Wednesday, August 12, 2009

Feeling ill

Here's the basic problem with health care reform in this country:

Something around three-quarters of Americans get good quality health care right now, and they don't want to change it. They don't want to go bankrupt in the face of a major medical crisis, so they are happy that they are covered through insurance via their employer -- even if they have to kick in up to 25 percent of the cost of premiums.

How, then, does anyone bring major changes to a situation in which a wide majority are satisfied customers?

You don't, at least not easily.

That strikes me as the key point in the discussion. When the Clinton Administration tried to make some fundamental changes back in the 1990's, it was shouted down quite quickly. This summer's debate has echoes of those discussions.

There are other factors floating around in the current argument. There is plenty of money at stake here, and the lobbying about where it might go -- particularly in the formative stages of legislation -- is frantic. That leads to misinformation about current plans.

I particularly like the idea that some sort of federal panel will decide whether you live or die under a proposed bill; the reality is that Medicare would simply offer counseling for end-of-life circumstances at least once every five years. It's an added benefit, not a death sentence.

But tell that to former Alaska Governor Sarah Palin, who issued a statement saying, "The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil."

Then there's the matter of the cost of any new health care reform package, which as far as I can tell is unknown at this point. Claims about the number, however, are all over the map, perhaps because nothing has been written in stone yet. We're a little leary of a government program that could, emphasis on could, cost billions and billions over the next decade, particularly in the light of recent government moves into private business like automobile manufacturing and banking.

Plus, there's still some left-over steam about the election from the right. You remember the talk last fall that Obama would put us on the road to socialism, and the usual media outlets are still blabbing about this -- again, without knowing what the final reform might look like.

Even those in good health in the current system, though, realize that we have some big problems. As Glenn Locke pointed out in his blog, you're only as secure as your job, and you may have learned just how secure you are in the past 18 months. There's the issue that some administrator in an office in Nowhereville can decide your preconditions disqualify you from health care, without your having an appeal.

And that doesn't include such matters as doctors who are so afraid of being sued that they order unnecessary tests just to cover themselves. Or of the poor who can't afford to get basic checkups under the current rules but have to get expensive emergency care that the rest of us end up paying for. Or people who lose insurance simply by moving to another state.

The idea of discussing all of this strikes me as healthy. A rational discussion about benefits and costs sure is a good idea. This Wall Street Journal article from today seems like a valuable addition to the dialogue.

But what has been shown at "town hall" meetings with representatives has been far less than that. Some of the citizens have come across as rude, uninformed, and unwilling to listen. It takes all types, which -- as I'm fond of saying -- is a shame.

It makes me a little ill to hear the nasty tone of the conversation. Good thing I have health insurance.


Suzie said...

Very well put. It's nice to see that the Fear Mongers from the Bush administrations still have their jobs (and likely their health insurance). I was recently without health insurance for a time, and discovered that two of my seven prescriptions cost more than $300 per month each ($500.39. Because $500 just isn't enough.) My doctor kept me hopped up on free samples until my new policy started - not exactly a long-term or global solution. I think of the tenants I used to defend in evictions, the ones I'd see again and again every few months. Because what else do you do when the medication you absolutely need costs as much as your rent?

Suzie said...

And here's a friend's blog on the uninformed people who are yelling the loudest at the town halls: