What are you thinking?

Bill Kristol speaking on Fox News Sunday today categorized last Thursday’s Health Care Summit as a dog and pony show that was an affront to all other dog and pony shows.   Mr. Kristol is spot on this one. 

For seven hours with TV cameras rolling  there was grandstanding, pontificating, preaching, condescension, but no resolution.  To me this is very simple.  The current legislation is  over-reaching, unmanageable, and most importantly unwanted.  In polling across the board, a majority of the American people do NOT support this attempt at reform, however those in attendance  on Thursday are not getting it.   

It appears to me that reform of health care can best be accomplished by the states, but there were no state governors invited to the health care summit.  To me that should have been a given. 

With a few exceptions,  I think that this assembled group was for the most part clueless.  And I have to ask:  What are you thinking? 

What is the most frustrating  to me is that health care reform was first and foremost proposed to provide health care insurance coverage to those  reportedly 50 million or so Americans who now do not have adequate coverage or can not qualify for coverage.  It has evolved into an attempt to create another government bureaucracy (and we all know how well those work out) that will control about 1/6th of the American economy. 

Are we ever going to cover those Americans who are now are without some kind of health care coverage ?  Absolutely not. There are those who just choose not to have health care insurance for whatever reason and in this nation, they can not be compelled to purchase it as is a part of this legislation.

The revelations this week of double and triple digit percentage increases in profits earned by insurance companies did not garner much sympathy for them.  I have asked my health insurance carrier on several occasions about their position in the health care debate, and my representative does an excellent job of regurgitating the talking points that she has obviously been provided with to respond to any such inquiries without taking a specific stance on the issue.

On a recent visit to my personal physician for my annual check up, I paid my $25 co-pay for the office visit.  I will receive an explanation of benefits from my insurance carrier which will tell me the exact cost of that visit, less the cost of the discount negotiated by the insurance carrier which in my case has 98% of the physicians and 100% of the hospitals in the state of Iowa on board with them.  The co-pay is just  a small fraction of the final cost.  This may very well be where one of the problems exist with the health care system.  Does anyone really know how much health care actually costs?   When you walk into the doctor’s office, there is not a menu with prices posted as in a fast food restaurant.   I am not sure that is appropriate, but why are we not better consumers?  If you know the price of your Big Mac, surely you should have some idea of how much your tetanus shot or x-ray will cost.

As a business owner, I also realize that the  cost of the office visit includes not just the professional service provided by the physician, but also the cost of staffing the office, paying the utility bills, mortgage and property tax payments, building  maintenance and the insurance that any business must have; and in the case of a medical facility, outrageous malpractice insurance costs.   Then, there is the  doctor’s salary which in most cases helps to repay the often hundreds of thousands of dollars in college loans that were taken out to pay for their medical education.    In discussing this issue with my personal physician, she estimated that $1 out of every $3 of health care cost covered these non-medical, but still essential business expenses. 

The system is in need of reform, but not reinvention.  We need to understand exactly how much our health care actually costs.  Health care insurance needs to be universally available to those who want to have it and  have the ability to pay for it and for those who can not, some kind of relief.  Not everyone wants to have health care insurance.  I believe that using the employer model for providing insurance is outdated and individuals need to be responsible for their own health care coverage.  Employer provided group plans are a one-size fits all. The  health care needs of a 28-year-old single woman are not the same as a 59-year-old corporate officer.   Competition for health care insurance just like with automobile insurance will go a long way to bring down the cost of insurance and that must be a part of any reform package. 

For the second time in 20 years, the attempt to reform the American health care system at the federal level has been summarily rejected by the American people.  There is no question that there is room for improvement.  But a televised “summit” with minutes being tallied as to how much each side had to present its argument did virtually nothing to bring about kind of resolution. 

Scrap the current bill.  Encourage state governments to begin the reforms as they did successfully with welfare reform.  State statutes can address  tort reform, competition for insurance carriers, and how to deal specific issues such as coverage for  pre-existing conditions.  Find solutions for the  unfunded mandates of Medicare and Medicaid and allow states to address specific needs for those programs much the same as they have with S-Chip legislation.  Involvement by the Federal government  to uncover waste and fraud in Medicare/Medicaid can go a long way to resolve the problems with those programs.    An all-encompassing solution from the Federal government will lead to a massive bureaucracy that will not be able to manage the health care issues of a nation of over 300 million people.  Iowans have a different situation than those in Virginia, California or Montana.  Young people have different health care needs than that of older Americans.  Dick Cheney has different health care needs than Michelle Obama.

Incremental changes at the state level, not an overhaul of the system by the Federal government is what is best.  If the Democrats decide to use reconciliation to push this legislation through, they do so at their peril.  And should this legislation pass, if the Republicans do not immediately announce that they will repeal this legislation if and when they are in the majority in Congress they are in trouble as well.    It is time to start thinking outside the box, that is if our leaders are thinking at all.


1 Comment

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One response to “What are you thinking?

  1. I agree with you that health care is best left to the state. We seem to be able to easily manage health care in Iowa for uninsured children. How hard is it to expand that health care for uninsured Iowa adults. The federal government needs to stop trying to do EVERYTHING POORLY and start sharing responsibility with the states. Then maybe the federal government can work on national needs that are often overlooked–defense, international relations, etc.
    In successful cooperation, CEOs and other leaders delegate responsibilities to others so they can concentrate on the big issues. The federal government needs to do the same thing with the states!

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