Monday, July 13, 2009

My thoughts on healthcare reform...

Here are some of my meandering thoughts on healthcare reform. Ta-da! ;)

Healthcare reform is a big topic and I’m by no means an expert in the subject. But, having worked as a healthcare provider and then also having the experience of being a user of healthcare insurance, I feel that I have a lot to say. :) First off, just a little background. Prior to kids, I worked as a dietitian for a few years. I’m also married to a healthcare provider. We’ve had great insurance (but paid a lot for it!) and mediocre insurance (and still paid too much for it) and now have no insurance for our family of 5 because hubby is in-between jobs. I have no party affiliation, though I’m registered as an Independent. So there you have it. :)

Having had all those different experiences, I do feel that our healthcare system does not work well for some but works great for others. I also know that some people don’t even have insurance, which is really detrimental to one’s well-being. With that said, I still don’t think we need to go as drastic as government-run healthcare. I feel that we can start by fixing some of the flaws in our current system – maybe even a major overhaul. But to throw the baby out with the bath water, so to speak, and give more control to a government, which I feel lacks financial wisdom, accountability and responsibilities, might be doing us a disservice. Not all change is a good change. So here’s what I see is a part of the problem with our current system and what I think can be changed.

Because consumers are currently stuck with whatever insurance companies their boss buys insurance from, there is no say in the price paid for premiums or services. I actually really liked the Republican’s plan of giving consumers money to purchase their own insurance, so that it would foster healthy competition between insurance companies, forcing them to be more creative with how to keep costs down, and ultimately drive prices down to draw customers. Why shouldn’t we be able to buy health insurance like we do car insurance or home insurance? Don’t we shop around for the best price and best package before deciding to buy? Don’t we have a choice in what we want to pay, in terms of premiums and such? It’d be great to have that with health insurance.

There is a problem with where the bulk of the healthcare dollars are going to. Some doctors are getting paid a minimal amount to do procedures requiring hours of work and some have quit because they barely make enough to pay their bills. (Aidan’s pedicatric ophthalmologist only got paid about $200 for doing eyelid surgery. That’s atrociously meager to me.) Insurance companies say they are going under because they’re not making enough money. Consumers are running out of money to pay for groceries because of their hefty medical bills. I don’t understand. Is it the insurance executives who are still earning big salaries? I’m almost scared to ask after the government bail-out money (which I really disagree with, btw) went to bankrupt companies whose execs were still getting bonuses and living it up. Maybe if the insurance companies can stand to make a little less, their companies would make a little more and be able to stay afloat? Please, no more bonuses, extravagant parties and corporate excess. Besides these corporate execs, I want to talk about some doctors that have lost their sensibilities and started to see patients simply as dollar signs. I know many great doctors that put patient care first and they are gems! However, I also know of a few that do certain procedures because it reimburses more and schedule more procedures than their patients really need because it brings in more money. It’s scary! [Please do your homework when choosing a provider!] Lastly, the fact is, many consumers are also abusing the system and milking it for all its worth. My husband has seen firsthand how people can circumvent the system and use it to get unnecessary handicapped parking tags, social security disability, extraneous medication to feed an addiction, depleting the funds for necessary medical treatments for others. In short, it’s really the lack of character on all fronts, that is causing this problem and it’s really a downward spiral. Consumers cheat the system. It’s depleting money from the insurance companies who are paying out ‘way too much’ and their execs are not getting enough, so they decrease the amount reimbursed and/or outright reject payments or coverage for more and more services. The hospitals are not getting paid enough because insurance is reimbursing less, so they raise their prices. Who gets the shaft? It’s those honest folks who are trying to follow the rules but are having to pay for things out-of-pocket because they have super high deductibles or their insurance won’t cover it anymore or they don’t have insurance anymore. It’s also those honest doctors who are putting their patients first and doing what’s best even though they are meagerly compensated. It’s a sad state of affairs.

And let’s talk about the fact that if the government-run healthcare gets passed, taxes will go up for those making more than $250K. Even though we don’t make nearly that much and won’t be affected by this hike, I don’t understand why only the rich have to shoulder the brunt of what they expect this new healthcare system will cost. Isn’t everyone using it? Aren’t the rich already taxes more? Maybe I’m one of the few that will say that – maybe I’m missing something here? Also, why say you’re going to raise taxes using the current system that isn’t even doing the job to collect the taxes it is due? Let’s not mention any names where but there have been politicians on both sides of the fence not paying the amount they’re supposed to. And even if it’s their “accountants fault”, don’t these politicians have enough money to hire accountants that know the current tax law? Anyhow, I don’t want to go there. ;) Let’s start by fix this faulty tax system and ask all the politicians to pay up all the taxes that they are supposed to and then see where we stand financially. And, by the way, President Obama (who makes $400K), the President of Bolivia voluntarily reduced his own pay to show the people that he was serious about making changes to how the government spends money. That's a great idea, don’t you think? ;)

Therefore, I think what we need is more competition, more accountability, more character (though that’s the church’s job), and more emphasis on preventative measures & living healthier lifestyles. And because the government is already riddle with red tape and lacking in accountability for so many other areas, I really think it’s best to keep it out of their hands.

I do applaud Obama on making healthcare reform one of his initiatives and appreciate the fact that he is following through on something that he’s promised. I really hope and pray that our leaders will take the time to really think things through before signing a bill that will impact us and our kids for years to come.

PS I didn't write about universal healthcare because I'm not sure if that's what this 'government-run' healthcare will be. But I have thoughts on that, too. :)

Thoughts, anyone?


autumnesf said...

I also have a personal look at this from two sides. I was born in military/government hospital (as was my mother and my children) and I work for doctors.

People have NO IDEA what they are in for if we end up with government involved in our health care. IT IS A MESS.

Working for doctors and having gone through audits and consultants to see how to keep afloat....doctors can not stay in business on medicare allowables. And guess what -- thats what government insurance pays...including current military.

As a patient it takes me WEEKS to find a doctor that will even accept our insurance as the good doctors just flat out won't deal with such lousy payments...and the hassel of dealing with whatever insurance company has the current government contract. It is a nightmare.

Plus, there are lots of things that will not be allowed under government insurance or hospital. Epidural for childbirth? Not medically don't get prepare for a lousy shot that knocks you out...not the pain. Great birth experience that. And thats just the tip of the iceburg. New or experimental drugs? No way. Or, if the drug is really new and there are no prepared to foot a large portion of the cost.

I could go on for days as to why government interference in medical care is not up to par with our doctors abilities.

Anyone that wants this....I want you to have it. You deserve what you ask for.

Sheryl said...

Another recent blog post with some interesting facts and numbers:
Let's all stay tuned to see how (if ever) this turns out.

Sarah said...

Great thoughts Jacklyn! Kudos to you for doing your research and taking the time to learn about this and write out your thoughts!

randi said...

Great post!

I definitely agree that we should fix what is already in place. Lawsuits and malpractice insurance are making it almost impossible for doctors to make a living anymore and it is driving up costs for the rest of us.

The government always likes to start giant new programs instead of making things work as they are. :(