Guest column | Dr. Marc J. Yacht

We can't afford for health care reform to fail

Political posturing aside, responsible Democrats and Republicans cannot deny the need for a radical fix to health care delivery. The American Medical Association is following many state and specialty associations calling for reform. This signal from the AMA is long overdue and represents a response to physician members who have tired of business as usual. The Florida Medical Association, still under the grip of ultra conservatives, seems to prefer a head-in-the-sand approach. They will lose more members as they rail against efforts for reform.

President Barack Obama continues to take the high road on the issue with his town hall meetings and the overwhelming public mood for a fixed health care system. As always, the devil is in the details. However, Blue Dog Democrats, feeling constituent heat for their behavior, are well on their way to a health plan agreement with the administration. Hopefully, the American people will see a bill that meets their needs and not one crafted by the health insurance industry. Such legislation would further sour the public on government initiatives.

Elected officials looking for dollars need go no further than their resident health insurance lobbyist. However, elected officials will have much to answer for at home and they know it. As the saying goes, "You can fool some of the people all the time and all of the people some of the time, but you can't fool all the people all the time."

What can we expect from good health care reform? The list is long. Universal health access would allow a medical home for everyone. This would not overwhelm doctors but enhance the viability of doctor's practices particularly in hard-hit economic areas where so many are uninsured. Many of the uninsured cannot pay their health bill. As with seniors covered by Medicare, all would be paying patients.

Hospitals would see their "no-pay" patients disappear as would other health care providers. The net effect would be to thwart escalating bad debt to hospitals and stabilize double-digit cost increases to prevent insolvency. Currently, the insured can less afford spiraling premiums, increasing co-pays and denials; hence, more uninsured. Individuals and businesses are trying to get out from under withering health cost increases.

Ironically, these increases are necessary to overcome the bad debt. It is a vicious cycle that must be broken. That will occur through mandated health coverage and anyone who understands the economics of health care knows it. It is criminal to posture on the issue. We lose 20,000 lives a year in this country because of lack of health insurance. Tens of thousands more are unable to get needed pharmacy or health care access because of costs both in doctor's offices and in hospitals. Charitable care, when available, is not equitable care and should not be perceived as such.

Those who argue we are moving too quickly are sandbagging the process. That argument has been made for 60 years and 60 years is more than adequate time for a solution.

Adequate access to health care means a healthier population, good preventive care and equitable management of chronic conditions. Less disability means more self-sufficiency and a more productive work force. There are vast financial benefits both directly and indirectly with universal coverage. The Europeans have understood that since they started their reforms in 1910. Can we finally get the message?

Yes, there are problems with universal health care, but I doubt you'll see any country with coverage ending it. I would further suggest that no citizen of a country with universal health would give up their medical system for ours. True, it's a constant fix and assessment, but that is true in both the private and government sectors in all industries. The question to be asked is how long we can afford to delay action while trying to create an ideal system. Perfection is elusive and of course should be a desired aim.

The essentials of universal health care are modeled in Medicare. Keep administrative costs down. Universally cover the defined population. Minimize the paperwork. Pay adequate reimbursements to providers. Develop effective regulation and oversight.

Medicare is not perfect and has problems, but it sure works for doctors, hospitals, patients and other providers. I would suggest that many of Medicare's woes, as is true of any health insurance provider, are directly affected by the burgeoning numbers of uninsured.

Responsible politicians and advocacy groups must stop picking apart a long overdue fix to health care reform. They should work constructively with the Obama initiatives and move it forward. The stakes are too high for another failed health reform effort.

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

We can't afford for health care reform to fail 08/10/09 [Last modified: Monday, August 10, 2009 6:58pm]

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