Wednesday, March 28, 2012

What is the Answer in the Health Care Debate?

Finally, we are entering the phase of the Supreme Court decision regarding the constitutionality of the Patient Protection Affordable Care Act signed into law by President Obama on March 23, 2010. If you are listening to the debate regarding the constitutionality of "Obamacare" you immediately see legal argument colliding with emotional argument. There is much about this law that is good. I would hate to see the Supreme Court strike down the entire law because the provision regarding pre-existing conditions and children staying on their parent's plan until age 26 are good provisions of the law.  However, it is the individual mandate in this law that has generated such a firestorm of debate.

Does everyone need health insurance? Should a person be forced to purchase health insurance? Do you know anyone who has not needed to see a doctor or access health services at one time or another in their lives? I submit to you that the answer is yes to all these questions. Everyone needs health services at one time or another in their lifetime.

The problem is that some of us choose to purchase health insurance coverage while others choose not to do. There are a myriad of reasons why people don't buy health insurance -
  • They can't afford the premiums.
  • They have been denied coverage because of a pre-existing condition.
  • They are young and well and don't think they need it.
The problem with the current health care system in this country is that the ones who purchase health insurance coverage end up paying for the ones who choose not to purchase health insurance coverage through their premiums. People don't buy coverage yet they use it anyway through emergency services.

It is estimated that 35 million people in this country are without health insurance coverage. You want to know why insurance costs are so high? That's why. Somebody has to pay for all those health services used by the uninsured. That somebody is people who have the coverage and pay the premiums. It also falls to the employers who provide health insurance benefits to their employees. Employers are being buried under the costs of providing those benefits.

Healthcare reform is a necessity in this country. The debate is how to get it done. The Republicans, who want to mandate procedures for pregnancy affecting women across this country, find the mandate for individual health care coverage unconstitutional. President Obama was opposed to a personal mandate before he was for it. Republicans were for the mandate in the 1990s. The hypocrisy in this debate is astounding.  I am sickened to death with the extremes in both political parties whose screams are drowning out any rational discussion regarding health care reform in this country.

When and if the Supreme Court strikes down the individual mandate provision of this law, I hope real healthcare reform can be on the people's agenda. I have listened to the pundits about healthcare reform solutions, i.e., give tax breaks to people who purchase health insurance coverage; allow interstate commerce regarding insurance coverage. The problem is those insurance companies who have monopolies and oppose people's ability to shop anywhere.

We elect our representatives to Congress to fix this problem. Quit screaming your extreme right or left positions and actually solve this problem.  Quit listening to the financial giants in the health care industry who are only concerned about their own financial gain.   Is that too much to ask?


  1. Your points are well taken. I have been appalled by my (Virginia) Legislature's attempt to pass a bill requiring an intrusive ultrasonic procedure and "counselling" prior to abortion. What passed was a water downed version of a more intrusive procedure. Never the less, it is an affront to all women and has not been popular. It will not be forgotten at election time. This was driven by a desire for social engineering, which the Republicans rail against when it is attempted by the other side. Sorry to get off the subject with that gem; I remain exercised by the matter.

    Now the debate about health care. Our system is in dire need of a revamp and most Republicans want it revamped. I would like to see the "pundits and the MSNBCs, the CNNs and Foxs" stay out of it. We need desperately to find thoughtful elected officials with access to physicians, hospitals and insurers. Unfortunately, there are very few of our elected officials up to the job of critical thinking.

    I have been vehemently opposed to this law from the beginning. It must be a strong strand of Southern skepticism. I cannot conceive of how any constitutional scholar can come to the conclusion that this mandate is constitutional. We'll know in a few months. If it isn't overturned, my faith in the court will be greatly diminished.

    Jen, you are absolutely right, how can we continue to pay for everyone that doesn't carry health insurance. Not to mention the thousands who are enjoying the benefit without citizenship. I don't have the answer, we must find one.

    I recall when my son no longer qualified to be carried on my insurance. I had the "you're an adult, get your own insurance" talk. He did, this has been several years ago; but, the cost then was $60.00 a month. I thought that pretty reasonable for the time.
    BTW the monopolies are perpetuated by government.

    newly minted Independent

  2. Short answer: Medicare for Everyone. Single-payer universal coverage.

  3. Thank you for a rational voice. Unfortunately like most political issues the silent majority is foolishly sitting idle 'hoping' that logic and intelligence will prevail in an environment that abhors both. As with many laws there is much to like and items that make you scratch your head wondering "why is that in there." But greed & a lust for power prevail in framing the argument. Especially if they scream, yell, sign enough petitions, etc. to make you believe they are the majority or at least if shouting loud enough it makes them "right." Kind of an Ugly American mentality when we think if we speak english slowly enough a non-english speaking person will somehow magically understand :)

    One argument I question is the impact of the uninsured on premiums. This is something the insurance carriers want you to believe. The insurance companies aren't paying for the uninsured and have no real basis to factor that cost into your premium. They negotiate payments with most healthcare systems prior to us having "coverage" - in the rare case that your 'covered' care isn't pre-negotiated the plan's case review process is actively negotiating the overall cost prior to your discharge.

    The provider, as long as they participate in a government program(Medicare/Medicaid), are already handcuffed by CMS' Usual & Customary fee schedule by region which in turn are leverage by the insurance companies as well. So it isn't you/me that are paying more directly, it is truly the uninsured if they can pay and/or the provider if they can't collect.

    That's only scratching the surface on one point and one-sided many will say - just a start.