Health Care Systems/Delivery 14 Aug 2009 01:24 pm
The U.S. Health Care Debate: Is There Really A Debate?
Over the past few months I have grown increasingly dismayed by the so-called “debate” on reforming the U.S. health care system. In my opinion, what started as a mostly civilized discussion, has devolved into chaos; it would be nonsense to describe the current goings on as meaningful discussions and clearly not a debate in the usual sense of the word.
I have been astonished at many of the statements I had heard from what I had formerly thought were reasonably intelligent elected officials. I have been no less amazed at the statements from the general citizenry; the amount of misinformation out there is now almost impossible to counter with truth.
Here I am not trying to “peddle” any particular health can plan but only that some degree of sanity enter into the discussions. In my opinion, the problem is two-fold. First it’s that those satisfied with the status quo (insurers, pharmaceutical companies, consumers who are satisfied with their health insurance, etc.) don’t want to risk any meaningful changes in the health care system. Maybe they aren’t entirely happy with the status quo, but they fear that any changes in the system will be much, much worse. What is that expression, something like “the devil you know is better than the one you don’t?” The second aspect of the problem is that politics have gotten in the middle of things (big surprise). It is clear that President Obama really wants health care reform. Those opposed to his presidency, believe that failure of the President to achieve his health care reform goals will “bring him down.”
I have no idea how things will end up. I am not optimistic that anything good will rise out of the mess. If I were running the show, I would back up and start over. The first thing we need is a small group of experts to lay out a blueprint for a health care system as it would exist in the future. The blueprint needs to deal with all of the current components of the system including private insurance, Medicaid, Medicare, the VA system, the U.S. Military health care system (troops and their families), and those people currently without any health care coverage. We need to consider how all of these components would fit together or at least coexist. We also need to consider how we would cut costs and slow the rate of future cost increases since, we can’t possibly afford universal health care without controlling costs. We also need to decide how we would pay for health care. There aren’t many options- a payroll tax, higher income taxes, a national sales tax, that’s about it. We haven’t had these critical discussions yet (call it a debate if you wish) and we can’t really move forward without a comprehensive look at what the experts think the system should look like when it’s all put together in about 20 years (if we’re lucky).
on 14 Aug 2009 at 1:39 pm 1.Steve West said …
Wouldn’t it be a good thing if we simply utilized free market principles to health care. We can start by doing away with Medicare which has increased the number of specialists as well as utilization of expensive procedures that the patient would never utilize were they responsible for the costs. After dissolving medicare we can do away with the OSHA, CLIA, HIPPA, the FDA, the licensing boards and other agencies which confer benefits so small that they can never even hope to approach their costs. Many economists blame the FDA for withholding or delaying many useful drugs as well as requiring inane studies that raise drug costs. I’m sure you are aware that last year’s flu vaccine shortage was due to FDA incompetence and arrogance.
on 30 Aug 2009 at 2:20 am 2.endodoc said …
thanks for your comment. We must not forget that Medicare started as a pre-pay health insurance plan (remember all thos payroll taxes). the problem is that the progfram design did not take into account the astonishing rise in health care costs. I think Medicare “premiums,” money from payroll taxes and individual payments for Parts B and D of Medicare cover only about 10-15% of current costs. I’m not sure we need to doaway with Medicare but we certainly need to change it rather drastically and rather soon.