This post is Part Two of the series, Healthcare: Yes We Can.....But We Probably Won't.
HEALTHCARE REFORM ISSUES
Affordability is a major issue that needs to be addressed. Under the current system, having more money means better access to quality care. No other developed nation allows their wealthy to step to the front of the healthcare line. The Obama administration pays lip service to the idea of making healthcare affordable for everyone, but proposed solutions have not met this goal.Accessibility is another issue. Most privately insured families see a healthcare provider who participates in their insurance plan; choosing a provider who doesn’t participate means paying a much higher percentage of the bill, and often the full amount of the visit. The coverage area for most insurers tends to remain localized, presenting problems for those who move or get sick while traveling on business. Those on Medicaid must see a provider who accepts the plan; providers who don’t are unlikely to see a Medicaid patient for fear that they won’t receive any payment for services rendered. Providers are not required to accept Medicaid, and those that do generally limit the number of Medicaid patients in order to stay solvent. Medicaid programs are operated at the state level, so Medicaid patients have problems receiving medical care if out-of-state; these patients usually can’t afford to pay for care upfront. Pharmacies are prohibited from filling prescriptions written in another state, making it difficult, expensive or impossible to obtain medications while traveling.Coverage is yet another obstacle. No one can guess at what health conditions they may have to deal with in future, nor how much they might cost. Yet even those with very expensive coverage have found that coverage limitations can be the difference between life and death, or a comfortable life and bankruptcy. Thick manuals are published by the health insurance companies, listing specific tests and procedures and types of care, how often they are allowed and cost restrictions. But there always exist segments of the population who may need more of one thing and less of another. Specific limitations don’t work, and too many options raises costs. Lack of care in one area can lead to the need for expensive care in another.
Cost is the final, and perhaps most discussed issue when it comes to reforming healthcare. Everyone is worried about how much it will cost to provide every American with the right to live a healthy life and be treated in the event of illness or accident, and whether or not it will increase their taxes. We need to take a long hard look at expenditures, identify areas of potential savings, ensure sustainability and above all, calculate costs and revenues correctly. Every healthcare proposal should be accompanied by the annual bill. The only costs allowed to be spread over X number of years should be one-time costs of implementation and infrastructure.
OBSTACLES TO HEALTHCARE REFORM
POLITICIANS
One major obstacle is the politicians who try to please everyone and end up pleasing no one. These elected officials forget why they were elected in the first place. They get caught up in the politics, seduced by the money and the power and attention, and neglect their constituents. They forget their campaign promises, reverse positions and brush off the wishes of the people as easily as brushing off a pesky fly. Their solutions, which place the wants of special interests within the healthcare industry above the needs of the people, are expensive, cost more than advertised, are more complicated than necessary and don’t work for every citizen.
SPECIAL-INTEREST GROUPS
Another obstacle is that of well-funded special interest groups, who pay lobbyists obscene sums of money to convince legislators to come around to their point of view. These groups wield their money like a vicious sword, donating generously to the politician facing re-election if they decide to vote for legislation favorable to the interest, and donating even more generously to that politician’s future campaign opponents if they refuse. In 2008, the insurance industry ranked 8th among industries in terms of monetary political contributions to candidates, giving over $28 million almost equally to Republicans (49%)and Democrats (51%).
These days, the poorly funded candidate is the losing candidate. By controlling the money, special interest groups can place the candidate more likely to vote for legislation favoring the group into positions of power.
THE PUBLIC AND MEDIA
Possibly the largest problem is the general apathy of the American public. Those from whom we descended wouldn’t simply allow the politicians to do whatever they wished; if they had, women would still be second class citizens without the right to vote, and blacks would still be slaves without political voice, individually accounting for less than a whole human being. The media bears some responsibility as well, for merely parroting what they are told and failing to thoroughly investigate or present oppositional viewpoints. There’s enough blame to go around when unpopular legislation is passed, but the most blame resides with us, for failing to educate ourselves on the issues and options, and exercise our power and civic responsibilities. We need to again become the pesky, persistent fly, buzzing loudly to the media about repeated brush-offs, never relenting in the campaign to make our voices heard. We need to become active and make our opinions clear, by flooding the media and elected officials with letters, emails, phone calls, visits and demonstrations, and continue even after passage in order to have legislation that is not in accordance with the wishes of the majority of Americans repealed.
LACK OF KNOWLEDGE
Another issue is that those making laws simply do not understand the details our current healthcare system involves. They do not fully understand the way things work or the problems that practitioners and facilities face. Advisors don’t fully understand either; due to the magnitude of the industry, there’s really no way for those who haven’t been involved at numerous levels and various areas to understand well enough to explain the realities to others. And if they don’t fully understand all the issues, they cannot formulate solutions that will address every problem.
For instance, the Obama administration wants to emphasize preventative care. President Obama campaigned on the healthcare issue by promising $2500 per family in healthcare savings. It sounded good, but what most Americans didn’t understand was that this savings wasn’t real. Obama wasn’t promising to give us $2500 per family; he believed that by passing legislation to require more preventative care, savings would be realized by private healthcare insurers, who would then pass those savings on to the consumer. While he probably meant well, Obama’s failure to understand the private insurance industry made his plan for healthcare meaningless.
Private health insurers already emphasize preventative care. They know that preventative care for certain conditions (high blood pressure, diabetes, etc.) is much less expensive than treating problems after the fact. Private insurance plans include everything from access to free condition-specific education and smoking cessation programs with financial incentives for attendance, to nutritionists, free annual and well-child physicals, free prenatal visits and even full or partial reimbursement for healthclub/gym memberships. So, passing legislation to require preventative care is completely pointless.
Private insurers are saving money from preventative care. Though the data is difficult to find, we know this in part because private insurers operate for profit, and it is highly unlikely that their shareholders are going to be happy about cutting profits to fund programs that aren’t necessary (from a contractual viewpoint). However, private health insurance premiums increase substantially every year. None of these savings realized by the insurer are being passed on to subscribers. There was no provision in Obama’s plan to force insurers to share savings with consumers, and it would be extremely difficult to word legislation of this type. Therefore, it was rather silly of him to assume that savings would be passed on; had Obama been better informed, he may have had time to develop a healthcare plan that actually works.
So what we have are lawyers and politicians making laws to fix a system that they don’t understand. How likely is it that they will be able to formulate a comprehensive plan for healthcare that actually works?
VIEWING HEALTHCARE AS AN INDUSTRY
Workable healthcare reform would be simpler if we shifted our view from healthcare as an industry to healthcare as a basic human right. Healthcare should not be viewed as an opportunity to make money, but as an opportunity to improve the health and quality of life for American citizens. Politicians and capitalists worry about putting the private health insurance industry out of business. But shouldn’t the right to live a healthy life trump profit?
PRIDE AND PORK
Elected officials like to tack on additional spending provisions to every piece of legislation, some totally unrelated to the original bill. Adding these unnecessary measures takes time, costs money, makes it less likely that those voting on the bill will actually read it prior to voting, and makes the whole endeavor far more complicated and expensive than it needs to be.
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Farleftside
MeatMonkey
Dr William Lee
Dennis Loo
Mike Lucier
Dan O'Mahony
Salon.com
Comments
I agree, for-profit healthcare will never be the best solution. I've pesonally seen the results when a nusing home changed from a non-profit to a "for-profit." Lower wages, less choice of supplies and less of them, fewer staff, worse care (and less of it). Placing profit ahead of lives is not what this country is supposed to be about. Our Constitution charges us with "promoting the general welfare". Nowhere in the Constitution does it say that we must adhere to capitalism.