Healthcare. Medicare. Rights. Pre-existing conditions. Freedom to choose. Insurance. Free market. Single-payer.
I find myself unsure of where I stand on the current, RAGING, healthcare debate. This, of course, has raised the ire of several of my friends. It has surely caused them to think I'm the demon spawn they always knew I must be. And it's even been remarked that I'm a traitor to San Francisco (which, really, WTF?!).
On the one hand, FORTY-SEVEN MILLION Americans uninsured. On the other hand, I'm terrified of turning over the reins of healthcare to a government that can't even properly manage its existing agencies -- seriously, have you tried to get something pushed through the SSA or the IRS lately?
So many of the arguments coming out of both ends of the political spectrum are clearly meant to polarize the members of each party, but they do no good helping our more moderate citizens break down the issues, the proposed solutions, and the long-term results of each.
For my own part, here are some of the key factors I'm looking at as I try to navigate these very muddy waters:
- Is health insurance really a right? From the perspective of the Bill of Rights, not so much. On the other hand, I do agree that providing basic healthcare is a humanitarian issue, and shame on us if we can't make it so. The challenge here, of course, is defining "basic healthcare."
- Pre-existing conditions... what a can of worms. If we are really calling this "insurance", then you SHOULD have to pay higher premiums if you have a pre-existing condition which makes you a greater insurance risk. My own father, who was self-employed, paid $700 per month in premiums because of his Pulmonary Fibrosis. While that sucked for him, it's the nature of insurance.
If we really want to force the hand of insurers against higher premiums for such conditions, then let's stop calling it insurance, and start calling it welfare, because that's what it will be. Wouldn't allowing insurers to compete across state lines create a system of supply-and-demand that could drive those costs down naturally?
- I'm also extremely conflicted about the free-market aspect of health care. What other service or product do consumers in America partake of before asking what it will cost? How have we become a nation of people so ill-equipped to manage our own medical finances? So afraid to ask, "what will this cost?" How can we lambast the insurers (for whom, believe me, I have no love) when we are unwilling to take control of our own healthcare costs, and instead leave them to negotiate with highly trained clinicians for what we deserve and what we should pay for it? And honestly, do you think the government will handle it any better?
- Why isn't medical malpractice thoroughly addressed anywhere in these discussions? Have you looked at the figures that some doctors pay for insurance, and the utterly egregious punitive damages that have been rewarded by juries lately? Of COURSE doctors order tests and scans and specialists that may not be necessary -- we've put them in a perpetual state of CYA. I mean, did you know that you can actually sue a doctor for "wrongful life"?
- On the flip side of all of these points are the emotions tied to my own personal experiences. Watching my father who, in the last months of his life could hardly work but wasn't eligible for disability, scrape together $8400 a year for his premiums, plus another $2000 in deductibles. Injuring my ankle last year, and seeing the Urgent Care center bill my insurance nearly $2500 for a lot of ridiculous stuff: $300 for crutches I could have bought retail for $150; $95 for a shot of painkiller that I didn't ask for and didn't actually need; $250 for 5 minutes with a Physician's Assistant who signed a form authorizing an X-Ray. And a bill at the end, for me, of nearly $1500 because the plan my small employer can afford covers only a minimum of urgent care. Meeting a 3rd grader whose eyeglass prescription is badly outdated because the minimal insurance his parents have doesn't cover vision care -- how can that kid be expected to do well in class when he can't see the blackboard?
I fully support healthcare reform. I know it has to be done, and I know that we are facing a growing firestorm if it doesn't happen soon. But I worry that the current administration's plan is actually moving TOO fast; I fear that it is not looking at long-term solutions to the issues, and is slapping a Band-Aid over a wound that actually needs a few stitches. And I worry that many of us are choosing sides based on emotion over logic, idealism over reality.
Where do you stand on the issue? What has made you a believer (or a non-believer) in President Obama's proposed healthcare changes? Please weigh in, and let's have a smart discussion in the comments.