normalizing it all

Health care reform of some sort is in the making for this year. The shaping of it probably should not be a political issue, but should be instead an informed decision made with wisdom.

Before medical procedures are performed a consent form called “informed consent” is read, (mostly) understood, agreed to, and signed. All speakers at medical conferences and authors of articles appearning in medical journals are required to disclose conflicts of interest before speaking or publishing. These declarations are made in public, in clear and open view of all. The declaration appears on the first page of each journal article and in programs and from the podium prior to each lecture, by the lecturer.

Our discussion of these issues both in the media and among members of congress and others with specific axes to grind and political preferences are not obligated to make any disclosures. From the democratic congress person receiving mega bucks to the republican senator receiving similar funds for campaigns, there is no requirement before making a statement to announce how much financial support they have received. Former members of congress do not make these declarations nor do they state what boards they sit on or organizations they’ve founded.  The news media does not state what their interests and conflicts are.

Yet, this debate should be beyond conservative and liberal. It should be between sense and nonsense. It should be what will be the best possible system in all regards versus a system of appearances that serves only those with the most money to spend lobbying and the most money to make. The debate between single payer and traditional insurance is over. We do need to consider though including a public option within the reform we will be making.

The obvious necessities will be in this plan. Elimination of prior existing condition clauses, better control of health care savings programs, and a wider, geographically based,  more inclusive amortization of costs will likely be implemented. These could have been implemented years ago. The usual recent buzzing issues that will be included are electronic record keeping, decrease in over utilization of tests and radiology services, and decrease billing  and other fraud within the healthcare system. This year physicians are required to make sure that their patients do not appear to be committing identity theft. We’ll see what next year brings.

A public insurance option be made available would set a minimal standard and put some pressure on the insurance industry to conform to at least this minimal standard and  to do so without deception in all of their plans. Some have declared that a government plan will cost people little but provide bad care. People don’t want bad care, although they would like less expensive care. Many have learned that cheap and bad care are not worth much at all, and would  be happy with something that works, is trustworthy, and isn’t necessarily at a rock bottom price. Newt Gingrich is now a prominent spokesperson on health care reform. He is one who has often stated that a government run health care program will be too expensive to the nation and provide miserable care for patients. He has recently amended that to also declare that it would drive insurers out of the market place.

Appearing recently on MSNBC  Gingrich said, “I think when the average American looks at the idea that we’re going to have a government bureaucrat decide whether you get, or your daughter, or your granddaughter gets the treatment you need, if you look at the death rate from breast cancer in Great Britain and the death rate from breast cancer here, I don’t think that’s a model we’re going to accept.”

The reality is that there is no way that traditional insurers will be eliminated. There is much they can do to make their programs attractive and have sufficient value added service to make them desirable for many. I do have a fair number of ideas on what they can do to be more attractive than a government run system, and I’m sure they have others making suggestions. They also have considerable power to market and to lobby and to even join the organization the Newt Gingrich founded the “Center For Healthcare Transformation”. The corporate members and even the existence of this organization is not often mentioned, if ever, when Gingrich is quoted in the media or appearing on a news show. The corporate members are not an absolute secret. A list is available online.

There is no need for traditional insurers to fear for their existence. They will survive, live long and likely prosper.

But for many people another option is required and that option is a public health care option. It shouldn’t and won’t be free but some will feel more comfortable within that system than what they have experienced within the current traditional system. The next area of concern is how to pay for it. Certainly part of the cost, and perhaps much of it may be borne by those who buy in to the plan. And that is how it should be. Do we need to increase taxes elsewhere? Do we need to tax other peoples health care plans? To me taxing others health care plans does not make sense.

A public option for health care does not have to follow any other model precisely. It doesn’t need to follow Canada, Switzerland, Sweden or the U.K. We have a specific set of expectations from our health care system that are different from our friends and neighbors. And “Freedom of choice” is a resonant slogan. We can work in freedom of choice, carefully defined benefits, prescription drug coverage, and choice into a plan.

How else can we cut costs? One way is to decrease the cost involved in caring for chronic disease. But, let’s save that for an upcoming blog. And, I’ll bet fitness and healthy lifestyle choices come into play. In the meantime, ask not what your health insurance company can do for you, ask what it will take to get some more options.

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