Wednesday, August 12, 2009

Healthcare reform questions

This will probably degenerate into a flame war, but I hope it doesn't. (This one time) stirring the pot is not my intention. :)

I've read through the bills and analyses and I must say, my biggest question is "What problem are we trying to solve?" I know healthcare is "broken" but we all seem to have different definitions of what "broken" means.

It appears that a big goal of the proposed healthcare reform is to reduce the number of uninsured. Is that right? And, if so, will the reform actually achieve that goal? The Whitehouse.gov site says: "Assure affordable, quality health coverage for all Americans" But what does "affordable" mean? I mean if I spend my money on Xbox games, then I can't afford health insurance. So how do we define "affordable" and what makes it not "affordable" today? Will the new plans really be more "affordable"? Why? How? In what way?

My take is that this reform is too much of a compromise and will end up not doing a whole lot, with a lot of potential for unintended consequences. It seems to be more of a health insurance consumer protection act than healthcare reform. As I read it, it sounds like it may help the uninsured at the expense of the rest of us.

Obama has promised, and the proposal states, that if you are satisfied with your current plan, you can keep it. However, your current plan must be a "qualified plan". The New York Times article A Primer on the Details of Health Care Reform quotes Dallas L. Salisbury, president of the Employee Benefit Research Institute, a supposedly nonpartisan group:

“The president and Democrats in Congress are saying what they would like [that people can keep their current insurance]. Their promises may not be literally true because your health plan may change, and your doctor may no longer accept your insurance.”


Regarding all the scare tactics from right-wing crazies about euthanasia and "death panels", even the AARP says “The rumors out there are flat-out lies.” So don't even go there, please.

I am concerned about one of the issues raised by the right-wing (and others): the potential impact to Medicare. Proposed cuts to Medicare account for nearly 40 percent of the bills’ cost (that's a lot of how the reform is so-called "deficit-neutral"). Obama says these cuts will not reduce Medicare benefits, but if you're taking $150 billion out of the system (over 10 years), one has to believe some things will change, that some doctors and hospitals might stop treating medicare patients on the new payment terms, etc.

But again, back to my original question: Can someone tell me what specifically this proposed reform is trying to fix (as opposed to in the general statements from the Whitehouse.gov website like "Improve patient safety and quality of care")?