The evolution of current health care legislation has more twists and back flips than a Chinese acrobat troupe. The congressional squabbles over health care reform are unending. Held at bay are 46 million uninsured, millions more under-insured, and millions insured who remain at risk to denials, underpayments, losing coverage, and potential bankruptcy due to increasing co-payment costs.
Driving the derailment of needed policy are current lobbying dollars from the health care industry to the tune of $1.4 million a day as reported by the Washington Post. Capital Eye Blog suggests congressmen received $586 million from 1998 through June 2009. Democrats and Republicans share equally at the trough. Much of these lobbying dollars come from insurance premiums that should be paying for health care. Perhaps elected officials receiving this windfall should treat patients.
A recent report in the American Journal of Public Health concludes that 44,000 Americans will die this year due to lack of access or coverage for health care needs. More than 15 percent of Americans are uninsured. Florida reports that 25 percent under the age of 65 have no insurance.
On a brighter note, the American Medical Association sat with the Obama Administration to craft a health care bill for the American people. The Florida Medical Association, on the other hand, made it very clear it had no interest in working with the administration and railed against the bill from the onset. They are opposed to any legislation that would bring a single-payer system or restrict physician payments.
The FMA suggests the bill will cause millions of Americans to lose their private coverage, create new layers of bureaucracy, inappropriately expand government's role in determining care and not address needed tort reform. Members of FMA leadership challenge the numbers of uninsured and think that most people are happy with their health insurance.
As for malpractice, the need for tort reform is not well understood. It's more about exorbitant premiums that become the cost of every physician's practice than actual lawsuits. In discussing this issue with Florida attorneys, it becomes clear that the cost and restrictions relating to bringing malpractice cases forward are prohibitive. However, premiums remain high due to the potential of suits and burden all doctors, sued or not.
Are patients happy with their health insurance? Understand only a small percentage of the insured will make other than cursory claims, but the ones that have more complex medical issues face catastrophic consequences when insurers show reluctance to pay. It is easy to perceive that all is well with coverage unless one gets targeted by the insurance provider due to personal medical issues. Escalating premiums make it more unaffordable.
A recent editorial by a furloughed journalist defined well his difficulty getting insurance at any price due to his chronic illness. Such stories are common and unconscionable.
Primary care doctors tend to be more sensitive to the need for meaningful health care reform as they are on the front lines when it comes to treating the uninsured. Specialists are somewhat protected as most of their work comes by referral and patients are more effectively screened. They tend to be more supportive of the status quo than the family doctor.
Another political hot button issue relates to the coverage of illegals. Public health officials know they need access too, as they might carry untreated infectious diseases such as tuberculosis and AIDS. Untreated, they represent a threat to their communities. Government clinics must remain open to them along with resources for networking needs such as specialists or hospitalizations.
Issues such as denial for pre-existing conditions, affordability, and coverage for all seem to be supported by all sectors of the debate. However, problems in hammering out a bill that would satisfy the House and the Senate seem insurmountable.
As for the price, much of that will be determined by whether or not profiteering and administrative costs will be addressed. Universal coverage will be expensive, but can we afford not to have meaningful reform for Americans?
Dr. Marc Yacht of Hudson is retired director of the Pasco County Health Department.