don’t want to do.

    It puts the healthcare dollar under the control of individuals.

    That’s an existential threat to the left.

  • Tad

    The recent economic stimulus package is a good example of what you end up having to do when you let a problem fester until it becomes a national emergency. We can do something about health care now, or we can do something about it later. But just like the economic stimulus, the longer we wait, the more massive and expensive it’s going to turn out to be.

  • D. Henry

    Did you know that on page 425 of the health reform bill it says that a scheduled meeting every 5 years will have people on Medicare seeing counselors that will tell them the various ways to kill themselves painlessly? Think about it this way. How much are your parents worth to you? More than $400 billion?

  • http://www.birdsonawireblog.com Paula

    D. Henry—-
    I read page 425 of the Senate bill (as passed) and see nothing at all about counselors telling patients how to kill themselves. Read it yourself. You won’t find one word about suicide, death panels, killing oneself or anyone else. Nada.
    That section of the bill provides reimbursement for physicians when they discuss living wills and advance medical directives with elder patients, something everyone of any age should do anyway. For an annotated discussion of that section of the Senate bill, see Wikipedia’s entry at http://en.wikipedia.org/wiki/America's_Affordable_Health_Choices_Act_of_2009
    I’ll happily pay my doc for her time and expertise so we can discuss end-of-life issues long before I need to make important decisions, knowing I might not make good choices in the heat of an emergency situation.

  • Tad

    These bizarre rumors and myths are so easy to look up, I’m amazed people don’t spend the 15 seconds it takes to do so.

    http://www.snopes.com/politics/medical/euthanasia.asp

  • http://fertilityfile.com IVF-MD

    I might be a little late coming to this discussion, but after reading the four arguments cited, I’m surprised.

    1. The current system is worse then broken.
    However terrible the current system is, it is due more to TOO MUCH GOVERNMENT MEDDLING AND CORRUPTION rather than not enough government. So then this is the argument to give up more individual control and hand it over to politicians?? How does that make sense?

    2. If we don’t act now, reform may never happen.
    When I was younger and more naive, I would go buy a car and the salesman would offer me a “special deal”, but hey, if I walked out of that lot without buying no, I may not be able to come back and get the same deal tomorrow. Does this kind of trick really fool anyone anymore?

    3. We are so close.
    Same argument as #2

    4. There are actually some good things that will happen if reform is passed.
    Such as what? Arbitrarily “giving coverage” to everyone sounds deceptively great, but it HAS to come from somewhere. There has to be a cost. Otherwise, why not pass even more “reform” bills giving everyone 5-bedroom homes, lifetime free gasoline, unlimited health care and all-the-ice-cream-you-can-eat.

    Supporters of the bill cite this boost in “coverage” as being an improvement. What good is Medicare-for-all if providers stop taking Medicare? Or if good people stop going into medicine?

    As a physician or if I were an insurance company, I would probably benefit from this bill going through. But I’m also a potential patient as are the members of my family and I care more about our health care options than I do about being in a special-interest group which can take advantage of lobbying the government to help me cheat the public.

  • Cynthia

    I was not too concerned with health care reform until a short time ago. I have good coverage and purchased coverage for my two college aged sons that recently went off my policy. I was concerned with the rising cost for the premiums, co-pays,medications etc but not alarmingly so. That all changed when I went for an appointment and was presented with a new form requiring me to pay the insurance portion of the bill if not paid within 60 days by the insurance company. I was refused as a patient when I would not sign. Most middle class people do not have the funds to cover even one major medical event out of pocket-even if they eventually do recoup the funds from the insurance company. The willingness of doctors to turn away paying patients leads me to believe they can’t be suffering too much, at least not in my area. My respect for doctors and the medical industry in general is suffering due to the current climate. I am starting to feel like the medical community is trying to punish the patients for having insurance. I thought I was being a responsible medical consumer but now I feel it is pointless to plan. The medical industry is shooting itself in the foot. The whole county will be screaming for federalization if this keeps up.