Thoughts about Health Care Reform

As a holistic health professional I am very interested in the future of health care and in the current debate regarding health care reform.  In striving to understand what is at stake, what is being proposed and how I feel about all of it I have hit several roadblocks in my understanding.  I heard questions raised about whether the government offering a public health care option would be socialist (but we have a public option in the education sector – our public schools and universities – and that hasn’t put private schools out of business).  I also heard concerns about whether a public option would create a poor standard of care (but our standard of care in the U.S. already ranks so low and isn’t competition-even if it’s federal- supposed to drive innovation).

I was having a hard time finding some specific answers to my questions regarding the health care debate and the 1,000+ pg bill that our representatives are currently considering.  It seemed that all I could find out from the “mainstream media” about the debate (and the bill it is about) was political rhetoric from both sides and about the powerful PhRMA lobby against the bill (and how many millions they are spending a week to ensure it does not get passed).  I turned to my old trusted standby npr.org and there I found a thoughtful discussion about the health care debate and enlightening information about the bill.  For instance, I didn’t know that the bill before Congress included vision and dental coverage, did you?

I invite you to take a listen to the near 20 minute discussion that Terry Gross of Fresh Air had with Maggie Mahar, a Century Foundation fellow and author of Money-Driven Medicine: The Real Reason Healthcare Costs So Much, as well as former financial journalist for Institutional Investor, The New York Times, Barron’s and Bloomberg, writer of the Healthbeat blog, a Century Foundation project, and contributor to Dartmouth Medicine, covering Medicare spending and the possibility of reform.  Here is a link to the npr interview:  http://www.npr.org/templates/story/story.php?storyId=111063048

I’ve included a few key points from the interview that I found worth sharing.  The most prominent of which was Ms. Mahar’s response to why, in her opinion, health care doesn’t work when left up to free market capitalism, as most of our society here in the U.S. is.  She says,

“In health care, market forces don’t bring prices down. We’ve seen that everything becomes more expensive every year: drugs, hospital stays. In other markets, the consumer has the power to bring prices down as producers compete with each because the consumer can say, you know, that laptop is a little expensive. I’m going to wait until a competitor, a rival, comes out with a less-expensive laptop that will meet my needs.

When you’re sick, you can’t say I’ll wait until a less-expensive cancer drug comes out. Eighty percent of our health care dollars are spent on patients who are seriously ill, suffering from chronic diseases like cancer. They don’t have the choice to wait.

They need what they need at that moment, and so they can’t help bring prices down by comparison shopping, by putting off the purchase, by any of those things. They essentially have to take whatever it is that the doctor or the hospital tells them that they need at that time.”

Ms. Mahar, also stressed that we need a shift from quantity of care (which is the current system, because it determines how much income doctors, hospitals and drug companies make) to one that emphasizes quality which she defines as “ good outcomes.”  She says that in the quantity model tests and treatments are ordered that “provide no benefit” but expose patients to risks.  She reminds us that “Up until now, insurers have largely focused on keeping their costs down, and not so much on encouraging the highest-quality care from their providers. But that is going to have to be their focus if they want to compete with the public sector option and survive.”

Besides, we have to research the alternative to reform; the status quo.  As Kathy Sebelius, Secretary of Health and Human Services, said repeatedly in her interview with Jon Stewart http://www.thedailyshow.com/full-episodes/233134/wed-july-15-2009-kathleen-sebelius the proposed reform is foremost about driving costs down for everyone, not just about providing coverage to those who don’t have it.

Ms. Mahar’s voice echoed the same sentiment, “you have to remember what the president said in a recent press conference, which is the system we have now is a plan where costs are going to double in the next 10 years, and many of you who now have insurance will find yourself uninsured, alone in a market where you have to, somehow or another, come up with the money to pay for insurance that is twice as costly as it is today. That’s the alternative to health care reform.”

Hoping to hear your thoughts on this important issue and wishing you lasting balance always,

Jenica

Tags: Health Care