The page in the left side bar of this blog has some graphs which indicate expense problems with current health care. Some points to bear in mind:
1. When people hear the trillion dollar bill mentioned as the cost of health care reform
a. This is not THAT much more than the Republicans blithely removed from the federal budget when they removed the estate tax which affected only the richest among us.
b. It will be spread over ten years.
c. PERHAPS, just perhaps, if it works, this money will really be redirected money that people are currently paying to private insurance companies.
I have qualms with health insurance reform. But we can't address our qualms effectively until we've moved from our current screaming match and are addressing questions from within the issue.
Qualms include:
a. Yes, bureaucracy. I'd like to see an outline of how this compares to current systems which contro medical practice and hospitalization, etc. My biggest annoyances were inspections of facilities and records that caused all of us to clean up stuff with some artifice just before inspectors showed up and that, yes, did interfere with treatment for various reasons. BUT THE INSPECTORS CAME FROM PRIVATE ORGANIZATIONS!
b. Lower prices for coverage and payments to providers should not be TOO low as Medicaid currently are. Medicaid was no great shakes when I was in the field, either, let me tell you. At times patients were victims; at times they couldn't find care.
c. Are there any efforts to deal meaningfully with law suits? As I understand it, law suits per se are not that much of a contribution to high costs, but the following surely are: doctor's liability insurance premiums, especially in some fields; the fear of suits leading to excessive and sometimes harmful tests and treatments.
d. Are there any efforts to have the government pay for medical school so that students don't think of medical school as an entrance to a high paying job as much as (or at least any more than) as a public service? Payment of fees should entail some obligatory medical service after training, as is done in Mexico.
e. Are there any plans to do something about the nurse and primary provider shortage? Primary providers would be key to efforts to lower costs. A primary provider also gains much better knowledge of his patients as people with a complex of issues than any specialist possibly can. They should be the lifeblood of medicine. This is what I think people are referring to when they talk about choosing their own doctor. Nurses actually could do with more equality with doctors. They are not diagnosticians, but in hospitals where they see patients more than doctors do, when they are good, they have the best insights into the patients and they also are key to patients' treatment and recovery.
d. There should be use of measures of treatment effectiveness and outcomes, but will those reviewing and writing standards of practice remember that statistics provide group answers, not individual answers, so that while 85% of people may respond to such and such a treatment, 15% won't so other treatments need to be available?
These qualms characterize the CURRENT system. I would hope that reform would CORRECT them.