Thursday, August 20, 2009

Curse the dark or light a candle

By Don Klein

If universal health care for Americans is weakened because of an honest discourse between the people and their government representatives,
that would be democracy in action. No dispute from me.

If on the other hand health care gets diluted to the level of being eyewash rather than a substantive reform because of fear, misinformation and downright lies, that’s a national disgrace.

What is going on now is a strange combination of both these propositions.

Fear seems to be playing the biggest part, though. When Iowa Republican Sen. Chuck Grassley put himself in the same box with former Alaska Gov. Sarah Palin suggesting old people might be euthanized there is only one explanation. Spreading fear.

Grassley knows better and should be ashamed of himself. I’ve given up on Palin. I can’t figure whether she is a demagogue or just plain stupid. She fits both personas.

There will be no medical coverage for illegal aliens nor will abortion seekers be handed free care, as many believe. But there are legitimate other concerns on the part of many people and even though I don’t indorse these worries, they are real.

For example, older folks feel that in order to do all that must be done to reform health options and to pay for it, Medicare recipients will have to accept reduced services and possibly higher deductions and co-pays. Obama said he wants to eliminate waste in Medicare and that raises the alarm bell for many seniors who love the program just the way it is.

Then there are the veterans who fear their health benefits will be severely altered to save money needed to fund the new health program. Obama swore their benefits will not be touched.

There is the fright that the government can’t run a complicated program like health care because government doesn’t run anything well. That is generally true, but it is not an axiom. The government runs Medicare well enough to please most seniors. It also does a fairly decent job with the military, although at an awfully high cost. And any retired person will attest to the dependability of Social Security.

What I see as the most consuming problem when universal health care becomes available will be the lack of adequate numbers of health care providers. There are simply not enough doctors to handle the health needs in the country now. Try to get a doctor’s appointment today without having to wait three or four or more months. I have to call my specialists for annual check-ups in November for January-February sessions or I have to wait months longer.

What is going to happen when we add the 46 to 50 million Americans who currently are uninsured. Even if only half of those who will be brought under the new health plan need to visit a doctor, the medical work load will more than just bend, it could fracture. This is especially so if we begin a new era, as Obama has said many times, of preventive medicine.

As of now doctors only spend a few minutes with each patient and in that time they are supposed to give you the full benefit of their medical expertise. We spend more time explaining the problems of our automobile to the service manager at a car repair shop than we do with doctors.

There is no excuse for the mechanic not making the correct repairs, but the doctor may fail your diagnosis because he has little time to thoroughly evaluate your problem and if the symptoms are not obvious it might be overlooked in the crush of his schedule. Add millions more to the patient pool and the situation could become disheartening.

That doesn’t mean we should not bring those in need into the medical insurance program. The worst thing we can do in do nothing because that invites even worse circumstances. We need portability of insurance, we need protection from being denied coverage because of pre-existing conditions, we need other procedural updates outlined many times by proponents of the plan.

We must expect a disruption in the way things proceed for the 80 percent of the country who are already covered by insurance. The change will not be smooth, change never is, but change is necessary and inevitable. Given these factors, I have a simple question to ask those who oppose universal health care.

Please tell me why you are championing the multi-billion dollar insurance industry which currently is pushing the nation towards bankruptcy to feed its own greed? There is absolutely no advantage to leaving things the way they are. None of us will benefit except the big insurers. So opponents should stop worrying about "death panels" that were never considered in the first place nor an Orwellian future of an all powerful government running our lives.

Today’s insured will loose some conveniences and the uninsured will gain coverage under a new system which will include everyone. It is a good trade off. We will still have our favorite doctors (although we will have to share their services with a larger clientele), we will still get our emergency care, our preventive medical treatment and no one will deny grandma her medicine when she turns 80.

Health care in this country now is more expensive than it should be. The costs get worse. We deserve better. So what’s the big deal in changing it and hoping for better. When it comes to health care the choice is clear: We can either curse the darkness or light a candle.


Charlie said...

We seem to be living in a era today where Big equates to Bad, greedy, wasteful, etc. The U.S. Government is our "Biggest" employer. And like corporate America, is largely comprised of structures mainly interested in self-preservation. The single differentiating factor is that the U.S. Government will not go out of business if it consistently looses money; it will simply raise your taxes. If we want to fix the health care industry, we need to start by fixing our cracked, if not broken, Congress along with the power of the big business lobby. Or, at least, include those measures along with others in the political debate about health care.

Charlie said...

It's not a question of reform or no reform. It's a question of smart reform. The following article illustrates this point.

WASHINGTON ( -- How big of a deal is cutting the rising cost of health care? Ask Massachusetts.

Massachusetts is three years ahead of the nation when it comes to health care reform.

The state now insures more than 97% of its population -- the highest such rate nationwide. But it's also grappling with higher-than-expected costs.

Now, some worry that the growing price tag in Massachusetts could threaten national efforts.

"Anything that is on the track that we're on today will not only derail health care reform but could literally derail the economy," said Lynn Nicholas, president of the Massachusetts Hospital Association.

To be sure, as Congress grapples with how to fix the nation's health care system, cost has become the hot-button issue.

President Obama and many Democrats in Congress say bringing down costs is a key element of current proposals.

But a congressional budget chief recently said that current proposals would not do enough to rein in costs.

And nonpartisan industry experts say lawmakers need to focus more closely on costs.

"There's enormous potential, and the bills have made a good start," said David Cutler, a Harvard University professor and health economist. "I think there's some sentiment for making them do a little bit more." Cutler suggested, however, that policymakers can always go back and tackle health care savings later on.

irwinb said...

Good blog. I think you overstate the problem of a doctor shortage, when the 40 million or so uninsured getr coverage. Most of those 40 million are seen now in Hospitals, and the rest of the population is paying for their coverage, either through Medicare or private insurance. The experience in Massachusetts has shown that the uninsured can be readily absorbed into the system.

I do agree with your other comments, especially those concerning costs of national health reform. We have to make sure that reform will bend the cost curve. This must be done through payment reform (getting away from fee-for-service payments to MDs. Go to the Gewande article in the June 1st New Yorker and see how the system is abused.To hold down costs, we need a public option that will pay providers at the average Medicare rates plus 10%.