Health Care Reform

I wouldn't give up on health care reform just yet, but I no longer think it will be the kind of real reform many hoped to achieve. What saddens me the most is that much of the rhetoric from the right has focused on the inclusion of a publicly-run option that would compete with private insurers. If they truly believed that a publicly-run option would ultimately be inferior, it is cynical to suggest that those seeking health insurance would choose that option in the first place.

I sound like a broken record but, as I have said many times, we already have a "public option" and have been paying for it for many years. When sick people have no insurance and no primary care physician to turn to, they turn to emergency rooms, the costliest way to deliver care for non-emergency, non-life threatening illnesses. Hospitals bill the uninsured emergency room patient who obviously cannot afford to pay; some of these patients who can't afford to pay make a choice between paying their hospital bill or their rent or mortgage. Many will pay the hospital and risk foreclosure. Many will pay the mortgage and fail to pay the hospital. Those of us with health insurance will watch their property values deflate due to foreclosures happening all around them. Many will watch their hospitals drop specialties that are not self-sustaining and instead rely on the overall income of the hospital to stay in business. Businesses do this all the time. Restaurants may lose money on some of the food they serve but make up for it by relying on beverage service to stay solvent. It's not that different for non-profit hospitals.

It's also convenient to overlook the fact that people with no insurance and no primary care physician are denied access to preventive care, typically the cheapest and best way to deliver care for common ailments - Type 2 diabetes, respiratory infections, etc. Untreated diabetes, for example, can certainly land someone in an emergency room because of the damage the disease can do to vital organs and even limbs.

If we end up with watered-down health care "reform", little will change. We will not spread risk, resulting in higher premiums for those with insurance. If that's not a part of paying for health care for the uninsured, I don't know what is.

If you do not believe that access to affordable health care is a moral obligation, I am sorry to tell you that it doesn't matter when it comes to what you pay for your own health care. We have a "system" right now that guarantees an economically inefficient delivery of care. The difference is that we had little control over its establishment - done piecemeal and without much debate. I wish we would all wake up and realize that it is better to elect people with the courage to replace the current "system" with an actual plan that makes getting and maintaining health care insurance possible for most, if not all of us. It turns out that we are sometimes our brothers' keepers, whether we like it or not. It's not a question of whether we do it piecemeal or comprehensively. Doing it comprehensively just sounds much more rational to me.