The Health Care Debate

There seem to be two significant debates going on right now in Congress and on the talk shows: Health Care and Torture. Here are my thoughts on health care:

The health care issue is about access to quality care. It is not about who has the best “Health Care System” in the world. One hears those on the right decrying a government takeover of the best health care system. I do not think that is the issue. It seems to me that we in this country do have the best doctors, hospitals, staffs, equipment, etc., the world has known for dealing with medical issues. The problem is that we have no system for accessing that exceptional health care.

An argument frequently trotted out is that if our system is so bad, how come people from all over the world come here for health care? The answer is they don’t. The people that come from other parts of the world are those from countries that do not have adequate health care. And the people that come here to the Mayo Clinic are among the wealthiest people in the world. Those who have a public plan such as most of Europe, do not come here. The Canadians do not come here. Wait! Isn’t Canada where everyone hates their plan because they have to wait in lines and can’t get good care? Then why are they not coming here?

The other side of that coin is why are our citizens traveling to India and other exotic locations for surgery? That is becoming a big business for India and the care is outstanding and the cost is reasonable.

Those against reform say that the government will only screw it up - that the government cannot manage anything well. These same people acknowledge that In America, we can do anything. I believe that is correct and that if there are significant flaws in the British or Canadian systems, we can learn from them and work around them.

I hear people complaining about putting a government bureaucrat between me and my doctor. I don’t want that any more than the next person. I also don’t want an insurance bureaucrat between me and my doctor. I want my doctor to decide what health care I should have. Right now the insurance company decides if I can get a procedure done, or take a certain medication, or see a certain specialist. My doctor recommends my health care to the insurance company and they decide if I am going to get what my doctor recommends.

The insurance company is in business to make money. Everyone wants health care and most of the people working full time jobs pay the insurance company for coverage. Small businesses and large also pay for this coverage. According to a study done by the Commonwealth Fund, Minnesota is among the states with the highest average premiums, topping out at $13,500 per year for family coverage. The CEO of United Health, based in Minnesota, is among the highest paid CEO’s in the country. The point is that the insurance company does not want to pay for anything that can be obtained at a lower price from someone else, or that can be simply put off. Again, the insurance company clerk is reviewing my doctor’s health plan for me and deciding if I can have the care my doctor thinks is best. And the clerk’s decision is based on profit, not expert medical advice.

How many drugs does we see advertised on television, in magazines, on billboards and on the radio? More than I care to watch. The costs are enormous. The drug companies say that drugs cost so much because of research and development. But many of these drugs are expensive because of advertising and lobbying. I switched from a brand name drug that cost the insurance company $176 per month to a generic drug that cost $10 per month. My doctor said they are both the same thing. And these companies lobbied Congress and paid enough that even Medicare is not allowed to negotiate prices on drugs, sticking it to our parents and us.

Many people do not have access to a doctor for preventive care because they cannot afford the coverage. They can’t afford it because they are not working or the contributory premiums charged by the carrier are just too much. It becomes a choice of eating or going to the doctor.

The government has a public option available now to many citizens: Medicare. No one wants to lose their Medicare coverage, yet these same people are manipulated into believing that a public option is a bad thing. In Minnesota, we have MinnesotaCare for those people of low income who would not otherwise have access to adequate coverage. These programs work. And they cost money. But I can’t imagine they cost more than taking care of these people in emergency rooms and operating rooms if they did not have coverage. Our tax dollars are going to pay for these people one way or another. Let’s make it the most cost efficient way, rather than the most expensive way.

Bottom line: The current debate is not about a government takeover of the health care system. It is a debate about a government takeover (or reform) of the insurance system and making adequate health care available to all.