Wednesday, February 9, 2011
Wednesday, September 2, 2009
Not to our liking.
Health care is on the table, this time as the main course, and there are a range of responses to a long list of proposed changes. Most noticeable are those whose protests are the loudest. They are getting more attention for this so why not continue. Terms like "death panel, socialist, Nazi,and tax and spend Liberal are fired into the mediasphere, and we sit up and take notice. The media in particular seems to report a good deal more about outlandish behavior, than it does about principled, honest, and factual debate. I guess if it sells more consumer products than open discourse then it must be good.
O.K. so far, after all loud disagreement is not necessarily wrong in context or content. If this were a measure of our rights and freedoms we'd be getting more than passing grades. Certainly most people in Iran would love to have our freedom to protest that which we find not to our liking. In this case however the debate is not about our freedom to dissent, instead it is about how to work as a nation to solve a huge and worsening problem, in this case our access to and quality of health care.
If shouting and calling people names solves this please sign me up. If there is an alternative and detailed plan that actually changes health care at it's roots, I'm avidly interested. By the way everyone who is really happy with their health care please stand up and be counted, and please share with all what makes it good for you.
So while I wait to become informed on other alternatives to the vast changes being proposed by the Obama administration, let's look at the current system.
We'll begin with what's called Health care management, largely operated by insurance companies calling themselves Health Care Providers, even though they don't provide anything. Basically they control who gets what and how much they are willing to pay. They sit between the patient and the doctor, and they decide who gets what. Their decisions have almost zero oversight except in cases too grievous to hide. So it's their panels who decide every thing from who you can see, what medical procedures they'll cover, and what medicines your doctor is permitted to prescribe. They determine your length of stay in a care facility to whether or not you can get mental health care. They also determine how mush you get to pay for your coverage and how much you'll pay for each thing action you take. As an example you get to pay a co pay at each window you walk up to even, if it's for the same ailment, just different departments. They get to raise your premiums with little or no oversight. In many instances they make your doctor or other caregiver the whipping boy for poor care, because it is so profitable. So profitable for them to do so that they fear any change to the system that takes total control out of their hands.
I would probably side with them on the basis of the old capitalist principle which says that you need to make a profit to stay in business, if they were doing a good job. By that I mean creating and operating a system of health which was easy to use, covered all of our health needs and included all Americans legally living in the United States, or it's territories. I would be eager to salute their good efforts.
Before I go much further let's pull back the rug on health care and see how it used to work, right here in the United States. In the period following WWII until somewhere in the 1980's the health care model was based on a different system of treatment and payments. What that means is that for the average working person, your health care usually began when you started work or after 30 days at the latest, was paid for by your employer in full and included your entire immediate family. If you needed care you went where it was right for you to go and the health insurance company paid for the care you received. To my recollection no one with coverage had to go into bankruptcy if they had a major illness or procedure, no employer went out of business from the cost and the health insurance companies mad a tidy profit each year.
Beginning in the early eighties the health care model was changed completely. The health insurance companies said, wait a minute, we get the bill so we should decide who gets what. So they became the gatekeepers, or if you will, the deciding panels.
The result is the system in place today, where most people fear a medical problem because they may not be able to afford the care they paid to get. It's a system that is arbitrary, confusing, and most of all expensive. It gets more expensive each year and we’re never sure who our doctor will be next as the plan gets renegotiated annually. The existing plans pay for treatment after we’re sick and next to nothing for preventive treatment.
It fails to cover almost 50 million Americans, who don’t get any help at all until they are so sick that the treatment costs are huge compared to earlier intervention. The health care providers don’t pay for this care, instead we taxpayers do in the form of an unaccountable tax which drains the coffers of state and local governments and has the effect of higher end taxes in various forms to absorb these costs for emergency, “indigent” medicine. Indigent in this case means you don’t have a job so you’re not insurable in their view. Please also remember that when poor people get very ill, we don’t just let them die on the street, we just treat them and pay out of our own pocket, which helps the Health Care Providers keep more of their profits.
Maybe I’m just a skeptic, but how many of the health care dollars that I paid to my provider are being spent to oppose change and stifle meaningful reform of a broken system?
By the way, you might to think of Health Care Providers in this light. Let’s say that when you bought a new car you called for your first oil change and your salesman said that you could only get those done at “oil change providers authorized by the manufacturers Vehicle Care Provider. The same thing for parts, service and accessories. Of course you could go outside the plan, but then you’d unfortunately lose your warranty. So now instead of you getting to find out what is available for these goods and services in the open and public marketplace, they would be determined by a private company without your consent. You can then imagine how much your maintenance and repair might cost you if you could not participate in the competitive market.
If you like that plan, please work hard to defeat health reform. If you don’t like that idea participate in open reform forums and offer up meaningful ideas on how to improve the system.
Lastly please remember that even reformed health care will take time to fully become a product intended to look after our health, not to make 100-200 people very extremely mega-wealthy.
That’s all for now.
O.K. so far, after all loud disagreement is not necessarily wrong in context or content. If this were a measure of our rights and freedoms we'd be getting more than passing grades. Certainly most people in Iran would love to have our freedom to protest that which we find not to our liking. In this case however the debate is not about our freedom to dissent, instead it is about how to work as a nation to solve a huge and worsening problem, in this case our access to and quality of health care.
If shouting and calling people names solves this please sign me up. If there is an alternative and detailed plan that actually changes health care at it's roots, I'm avidly interested. By the way everyone who is really happy with their health care please stand up and be counted, and please share with all what makes it good for you.
So while I wait to become informed on other alternatives to the vast changes being proposed by the Obama administration, let's look at the current system.
We'll begin with what's called Health care management, largely operated by insurance companies calling themselves Health Care Providers, even though they don't provide anything. Basically they control who gets what and how much they are willing to pay. They sit between the patient and the doctor, and they decide who gets what. Their decisions have almost zero oversight except in cases too grievous to hide. So it's their panels who decide every thing from who you can see, what medical procedures they'll cover, and what medicines your doctor is permitted to prescribe. They determine your length of stay in a care facility to whether or not you can get mental health care. They also determine how mush you get to pay for your coverage and how much you'll pay for each thing action you take. As an example you get to pay a co pay at each window you walk up to even, if it's for the same ailment, just different departments. They get to raise your premiums with little or no oversight. In many instances they make your doctor or other caregiver the whipping boy for poor care, because it is so profitable. So profitable for them to do so that they fear any change to the system that takes total control out of their hands.
I would probably side with them on the basis of the old capitalist principle which says that you need to make a profit to stay in business, if they were doing a good job. By that I mean creating and operating a system of health which was easy to use, covered all of our health needs and included all Americans legally living in the United States, or it's territories. I would be eager to salute their good efforts.
Before I go much further let's pull back the rug on health care and see how it used to work, right here in the United States. In the period following WWII until somewhere in the 1980's the health care model was based on a different system of treatment and payments. What that means is that for the average working person, your health care usually began when you started work or after 30 days at the latest, was paid for by your employer in full and included your entire immediate family. If you needed care you went where it was right for you to go and the health insurance company paid for the care you received. To my recollection no one with coverage had to go into bankruptcy if they had a major illness or procedure, no employer went out of business from the cost and the health insurance companies mad a tidy profit each year.
Beginning in the early eighties the health care model was changed completely. The health insurance companies said, wait a minute, we get the bill so we should decide who gets what. So they became the gatekeepers, or if you will, the deciding panels.
The result is the system in place today, where most people fear a medical problem because they may not be able to afford the care they paid to get. It's a system that is arbitrary, confusing, and most of all expensive. It gets more expensive each year and we’re never sure who our doctor will be next as the plan gets renegotiated annually. The existing plans pay for treatment after we’re sick and next to nothing for preventive treatment.
It fails to cover almost 50 million Americans, who don’t get any help at all until they are so sick that the treatment costs are huge compared to earlier intervention. The health care providers don’t pay for this care, instead we taxpayers do in the form of an unaccountable tax which drains the coffers of state and local governments and has the effect of higher end taxes in various forms to absorb these costs for emergency, “indigent” medicine. Indigent in this case means you don’t have a job so you’re not insurable in their view. Please also remember that when poor people get very ill, we don’t just let them die on the street, we just treat them and pay out of our own pocket, which helps the Health Care Providers keep more of their profits.
Maybe I’m just a skeptic, but how many of the health care dollars that I paid to my provider are being spent to oppose change and stifle meaningful reform of a broken system?
By the way, you might to think of Health Care Providers in this light. Let’s say that when you bought a new car you called for your first oil change and your salesman said that you could only get those done at “oil change providers authorized by the manufacturers Vehicle Care Provider. The same thing for parts, service and accessories. Of course you could go outside the plan, but then you’d unfortunately lose your warranty. So now instead of you getting to find out what is available for these goods and services in the open and public marketplace, they would be determined by a private company without your consent. You can then imagine how much your maintenance and repair might cost you if you could not participate in the competitive market.
If you like that plan, please work hard to defeat health reform. If you don’t like that idea participate in open reform forums and offer up meaningful ideas on how to improve the system.
Lastly please remember that even reformed health care will take time to fully become a product intended to look after our health, not to make 100-200 people very extremely mega-wealthy.
That’s all for now.
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