September 2012
Why I support Healthcare reform
21/09/12 12:10
I want to share the reason I support health care reform. It's based upon my experience and my reflections, so it's very personal. I believe the status quo isn't working, and the reasons for change are compelling.
My mother worked as a nurse, and was adamant that (among other things), we should always be covered for health care. So I have been. It was fine up until I was laid off in 2001. When COBRA ran out, I found out that while they'd give us a family plan, they wouldn't cover my lad under that plan, and that while they were required to provide a plan for him under HIPAA, it didn't have as good a coverage as the rest of us had. He was a second class citizen in this country where "all...are created equal"!
It's not like he's got a serious problem. He has what's known as a Ventricular Septal Defect (VSD), colloquially known as a heart murmur. In his case, it's a small hole in the wall of his heart. It's not getting bigger, it's causing no complications, and doctors tell us not to operate, that it's fine. However, the HMO doesn't want to cover him unless we cut into his healthy young body! That's just bad craziness.
Then, of course, our insurance rates went up 400% in 4 years, now rivaling our mortgage (and we live in California). It's not like the quality of our care went up, or the cost of living, or our income, just the rates. It's hard to budget when you've got such an inequitable rise, and it's hard to countenance.
Now, to put this in context, we lived overseas in Australia for 7 years. Let me tell you about their healthcare system. You see the doctor you want, and get the treatment you need. It cost each of us 1.5% of our salary (yes, you read that right), and that doesn't vary much by governmental administration. But it does vary by your income. Everyone's covered. Period.
The system is single payer, reducing the redundant processing we see across providers here. And, yes, there are a (very) few horror stories. Note that we see the same here, and probably more! Certainly not people being cut off from coverage when they need it most, or not able to get coverage. And you can get private health insurance on top of the base level if you want, that lets you get private rooms and other benefits. We got it when m'lady was pregnant with the lad, just to be on the safe side. I don't think many Australians would change their health system for ours!
It works for every Australian, but it also works for Australian business as well. They don't have to worry about providing healthcare, and consequently they are more competitive than they would be otherwise. And there is a role for private insurers, too. So it's not stifling business, and yet it's also not leaving anyone in the lurch.
Compare that to the US, which doesn't seem to be working for much of anyone except the shareholders in health care and medical providers (e.g. pharmaceutical companies). The non-insured and the 'uninsurable' aren't covered. The self-insured can't cope with the costs. The employees with health coverage are being asked to shoulder more and more of the cost, and companies are finding the increasing costs undermining their competitiveness. And doctors are being pressured to take more patients, live with more constraints, and face ever more complicated billing procedures.
Of course, I understand the fear of government intervention. And the fear of the associated costs. But, logically, the upside overwhelms the potential downside. Everyone covered at a rate that they can afford and doesn’t burden business success. Quality? I felt the quality in Australia was the equal of the care I get here. Actually, slightly better since the doctors weren't so pressured to service more and more patients in the same time due to reimbursement rates, and their overhead wasn't as slammed by multiple billing requirements.
And we're ignoring that the costs of the uninsured are being born by the rest of us one way or another. Really, single payer is the right solution, because the savings from removing redundant administration would offset any inefficiencies. Given that single-payer seems to be politically too big a step, a public option is our only other course of action.
I know some say that we could just regulate the existing health care companies to get what we need: cost reductions, full coverage, no denials. And that there's more we could do by facilitating competition. I agree that we could do more, but I'm beyond that point. My response is that we've had a long period of little regulation and opportunities for competition, and the companies have blocked competition and stifled regulation. At this point, frankly, I just don't trust the free market, at least in this instance. We don't have, and aren't likely to get, the openness we'd need without a legitimate public competitor.
It finally comes down to whether you believe healthcare is something that should be part of the infrastructure or not. You certainly do have infrastructure provided by the government in other areas, even if you complain about paying for it: interstate highways, mail, defense, and lots more. However, it seems clear to me that no one, particularly children, have a choice in needing healthcare, and therefore it should be a national responsibility. I believe that the rest of the developed world is showing us that. As I told you, this is a personal note, and this is what I believe is logical and right.
UPDATE: We've had the Affordable Care Act of late (aka Obamacare), and it's been a great improvement. It's provided plans with necessary minimum guarantees, kept costs down, and covered those who had pre-existing conditions (like my son). The current threats to it are worrying for sure.
My mother worked as a nurse, and was adamant that (among other things), we should always be covered for health care. So I have been. It was fine up until I was laid off in 2001. When COBRA ran out, I found out that while they'd give us a family plan, they wouldn't cover my lad under that plan, and that while they were required to provide a plan for him under HIPAA, it didn't have as good a coverage as the rest of us had. He was a second class citizen in this country where "all...are created equal"!
It's not like he's got a serious problem. He has what's known as a Ventricular Septal Defect (VSD), colloquially known as a heart murmur. In his case, it's a small hole in the wall of his heart. It's not getting bigger, it's causing no complications, and doctors tell us not to operate, that it's fine. However, the HMO doesn't want to cover him unless we cut into his healthy young body! That's just bad craziness.
Then, of course, our insurance rates went up 400% in 4 years, now rivaling our mortgage (and we live in California). It's not like the quality of our care went up, or the cost of living, or our income, just the rates. It's hard to budget when you've got such an inequitable rise, and it's hard to countenance.
Now, to put this in context, we lived overseas in Australia for 7 years. Let me tell you about their healthcare system. You see the doctor you want, and get the treatment you need. It cost each of us 1.5% of our salary (yes, you read that right), and that doesn't vary much by governmental administration. But it does vary by your income. Everyone's covered. Period.
The system is single payer, reducing the redundant processing we see across providers here. And, yes, there are a (very) few horror stories. Note that we see the same here, and probably more! Certainly not people being cut off from coverage when they need it most, or not able to get coverage. And you can get private health insurance on top of the base level if you want, that lets you get private rooms and other benefits. We got it when m'lady was pregnant with the lad, just to be on the safe side. I don't think many Australians would change their health system for ours!
It works for every Australian, but it also works for Australian business as well. They don't have to worry about providing healthcare, and consequently they are more competitive than they would be otherwise. And there is a role for private insurers, too. So it's not stifling business, and yet it's also not leaving anyone in the lurch.
Compare that to the US, which doesn't seem to be working for much of anyone except the shareholders in health care and medical providers (e.g. pharmaceutical companies). The non-insured and the 'uninsurable' aren't covered. The self-insured can't cope with the costs. The employees with health coverage are being asked to shoulder more and more of the cost, and companies are finding the increasing costs undermining their competitiveness. And doctors are being pressured to take more patients, live with more constraints, and face ever more complicated billing procedures.
Of course, I understand the fear of government intervention. And the fear of the associated costs. But, logically, the upside overwhelms the potential downside. Everyone covered at a rate that they can afford and doesn’t burden business success. Quality? I felt the quality in Australia was the equal of the care I get here. Actually, slightly better since the doctors weren't so pressured to service more and more patients in the same time due to reimbursement rates, and their overhead wasn't as slammed by multiple billing requirements.
And we're ignoring that the costs of the uninsured are being born by the rest of us one way or another. Really, single payer is the right solution, because the savings from removing redundant administration would offset any inefficiencies. Given that single-payer seems to be politically too big a step, a public option is our only other course of action.
I know some say that we could just regulate the existing health care companies to get what we need: cost reductions, full coverage, no denials. And that there's more we could do by facilitating competition. I agree that we could do more, but I'm beyond that point. My response is that we've had a long period of little regulation and opportunities for competition, and the companies have blocked competition and stifled regulation. At this point, frankly, I just don't trust the free market, at least in this instance. We don't have, and aren't likely to get, the openness we'd need without a legitimate public competitor.
It finally comes down to whether you believe healthcare is something that should be part of the infrastructure or not. You certainly do have infrastructure provided by the government in other areas, even if you complain about paying for it: interstate highways, mail, defense, and lots more. However, it seems clear to me that no one, particularly children, have a choice in needing healthcare, and therefore it should be a national responsibility. I believe that the rest of the developed world is showing us that. As I told you, this is a personal note, and this is what I believe is logical and right.
UPDATE: We've had the Affordable Care Act of late (aka Obamacare), and it's been a great improvement. It's provided plans with necessary minimum guarantees, kept costs down, and covered those who had pre-existing conditions (like my son). The current threats to it are worrying for sure.
