Health Care Reform ~ Answering a Niece's Questions...

I recently received an email from my 20-something year old niece, who Cc'd: her email to other important adult family members (such as her mother and our father [her grandfather])...

Here's what she wrote:

Subject: I need your opinion

Would you mind answering this question? I need a few opinions on the subject (short)..

Do you believe that the approach to health care in the US constitutes a social problem? Is our health care system in need of reform? Why or why not? What type of reform would you advocate?

Thanks so much!!

Love
A.

Here's my response back to her:

I agree with my dad, that no answer to your question can be short and also address your query,
"Why" or "Why not"

So I will do my best to be concise rather than brief.

As a health care provider and business woman, I have a different slant on the entire issue of healthcare reform, and all that these issues create in the way of debate and dialogue. Being intimately involved in helping families to pay for their maternity care, for example, and participating in their struggle to get their insurance to pay for their care. causes me a great deal of angst & aggravation.
Helping clients to make their best health care dollar choices is the most frustrating. Many people decide that paying a "small co-pay" to the doctor and hospital is "better" than paying me $3000. But in reality, they often end up paying thousands of dollars more than my $3000 fee for a birth experience that is FAR and AWAY different from that which they desired and hoped for.

I have to work extra hours "proving" to insurance that they should pay my assistant fee of $700 because her attendance at the birth is essential to delivering quality, safe care to my client. Yet they are just fine with paying for a epidural ($800 - $1200) despite the fact that it increases the risk of birth and neonatal complications.... I could go on with this rant and tangent, but I shall move on...

You asked: Do you believe that the approach to health care in the US constitutes a social problem?

Absolutely!! The distribution of quality health care in the US is most certainly a social problem. Both Medicare and Medicaid recipients, as well as those without insurance, suffer the most. Their healthcare needs are met, yes, but often at substandard levels of quality. At the delivery point, meaning the care given by nurses and doctors, the attitude has become insensitive and unsympathetic. The
work of caring for and helping people to be well and healthy as been replaced with callousness, cynicism, impatience, lack of compassion, and an overall disregard for a patient's rights. This is no more evident than in the emergency rooms across our country. People wait of hours, sometimes giving birth, collapsing, or even dying in ER waiting room! A social problem... most certainly.

You asked: Is our health care system in need of reform? Why or why not?

Of course it is in need of reform! Why?

* The United States is the only wealthy, industrialized nation that does not ensure that all citizens have health care insurance coverage. At least 15% of the population is completely uninsured and a substantial additional portion of the population is "under-insured", or less than fully insured for medical costs they might incur. That lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States, according to the Institute of Medicine; while a 2009 Harvard study published in the American Journal of Public Health found a much higher figure of more than 44,800 excess deaths annually in the United States due to Americans lacking health insurance.
* The US health care system does not deliver equivalent value for the money spent. More money per person is spent on health care in the United States than in any other nation in the world, and a greater percentage of total income in the nation is spent on health care than in any other United Nations member state except East Timor. Despite the fact that not all citizens are covered, the US has the third highest public health care expenditure per capita. And medical debt is the principal cause of personal bankruptcy in the US.
* The US pays twice as much yet lags behind other wealthy nations in such measures as infant mortality and life expectancy. Currently the U.S. has a higher infant mortality rate than most of the world's industrialized nations. The USA's life expectancy lags 42nd in the world, after most rich nations, lagging last of the G5 nations: (Japan, France, Germany, UK, USA) and just after Chile (35th) and Cuba (37th)!

And there are plenty of other reasons beyond these bullet points. Here is a very good article on understanding health care reform from a business perspective:
Understanding Healthcare Reform ~ Rethinking the Business of How Americans Receive Their Healthcare

You asked: What type of reform would you advocate?

Now THAT is THE question isn't it? That is exactly what all the wrangling is about. Private sector, Gov't option? Universal Coverage? And HOW do we do that?
The debate stems from basic questions:

* Is health care a constitutional right? Or...
* Is health care a responsibility or obligation, meaning an individual must purchase it for herself and her family like we do for food or shelter?
* Should access to care be equitable, despite of income, socio-economic status, prestige or class? (i.e. Should the child of an unskilled hourly worker have access to the same care options as the CEO of a large corporation, or a U.S. Congress member, or a retired union member? Should the child of a corporate CEO have access to better quality care than the child of a laborer?)

I am of the opinion that health care is NOT a constitutional right (meaning that the government must provide it).

My rational: the framers of the Constitution were smart enough to simply state that one of the main goals of government is to “promote the general welfare” of its citizens.

More specifically the 10th Amendment to the Constitution states:

"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."

This will be used by the citizenry to challenge the current health reform bill as unconstitutional. Forcing a citizen to buy health insurance and fining those who do not, is unconstitutional, pure and simple.

What do I support?

* Health Insurance Industry Regulation ~ more regulatory control over the business/industry of Health Insurance so that people have easier access to coverage, and so that the services that they desire can be rendered by the provider of their choice, in the facility/place of their choice, and that the costs are controlled so that the bill is paid by insurance without question about the service or its veracity;
* Tort Reform ~ caps on the amount that can be sued for, limiting "defensive medicine" practice, and eliminating frivolous lawsuits,
* Easier Access as a Medicaid Provider ~ making easier for licensed providers like myself to become Medicaid providers and get paid for services rendered,
* Cost Transparency ~ currently patients have little idea of what health care really costs, which is considered to be one of the reasons health care in the United States is so expensive,
* Controlling Billing fraud and Overcharging for Services ~ this takes place in both government payment systems and private
* Controlling the costs of drugs & devices ~ Patients in the United States pay more for drugs and medical devices than patients anywhere else in the world
* Prohibiting Payments to Doctors and other health care providers by pharmaceutical companies and medical device companies
* Transparency in Error Reporting ~ Medical error transparency will improve safety. Safer health care leads to fewer lawsuits which then means lower healthcare costs overall.
* Reducing Prescription Drug & Medical Procedure Errors ~ Clearly, patient safety must be considered among the many issues in health care reform. It's ties to the cost of care, malpractice suits,etc... are important in the bigger picture.

Not a short or easy answer... but I took that time to give you one.

Smooch!
Kim