Health-care reform

As the mother of a kidney transplant recipient and the wife of a cancer survivor, you might think I would be a strong supporter of a government-run health-care system. In fact, it scares me.

Ten years on Medicaid taught me that many doctors are not taking any more Medicaid patients, as they are reimbursed at rates that make it impossible for them to make payrolls, student loan payments and malpractice insurance premiums.

Forcing doctors to accept more Medicaid patients would only force more doctors to quit practicing, especially in rural and urban-core areas already suffering from a shortage of medical professionals. Just try to find an OB/GYN in rural southern Missouri.

It does no good to have coverage if no one accepts the policy.

Donna Godding
Independence

Luckily, I’m not among the 45 million Americans living without health insurance, either because they can’t afford it or were denied coverage due to pre-existing conditions. As the health-care debate rages, there has been a lot of emphasis on covering the uninsured. However, it’s also important to keep in mind people like me who are in jeopardy of losing their current coverage because of skyrocketing costs.

The bottom line is that our health-care system is broken. We need reform that will lower costs as well as ensure that access is affordable for every American and businesses both big and small. With employers’ health-care costs on track to increase 9 percent next year, we can’t delay any longer. President Obama’s plan to control costs, protect choice and make quality, affordable health care a reality for every American is something we all should stand up for.

Todd Bradley
Mission

Recently I was forced to leave my local, competent and friendly pharmacy. The reason was that my insurance provider started charging higher co-pays for the same medicine if I didn’t use their distant, faceless, centralized pharmacy.

I am thankful that the medicine in question is not life-sustaining, but it does make my life easier. When I received my prescription, 10 days later, it was the correct medicine with the proper strength but the quantity was wrong (30 mg instead of 45 mg).
After going through a veritable maze of phone options, I finally reached a live person. But no amount of explanation would convince him that a mistake had been made. He even refused to provide his fax number when told that I had a copy of the prescription that would prove the mistake.

The net is: My choice of pharmacy had been removed, it took longer to get my prescription, the amount was incorrect, and I didn’t save any money.

Is this is a simple illustration of how the future of health care will be, should President Obama’s national program become a reality?

Jim Griggs
Stilwell

Comments

[NoMoreMrNiceGuy]

Devin I would agree that having accountants or deadbeat lawyers in Washington making health care decisions is bad business.
Why is it we think lawyers are the all knowing when they rank equal to terrorists and crack dealers ont he food chain?

[devin]

"Nationalized healthcare has been an aggregate failure in virtually if not every implementation."

I never understand such statements. The best support I've ever seen for this kind of statement is articles using cherry-picked statistics for average waiting times for specific procedures in Britain or Canada (which are widely recognized to be the worst examples of nationalized health care). Using objective, big-picture measures (life expectancy, infant mortality, disease incidence rates, etc.), most nationalized health care systems perform better than the US. And they all do so for a tiny fraction of the cost by any measure.

My own experiences, and those of my wife while leading thousands of people on international tours, have invariably been that health care in most other countries is remarkably effective and affordable. You simply walk into a hospital or doctor's office, describe what's happening, wait a few minutes to a few hours, get treated, and pay a small bill if you're in a country that charges foreigners. Then there's our system that requires numerous phone calls to try and get an appointment, endless questions about whether and how the treatment will be billed to insurance, waits ranging from several days to several weeks (unless you go straight to the ER because you can't get in to see a regular doctor who takes your insurance), and an enormous bill at the end that you'll inevitably have to fight your insurance company to pay the portion they agreed to in the contract. Calling nationalized health care an aggregate failure by comparison seems like the height of insanity to me.

And then there's the whole issue of having a corporate account standing between you and your doctor. My mom, a nurse, worked in Authorizations for a big insurance company. I can't count the number of times she'd come home frustrated over having a procedure she approved as medically appropriate and necessary get denied because an accountant decided it wasn't good for the bottom line. To me, having an accountant who's looking out for shareholders before patients making medical decisions seems worse than having a government bureaucrat making the call. But if you like the current system so much, then next time you need health care, why don't you just cut out the middle-men and call a CPA?

[JoCo]

A JoCo Quick Pick:

KC Star, Thursday, 7/9/09, pg.A-18, Letters:

REFORM HEALTH CARE

I certainly hope that Cathy Ash and Mary Goodwin (7/3 Letters)will read Barbara Shelly's column "Health care Stories Tell Her Changes Are Needed" (7/3 Opinion). It brings to a personal level the need for reform of health care in the U.S. I have no fear of a Medicare-type health care for all. Indeed I hope for it. I have had 5 surgeries in the last 5 years, and with Medicare and my gap insurance, I paid only a pittance-- and received excellent care with no waiting.

Kris Cheatum
Kansas City

[JoCo]

pmcw,

Smiling, and with a renewed sense of hope that IT is possible ( Hands clasped behind head)

[JoCo]

pmcw,

I've always had a problem with the reference to our economic system,particularly as time passes, as "free market". Though maybe WE haven't abandoned IT, IT has been kidnapped. Really, I was taught that Adam Smith's "invisible hand" was to occur on an island economy, not unlike his own G.B.,in isolation and could never exist in a world buffeted by transcient economic/political power.

The historical irony of Smith's timing, concurrent with the U.S. founding, may help explain the heavenly perfection espoused in the Declaration. Ensuing industrial history has warped any market freedom in many ways.

Still, on balance, let's go with what we have; which is a free climate to discuss how we can now restructure endemic socioeconomic bastardization of free market ideals, to better allow free interaction of supply/demand toward fair production/price

[pmcw]

Our healthcare system, while still the best in the world, has huge problems and is in desperate need of repair. Costs have skyrocketed, the best preventive courses to good health are challenging for most and access is limited due not only to cost, but also insurance policy.

These and more are all givens in this equation that I think we can all embrace. However, it appears there is a huge gulf of disagreement as to how we should fix the system.

It's been my experience as a former CEO and consultant to executives that one must start by defining the problem(s) first and then focus on discovering their root cause; anything short of that is a Band-Aid and if the problems are bad enough to warrant surgery (a radical change) anything short of full discovery is often more harmful than good.

The trend today is tantamount to throwing out the proverbial baby with the bathwater. The reason U.S. healthcare is, on balance, the best in the world is due to our free market systems; that is a benefit we should be hesitant to abandon. Nationalized healthcare has been an aggregate failure in virtually if not every implementation.

What we should be asking is why have healthcare costs skyrocketed substantially above the rate of broad inflation while other industries that are also driven by technology have substantially declined in price? Take for example communications, computing, networking and even mass transit. Why is it so difficult and costly to buy medical insurance? Why are clearly good investments in preventive medicine often not covered well by insurance? Why are malpractice insurance policies often priced well in excess of $100,000 per year for common practitioners like OB/GYN? Etc... There are root causes for all these issues that should be addressed first - long before we decide we will be better off with a nationalized system.

I don't have a full answer for this dilemma or even know how to weight the factors I can name like poor regulatory policy and insane tort law, but I do know the process for finding the truth and that we're not even considering addressing root cause as a potential route to solving the problems.

Remember, we pay for government and everything government does - there is no free lunch. Therefore, we should always be skeptical when the government wants to expand its power and influence; particularly when it suggests it can do something better or for less cost than the private sector. More often than not, its bad government policy that creates the seemingly high private sector costs in the first place.

[NoMoreMrNiceGuy]

Yes let's take all risk base models from all insurance and lending. We need to simply work out something so individuals carry their insurance themselves rather than their employers. A plan that locks in rates for a given amount of time and limits the rate increase with age. Government running or competing is not an option.
Government has a track recod of being unaccountable and crooked, I do not trust lawyers. Obama is a lawyer.

[whispering_to_kc]

Healthcare/insurance industry lobbyists are swarming all around Washington over "reform". They're pulling out all the stops to make certain "reform" looks a lot like the status quo. Whatever is crafted from their efforts will likely be more friendly to the industry than "Americans".

I'd be surprised to see either single-payer health insurance or even a government run option come out of all the talk.

Nothing much will change. As you were, all is well, move along, nothing to see here.

[JoCo]

Private insurers, who have been HUGELY profitable in a supplier market, cannot compete with a government that doesn't have to show a profit?

That's like saying UPS can't compete with USPS.

[JoCo]

Kee,

Sorry, but I don't get it. First you decry that we may be stampeded like at the current DMV because of a false "crisis" and then you promise we'll see a change coming in the DMV which is already a public function. What, is it going private AND will be worsening? One? The other? Both?

Talk about a cry of crisis.

[JoCo]

OOPS, With glasses I see ...!!!

[JoCo]

Hey Marctnts,

Very good ideas, IMO. But how do you post a blank? I've tried inadvertently and the machine won't allow it.lol

[JoCo]

I still fail to see the comparison to the DMV. What, if you go in, you might wait an hour? More and more, if you have your shmidt together you can jump online and send an e-check or,a little more expensive (in JaCoMo) use a card.

BTW, I don't mind the queue at the fee office. Except for the slowdown by APPLICANTS that are unprepared, the line moves along and invariably a conversation with a stranger is struck up or I see a friend.

Once I saw Royal Duke Wathan (I had JUST seen him on ESPN Classic as manager of the Angels?!)so I mentioned the story and we talked about it for ten minutes. Heck, even the Duke goes to the DMV.

[Kee]

Gayhawk how naieve can you be? Do you really think private insurors can compete with the government? The government does not have to make a profit Gayhawk. So how long will it take for private insurors to realize they cannot compete?

In a matter of a few very short years the DMV plan will be in place, count on it.

[JayhawkinMO]

Griggs is very confused. Perhaps he should have his doctor check his meds... He describes being jacked around by his insurance company and then lays the blame on some fear of "Obama's national plan." I wish the fear-mongers would take a hike. AARP and the Consumers Union both agree that a hybrid program combining private insurance and government programs will evolve. There will be no "DMV type" of system that Kee charges...

[Marctnts]

...

[Marctnts]

"...as well as ensure that access is affordable for every American and businesses both big and small."

I'd say the real answer to this issue is to address the costs themselves, not simply who is paying the bill. The last study I saw, about $0.14 of a health care dollar went to insurance costs, about $0.03 of which was profit. The remaining amount, $0.86, was directed towards the cost of delivering services.

In my opinion, a REAL discussion about the reasons for the exponential increase in health care costs and REAL strategies for addressing the problems will go a lot farther towards making care more affordable than simply arguing about who gets to pay the bill (because after all, WE are the ones paying the bill no matter who the middle man is).

[Kee]

That 47 million number is a real red herring. How many of them are illegal aliens? According to some estimates there could be as many as 18 million.

How many of the 47 million can afford health insurance but because they are young and healthy elect to purchase "cable" instead?

How many of the 47 million are simply between jobs and insure temporarily or wait for coverage?

I would hate to see us stampeded toward a "DMV" type of health coverage because of a few inflated numbers, and the cries of "crisis".

[JoCo]

Who knows about the FUTURE, Jim, but I think you were relating your nightmare about what it has become NOW.

Donna, Medicaid is a notorious skinflint and only begins to pay, as you may know, after the applicant has proven poverty to the States' forensic accountants. It is a classic example of what's wrong with this catastrophic coverage; it's mainly for the very poor, and of necessity, public. Your unfortunate experiences might have been even worse if not for Medicaid. Physicians who do not accept Medicaid may be booked with better-insured patients and simply making carrer decisions or following their groups' policies.

Todd, maybe your plea to "all stand up" will become pertinent once we see the definitive plan proposal. Til then, it's only conjecture. And the only "All Stand Up" I've seen lately has been on Comedy Central