09/09/09: The Outlook for the future of Health Care in America...

Let me start by saying what should be obvious to everyone at this point; we need health care reform.
Make no mistake about that.  The system we have now is broken and it is unsustainable.  Costs are
out of control, and will continue to climb until the government steps in to control them.  Yes, that's right,
the government.  Why the government?  Because only the federal government has the power to force
corporations to behave in a reasonable manner, as opposed to charging us an arm and a leg and then
not giving us help when we need it.

Now, let's focus on a few specific issues...  First I'd like to clear up some misconceptions that people
have been fed by opponents of health care reform.  Number one, there are NO death panels!  End of
life counseling is about discussing your options -including getting a living will.  A living will, just like an
ordinary will, says whatever you want it to say.  If you want them to just let you die, then that's what
happens.  If you want them to try to keep you alive no matter what then that's what they'll do.  Second,
opponents of reform insist that if reform passes, you -the American tax payer- will be footing the bill for
millions of illegal aliens to have health care...  Newsflash!  You, the tax payer, already are footing the bill!
All hospitals in the United States are required by law to treat anyone who comes to the emergency room.
Also, you're paying for the cheaper prescription drug prices in other countries.  American drug companies
can afford to sell their products cheap in other countries because they can make all their profit off of the
citizens of the United States.  Moreover, the proposed reform bill specifically states that undocumented
aliens will not be covered.  Third, there's the 'we're going to be forced to pay for abortions' crap.  This
is quite simply not true.  There is already a law on the books that prevents federal dollars being used to
fund abortions, and no proposed health care reform bill would change that.  Fourth, the total bullshit
about 'mandatory abortions' and 'mandatory sex changes' is so absurd neither myself nor anyone else
should have to seriously address it...  Fifth, the charge of 'government bureaucrats will choose a doctor
for you' or that they 'will tell your doctor how and/or whether to treat you' stems from wording in the
reform bill(s) which refers to helping provide your doctor with your medical history, etc., so that he can
determine how best to treat you.

Finally, a misconception that isn't completely a misconception...  Opponents of health care reform have
gone on and on about government run health care being socialism!  They're right.  Government run health
care would be socialism.  But there are two points to made on this subject.  One, the health care reform
that is actually being discussed is a far cry from full-blown, socialist, single-payer, government-run health
care.  The public option -which is not likely to even be in the final bill- is the only part of the proposed
reform that actually represents 'government-run' health care.  Two, we already have socialized health care
in this country -it's called Medicare.  Social Security is also a socialist program.  Opponents of reform
continually state that 'socialized health care' doesn't work.  If that were really true, then why is it that the
United States is the only industrialized nation on Earth which does not have some form of socialized
health care that provides universal coverage?  Opponents of reform claim that we already have the best
health care system in the world and that every single person in the world wants to come here for treatment.
In truth, the United States is surpassed by dozens of other countries when it comes to health care.  Even
Costa Rica provides its citizens with better health care than we do!

So, what needs to be included in reform, what needs to not be included in reform and what are we likely
to actually get?  Strictly speaking, what we really need is to join the rest of the civilized world and have
something like a single-payer system.  But that's not likely to happen in our lifetimes.  If reform is going to
mean anything, there are a few must-haves.  There needs to be regulation of health insurance companies
to make certain they neither refuse up-front nor later drop customers for reasons such as 'they had a
pre-existing condition.'  Also, insurance companies must be prevented from either dropping or watering-
down coverage when it comes time for them to pay for people's medical expenses.  So far, it looks like
those things will be in the bill.  Also of key importance, is a mechanism for controlling costs...  That means
either a Public Option to compete with private insurance or strong regulation to reduce the amount they
can charge their customers.  Right now, it looks like a toss up on whether or not the Public Option will
happen.  If there is no Public Option, then it is vitally important that there be something that will actually
control costs.  The only thing that Republicans have offered as a way of controlling costs is to allow
people to 'buy insurance across state lines'.  I wish I could believe that 'market competition' would insure
lower costs, but it just doesn't work that way...  When thinking about this concept, it might be helpful to
know something that's been happening for a long long time in the beer world.  For many years there
were the 'big three' brewers; Bud, Miller & Coors...  Almost every single year for a long time now, all
three companies have raised their prices by more or less the same amount per case, matching each
other on virtually every tier...  As with all other industries, the big beer companies have continued to merge
and make ever bigger corporations...  In situations like these, you don't get competition...  You get price
fixing.  These huge corporations have silent agreements to never under cut one another on price -that
means us (the little guys) get screwed no matter what.

After Obama's speech, I feel a little better about a couple of things that were really beginning to worry me.
I was very concerned about the possible impact of both the individual mandate and the employer mandate.
If either (or both) of these items were in the health care reform bill, but there were insufficient cost controls
included, it could have been a real disaster.  If I can't afford to buy insurance and I'm required to buy it
from an insurance company who gets to charge ever higher prices them I'm screwed.  Equally, if a small
business (like the Red Barn) is required to provide health insurance to its employees but can not afford to
do so, then it must either stop employing those people and/or go out of business.  I was pleased to see
that Obama addressed both these issues, if only briefly, in his speech to congress.  According to the
President's speech, there will be an 'exchange' to help provide competitively priced insurance plans, for
those who still can't find insurance they can afford there will be a tax credit to help them pay for a
policy.  For those who still can't afford to buy health insurance there will be a hardship waiver.  Finally,
the President stated that although there will be an employer mandate, 95% of all small businesses will
be exempt from that mandate.  Only time will tell what really happens, but I feel hopeful that we will
finally see something substantive come of this debate.

Reform has been a long time in coming, folks.  Presidents have been trying for a hundred years now to
fix health care in America, and the only true reform to date was when LBJ signed Medicare into law
some four decades ago.  For the sake of generations to come, we must at least make a start toward a
better tomorrow.  -JH