Sunday, August 9, 2009

Health Reform Confusion

There are a lot of rumors out there about health care reform that are completely baseless. They are politically (not empirically) motivated and lack respect. Remember why health care became such a huge topic during the debate: the number of uninsured are on the rise and costs are skyrocketing. Small business owners are struggling to afford health insurance benefits for their employees (and themselves!). An excerpt from David Gewirtz's upcoming book, How to Save Jobs, provides a statistically coherent and humorous reminder worthy to read (good marketing for the October release...).

Here are some quotes related to the highly contested health reform bills being proposed in the House and Senate. Let's exercise some common-sense people.

"[We] cannot continue to cling to health industry practices that are bankrupting families, and undermining American businesses, large and small. They know we cannot let special interests and partisan politics stand in the way of reform." -- President Barak Obama, Weekly Address July 18, 2009

Something I want to clarify: there is no "Obama health care bill" (as Fox news suggests). Both the House and Senate have developed two different bills that will be voted on before being reviewed, revised, and developed into a joint bill to be voted on and sent to the President for approval (see my previous post in Society & Health for a comparison and links). Obama has outlined what he would like to see in the bills; however, that does not mean that he has dictated every aspect of each bill.

"Health providers would be required to explain to seniors the end-of-life services available, including 'palliative care and hospice.'" Fox News, August 8, 2009

This provision in the House bill has been used by health reform opponents to scare Americans into believing that these mandated health education sessions would be used to convince seniors to prematurely end their life! There was even an Opinion piece in today's Boston Globe suggesting the provision was equivalent to sending a cyanide pill to all elderly! This will likely be removed from the Bill (especially given the outrage and attention to it) -- should it be a reason to oppose health care reform -- no?! Did the idea of providing education about end-of-life care to all seniors seem sensible to the drafters of the legislation, probably! Is it evidence-based? YES!! Will it survive the political onslaught? Probably not.

"Health care by definition involves life and death decisions. Human rights and human dignity must be at the center of any health care discussion." - Sarah Palin, Facebook Page, August 7, 2009

I admit this quote came after her rant about how "nationalized health care" is "evil" and that under the proposed health care reform "bureaucrats can decide" who gets health care services; leaving out the elderly, disabled, including her own child with Down's Syndrome. AGHHHH!! Palin shows a glimmer of wisdom amidst of a sea of stupidity (yes...I said it). Have we already forgotten that the health care "system" is dominated by profit-driven, money-hungry insurance company execs who decide whether you get care or not? How is that better than a coalition of health professionals (and albeit some politicians) accountable to the American public making those decisions? Common-sense -- doctors and patients will be the final decision makers.

I have done enough research in public health to understand that uninsurance is the cyanide pill of the poor and marginalized. That we have a moral and ethical responsibility to provide basic health care coverage to everyone. Do insurance companies share this responsibility? Thus far, they have not. Does our government? That looks like it may be the lone alternative. We need a solid debate on how to finance and fund health care reform. These scare tactics and ridiculous claims kill the debate on health care reform that is desperately needed.

Expanded government insurance may not be the answer. It might be tighter regulation or standardization of claims, so that health insurance companies have incentives to lower premium costs and provide (through mandate?) insurance to all Americans. Let's talk about the possibility of funding primary health clinics next to emergency rooms so that the un- and under-insured do not have to use expensive urgent care resources for basic medical issues. Let's discuss funding prevention and wellness -- incentives for gym memberships (especially in places with long winters), subsidies for local farms to provide nutrition-rich fruits and vegetables, increasing access to fresh produce in all communities, expanding bike path, and maintaining sidewalks and trails. Why haven't we heard of these aspects of the health reform proposals in the media?

We need debate, not distraction.

Update (08/11): Check out an excellent article in the New York Times that lays out the process of health care reform legislation (passing through each body of Congress and reaching the President's desk), as well as some of they primary arguments for and against health care reform as it is presented in the proposals and media.

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