Looking for the Right Health Care Reform

With the current Supreme Court hearings on the Affordable Care Act, I thought I'd repost one of my columns that was printed in the Edmond Sun on Dec. 29, 2009. Here's the link: http://www.edmondsun.com/opinion/x546158515/Looking-for-the-right-health-care-reform

Enjoy!
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EDMOND — After months of hearings and haggling, Congress is in the final stages of reforming our health care system. Lawmaking has been compared to making sausage — combining perfectly good steak with other less desirable ingredients, then trying to pressure it through the legislative machinery. It’s not pretty, and we get the good with the bad, but that’s the way the process works.

There’s no question we need health care reform. Americans pay more than twice as much for health care per person as in other industrialized countries, and that cost is growing three times as fast as wage increases. But what do we get for our money?

We’re 50th in the world in life expectancy, just ahead of Albania. Our infant mortality rate is higher than in other Western nations. Sixty-two percent of all bankruptcies filed in 2007 were linked to medical expenses, even though 80 percent of those who filed for bankruptcy had health insurance. We spend more than a thousand dollars per person per year on medical paperwork and overhead alone, more than three times as much as in Canada. And for all that, we leave 45 million people without any coverage at all.

How did we get in this mess? In 1900 there was no such thing as health insurance. Medical care was paid for through barter or out of your own pocket. In today’s dollars that averaged about a hundred bucks a year. Now we spend $3,000 a year on health care per person.

When hospitals faced empty beds and unpaid bills in the Depression, Baylor Hospital administrator Justin Kimball developed a plan under which teachers could prepay for hospitalization. Within a year, 75 percent of Dallas teachers had enrolled; soon, other employers began offering such benefits as a recruiting incentive. Private health insurance coverage grew from 9 percent in 1940 to 70 percent in the 1960s. An entire insurance industry has mushroomed around the idea.

But times have changed. Today the percentage of Americans with health insurance provided through their employers is 56 percent and falling. To mandate that burden on all employers with penalties, as current legislation proposes, will be difficult to sell.

Republicans, and now Sen. Joe Lieberman, balk at the idea of having a public option to private coverage. Medicare and Medicaid are both “public options” of sorts, and help moderate the cost of health care. But the insurance lobby has a lucrative product and they don’t want to lose it.

Howard Dean is right — the current proposal working its way through Congress will be a victory for the insurance industry, not everyday Americans.

Good health care shouldn’t depend on the wealth of the patient. The cost of heart surgery is the same for rich bodies and poor ones. Why should a wealthy person have access to it and a poor person should not?

People have no more right to medical care than they do, say, to highways. But the government builds highways and bridges for everyone to use because it benefits all of us. When we buy a car, our choices are governed by our wealth. You only buy a Lexus if you can afford it. But luxury cars and clunkers share the same highways, where equal access is guaranteed to all.

The same principle should apply to health care.

I once listened to a radio personality named Rush Limbaugh. Before his prescription drug abuse problems surfaced, he once said his health care solution was to simply pay cash for routine doctor visits. He said it really didn’t cost that much, and was easier than dealing with the insurance paperwork. He’d save his health insurance for catastrophic care.

I hope you’re sitting down. For once, I agree with Limbaugh.

Instead of expanding a system that doesn’t work, let’s wean ourselves from our addiction to health insurance. Let people pay for everyday medical expenses out of pocket. We should expand Medicare and Medicaid and SCHIP to cover all Americans, employed or not, for catastrophic illnesses that would cost more than, say, $10,000 a year. In turn, employers would pass along the premium savings to their employees. The healthier we lived, the less we’d need to visit the doctor, and the more of that we’d pocket or spend on other bills. The added income would generate higher payroll taxes to help cover the cost.

The issue of abortion coverage would disappear because first trimester abortions usually cost under $1,000. Almost all plastic surgery also would be excluded. If that’s what you want to spend your money on, go ahead — but don’t expect the rest of us to pay for your implants.

I’ll leave it to smarter people like my friend Mickey Hepner to figure out the details. But spreading the catastrophic care costs across all taxpayers would make the system more manageable. Risks would go down, and more people would bear the responsibility for healthier lifestyles. Health care providers would focus on providing better outcomes instead of simply running more tests for the sake of profiting from them.

We need health care reform. But we need the right type of health care reform. Simply saying no isn’t the answer. Simply saying yes to the health insurance industry isn’t either.

Health Care in Oklahoma: Change Starts At Home

During this summer’s debate on health care reform, there’s no place in the country where the stakes are as high as they are in Oklahoma.

In the 2008 Annual State of the State’s Health report issued by the Oklahoma Department of Health last month, Oklahoma continues to rank as one of the worst states in the nation when it comes to our quality of health. Our rates of deaths due to heart disease, strokes, respiratory disease and diabetes are through the roof. The report concludes we need to exercise more, eat more fruits and vegetables, and avoid smoking tobacco. The entire report, which makes for interesting reading, is available to download at no cost from the Health Department’s website.

Despite the headlines, governmental intervention is not the only way to achieve health care reform. We first have to check our lifestyles and attitudes on a personal basis. It’s less expensive to eat better, exercise more, and stop smoking than it is to pay for emergency rooms or insurance premiums, and that applies to us both individually and collectively.

One of the most important things we can do this summer is to support the Obama administration’s efforts to bring about change in health care in this country. It’s been tried before, but this time with a Democratic Congress and White House there’s real hope that substantial progress will be made. President Obama has brought together the major stakeholders, usually at odds with each other, to bring about a consensus for change, and he wants results in the next ninety days or so. The results may not be perfect, but they should help improve the quality of life and stem the swelling cost of health care in the United States. If we don’t deal with it now, it will only get worse tomorrow.

Everyone has a horror story about how the health care system hasn’t worked for them or someone they know. The administration’s starting point is to collect those stories. They are encouraging Americans to meet and discuss both the problems and potential solutions, and at the very least raise awareness in the community. From there, they can start to fashion solutions. If there’s enough demand for a solution, the political tide can reach critical mass and solutions can be found.

A well-attended public forum for that purpose was held June 6 at the OU Health Sciences Center in Oklahoma City. One of the keynote speakers was Edmond’s Wayne Rohde, who has championed the cause for insurance coverage for autism care in Oklahoma. Those who attended were invited to share their frustrations and suggestions with policymakers in Washington. The public can still submit their views through the website www.mybarackobama.com.

The next step is the National Health Care Day of Service on June 27. A free Health Fair is being sponsored by Change Oklahoma, Organizing for America and the Community Hope Improvement Project from 10 to noon in the south parking lot of the State Capitol. There will be free blood pressure checks, public health information, snacks and drinks, and a food drive for the Jesus House (please bring non-perishables and canned goods). There will also be plenty of people around to discuss health care issues and raise awareness about the need for change.

Change Oklahoma is also working with The Oklahoma Blood Institute (OBI) on a statewide Blood Drive on June 27. This is a perfect opportunity for almost all Oklahomans to participate; for some, it may be the first time they’ve donated blood. One of OBI’s bloodmobiles will be located at the Home Depot on Broadway in Edmond. Other events are taking place nationwide Saturday, and can also be located through www.mybarackobama.com.

Change Oklahoma is also beginning an initiative to encourage Oklahomans to be more physically active. The Health Department study ranks Oklahoma as the fifth most physically inactive state with almost 30 percent of our adult population reporting no exercise in the preceding thirty days. Physical activity has a role in reversing or preventing diabetes, heart disease, stroke, cancer, arthritis and other health problems. Some physical activity is good, but increased activity is even better. In other words, go around the block one more time on your morning walk. Park a little further from the store. Spend less time on the sofa or in front of the computer, and find a new hobby that will get you up and moving. That’s a project I’m going to adopt myself.

We all need to go the extra mile to become a little healthier. That may be the greatest and least expensive health care reform of all.