Tuesday, August 18, 2009

A Reasonable Discussion on Health Care

Even our Narcissist-in-Chief, Barack Obama, is showing signs of recognition that the government takeover of Health Care in the United States is strongly opposed by the people. Opposed enough that the totalitarians who tried to shove this treachery through Congress are finding their own political careers in jeopardy, which is the sole language to which they would listen. The prospect of a major shift in Congressional control in 2010 has finally convinced the political con artists to back off this abomination just a bit.

This opens the door to a more rational discussion about Health Care, what is really needed and what can really be done. There are certain ideals which each side desires, but the practical limits offer a small range of options. Even so, an opportunity now exists to arrive at a better solution, one which is realistic and which listens to the public.

There are many special interest groups in any debate about Health Care, which is no surprise given the money concerned and the number of people affected. To begin, it should be obvious that the public will not countenance government-run Health Care. The ‘single payer’ option is unacceptable and the Obama Administration had better accept that fact. However, at some point it is also necessary to accept that major changes are necessary for American Health Care to remain as effective as it is today. It seems strange, given the political indifference to the blunders of Social Security and the Income Tax Code, but for once the government is a bit ahead of the curve in seeking a reformation of the industry in Health Care.

A bit of background here, and something like full disclosure. I worked for five years in Health Care, at an independent third-party administrator of medical claims. That is, it was my job to determine if an insurance claim was valid under the terms of the insurance company’s contract with the medical provider, and – in order of priority – to protect the patient, medical provider, and insurance company’s respective rights under the network provisions. I also performed field audits to insure compliance by medical providers and facilities with their promised levels of accessibility and performance. Also, on the other side of things I am a cancer survivor and a patient at M.D. Anderson Cancer Center in Houston, having been diagnosed in 2006 with pseudomyxoma peritonei, a form of abdominal cancer – specifically known as a non-carcinoid neoplasm of the appendix. My condition is treatable but not curable, and therefore I must plan on a very long term prognosis, one which is promising but at the same time a permanent condition. Consequently, I am very familiar with the needs and concerns of those patients whose conditions are rare and unlikely to be mentioned at all in a one-size-fits-all plan. I know for a fact that neither Medicare nor Medicaid would cover the treatment for my condition, and as a result a national plan built on the foundation of Medicare would be, by definition, unacceptable to me.

That said, I do think a long and detailed discussion about what is needed and how it should be paid for is a good idea. Now that Obamacare has been clearly shown to be unacceptable, it seems appropriate to suggest a better plan. That plan, I think, would best be found by considering and addressing the patients not properly covered by the present system, and by proposing, a la carte I should think, means by which the industry might move forward, such as improving the primary-care to specialist balance among professionals and allowing patients more tax benefits for making effective use of their preventive care options. But the conversation is best served by broad participation, rather than a few dictating terms to the rest.

1 comment:

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