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Guest column | Marc Yacht

Health care reform fight shows dark side of democracy

Wherever you stand on the recently passed health care reform, passions run high. Protests against the bill have ranged from racial slurs, spitting, window smashing and undignified behavior in the House with shouts of "baby killer" viewed internationally. Supporters have stood toe-to-toe with opponents waving signs creating one of the most volatile displays of mob behavior since the civil rights marches.

Both sides share the blame for what have become mindless demonstrations leaving the democratic process in shreds. Thirty-six states including Florida have suggested they will challenge reform in the courts. Not one Republican in Congress supported the legislation after a year of efforts to find consensus between the parties. What we have is a mess with no end in sight for a polarized Congress.

It is clear that health reform leaves much to be desired. The compromises to make progress have protected private insurer's abilities to write policies. This flies in the face of one-payer system advocates. The Physicians for a National Health Care Plan railed against the bill, claiming it was written by insurers. Michael Moore supports the bill but admits it represents a financial boon to health insurers who will now add 32 million people to their roles and he further questions the effectiveness of sanctions for insurer abuses.

However, we have a bill and it should: Reduce the uninsured by 32 million; offer insurance portability when you change jobs; provide health care tax breaks for small businesses; stabilize insurance premium hikes and hopefully reduce premium cost; close the Medicare donut hole; address insurer abuses such as dropping coverage and denial for pre-existing conditions; increase Medicaid eligibility to 133 percent of poverty; assure the coverage of sick children; allow state-run exchanges to pool the self-employed and make insurance affordable; mandate coverage that is so important in stabilizing health care costs; include insurance for children up to the age of 26 who are in school under the parents' plan; and force insurance companies to use 86 percent of premium dollars for health care.

However, it does not: effectively address administrative costs; provide money for pregnancy termination; provide a public option important for competition; end for-profit health insurers; create and empower death panels; cut Medicare benefits; allow annual caps on health care costs to the ill; create socialized medicine nor allow government-run health care.

This bill is not fully what I wanted, but has my support and I congratulate the legislators who accomplished it. It would make more sense for all legislators and citizens along with professional organizations to work through the details of health care reform and help make it work for the American people. All doctors should come on board and accept Medicaid. That will be key to access.

The current raucous climate is undermining our system of democracy and showing nations around the world a darker side to democracy. The majority has ruled and now is the time to sit down and work through the process of implementing the bill.

In November, the American people will have their opportunity to express their satisfaction or dissatisfaction with the accomplishments of this administration. I hope voters understand the implications of the bill before they vote. It was 100 years in the making.

President Obama will take to the road in the weeks to follow to explain this package. My recommendation is to listen.

There are questions. How will administrative costs be controlled and what sanctions will be in place to curtail and end insurer abuses? How will we complete the mission and get everyone covered? How will Congress get the physician community on board to better support Medicaid?

It is important to ask questions. It is imperative to listen to the answers.

Dr. Marc J. Yacht is the retired director of the Pasco Health Department.

Health care reform fight shows dark side of democracy 03/27/10 [Last modified: Saturday, March 27, 2010 1:35pm]
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