Saturday, October 3, 2009

Health Care Reform As It Is ... Is Broke

For some time now, I've been watching the debate, writing my Congressional representatives, and reading extensively. Maybe I'm becoming more pessimistic as I age, but I've come to the conclusion that no matter what health care reform proposal ultimately gets passed, it just isn't going to yield the results that the American Public is hoping for. You see, whatever proposal gets passed is going to be hobbled by the systemic problems that are currently present and that they've failed to address.

If you don't know care where you're going ... then any road will get you there. Most folks who design training programs for a living know that adage well. Training designers, instead of using "forward" thinking that could allow all kinds of unnecessary information to become integrated in the program, use "backward" thinking instead. In other words, they start their design with the end in mind. They ask what would successful performance look like and they work backwards from that specific point so they can figure out exactly what a worker needs to learn to enable successful performance. Congress hasn't done that in designing health care reform legislation that would truly make a difference in health care across our nation. Not one plan, in either house, was designed with the end in mind. They're all just mixed bags of various initiatives that probably, in the long run, won't make a bit of difference in ordinary citizens' lives.

Systemic problems are being totally overlooked ... or worse ... being protected.

  • U.S. Patent Office. The Patent Office grants patents to drug companies and research firms on things like human genes that cause or contribute to cancer, which gives those companies/firms exclusive rights (monopolies) to research and provide treatments. "In the United States, gene patents are now being used to halt research, prevent medical testing and keep vital information from you and your doctors. Gene patents slow the pace of medical advance on deadly diseases. And, they raise costs exorbitantly: A test for breast cancer that could be done for $1,000 now costs $3,000. Why? Because the holder of the gene patent can charge whatever they want, and they do." [NYT] Just try doing a Google search on: patent gene and read through a few of the articles that come up.

  • Existing Premium Rates and Fee/Service Schedules. If you've really listened to the debate and understand a small bit of what's going on in the industry today, you know that those of us who actually have insurance end up paying higher premiums and service fees to doctors and hospitals. That's because factored into those rates/fees are monies that help doctors/hospitals provide services for the uninsured. While a number of the bills now before Congress mandate that we all have to have insurance (a serious gift to the insurance industry), I see nothing in any of the bills that addresses the inflation in service fees and premium rates once everybody is insured. "The average U.S. family and their employers paid an extra $1,017 in health care premiums last year to compensate for the uninsured..." [USAToday]. I don't know about you, but I seriously doubt if many of us will see reduced charges from our doctors, hospitals, clinics, pharmacies and insurance companies should any of the current bills become law. What we'll most likely see is today's costs as the baseline for future rate and premium increases ... in other words, maintenance of today's overpriced status quo.

  • Medical Liability Tort and Insurance Reform. Doctors pay malpractice premiums that can run up to $250,000 a year for specialties such as neurology or obstetrics. Doctors also police their own, frequently allowing doctors who shouldn't be practicing to continue opening their doors to new patients. And ... especially in the big cities, people are becoming more litigious ... and worse, juries are becoming excessively generous in dubious cases. Opponents of reform claim that tort reform would yield only 1-2% savings, but for a $Trillion industry, that's 1-2 $Billion in savings to consumers.

  • Need for Corporate Lobbying Reform. The health sector spent $150 million on campaign contributions in the 2008 election cycle, more than the $123.7 million it spent in 2003 and 2004. It spent $365.1 million on lobbying in the first three quarters of 2008. Those are dollars we spent for health care that instead are going to campaign coffers of our elected officials. Personally, I don't get to deduct any contributions I make to elect a Congressman or Senator, therefore, lobbying expenses should NOT be deductible for corporations. Allowing lobbying efforts and contributions as an allowable expense of doing business does two things: (1) it corrupts the political process in the direction of those with big pockets, and (2) the views and desires of ordinary citizens are ignored in favor of the desires of those with lobbyist dollars.

If health care reform passes without a viable public option, it won't represent health care reform, but instead, an early Christmas present to the health care industry.

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