Responds To Healthcare Legislation Letters
To The Editor:
In response to the letters in last week's "News" regarding healthcare legislation:
1. The healthcare crisis is not phony or made-up. Anyone who has been paying attention the last few years knows that there are lots of problems with our healthcare system - including the cost of it. A lot of people have had their benefits - as provided by their employers - curtailed or cut off completely. Employers simply have had a difficult time keeping up with the increasing cost of health insurance for employees. I saw this over the last several years that I worked for the county. In order to keep employees insured, county commissioners had to change plans that sometimes reduced benefits or raised deductibles and copays. The commissioners did a good job of shopping around, but the bottom line is that the county is just like other businesses; they have all been struggling to try to keep their people insured, but at ever increasing cost. Other businesses have cut off family coverage or cut off insurance altogether. These are not "made up" stories. They have happened. So why does anyone think the healthcare problem is just a "phony?"
(By the way, although I get a county pension, I do not have insurance through the county anymore. I self pay my own insurance through Aetna. I think that anyone who criticizes or supports efforts to reform health insurance should have to disclose their insurance. I have heard some healthcare-reform protestors argue that no reform is needed, and then turn around and admit that they have Medicare or government insurance. Of course they don't want things to change. So, Mr. Land, what is your insurance coverage? Mr. Joyce, I know you are covered by the county or are eligible for county benefits. Do you still have coverage under your state police retirement?)
2. As far as "healthcare savings accounts" are concerned, I think they are a good idea. But, even the county commissioners did not adopt that option. It sounds good for employees, but isn't as attractive to employers. Trying to fix things piecemeal is not always a good idea.
3. Tort reform is always trotted out as a big answer. But tort law is the way our society regulates behavior and compensates people for the wrongs that other people have done them - including such wrongs as malpractice. To prevent lawsuits when someone has been injured - sometimes severely and for the rest of their lives - or to cap their damages at some artificial number (especially when the doctors and the hospitals and the insurance companies can just raise fees to cover smaller jury awards) sounds like a way to eliminate any regulatory or deterrent effect that tort law is supposed to have.
I am not opposed to tort reform, but I have always thought it should be coupled with some real offers from doctors and hospitals to do some of their own policing of the medical profession. Part of the Obama plan is to encourage just that. Obama urges legislation that would require hospitals and other medical providers to collect and publicly report objective data regarding healthcare costs and quality, including data on preventable medical errors, nurse staffing ratios, hospital-acquired infections, and other information. Health plans would have to publicly report the percentage of their premiums that actually go to paying healthcare costs rather than administrative costs. What is "socialist" or "dictatorial" about that?
As a matter of fact, free-market enthusiasts ought to be behind such efforts. If we want people to make informed, marketdriven decisions about healthcare, then we need to make sure they have the information to make wise economic choices. But I'm not so convinced that market forces work in the choice of medical care. When your child is sick, running a high fever, bleeding, vomiting, are you really going to make decisions based on cost?
4. I'm not saying that the legislation before Congress is the best or that it isn't being rushed through. It is a shame that we cannot have a nice, long, quiet, civil debate, based on the issues and not on politicized scare tactics. But that is not going to happen, no matter how long we let it open for debate. We need to act, and not be paralyzed by the lobbyists for insurance companies, hospitals and high-paid medical specialists.
5. Rationing care and making end-of-life decisions. You don't think this doesn't happen already? Insurance companies have lists of drugs that you can't have, even if your doctor prescribed them. In order to get them covered, you have to prove why you need them. A government bureaucrat does not decide whether you have proved your need or not - an insurance company bureaucrat does. Under my own insurance, I can't go to a specialist unless a doctor - who is in the company network - refers me to him. And the specialist has to be "in network" too, or I have to pay him myself. So much for being able to "choose my own doctor." When I took my 90-year-old father to the hospital before he died, I had a heck of time trying to keep the doctors from just writing him off as old and ready to die. The primary physician had never seen him before but just assumed he was invalid and it took persistence to make sure that we got the doctors to give us the full information about his condition so that he could make his own end-of - life decisions. It was not a government bureaucrat who did that, it was the doctors themselves. It would not hurt to have laws and rules that would regulate this kind of thing.
6. Finally, this is addressed to the issue from several weeks ago about the woman who complained about her treatment at Fulton County Medical Center. Mr. Land said it was an example of "entitlement gone amok." I don't think so. It is what you get when you call yourself a "nonprofit, community hospital" and when you have your picture in the paper getting a big check from the governor of taxpayer money. Under those circumstances you can't blame some people in Fulton County for still thinking of the Medical Center as the community hospital that it was when any citizen could be a "member." Let's understand this - the Medical Center corporation is nonprofit but that doesn't mean that no one is making a profit out of it. I assume that the doctors and administrators are getting some pretty good money. And citizens can no longer be "members." The Medical Center is run by a board of directors. You will have to excuse some people. They still think of the Medical Center in the old-fashioned way. Like when I was a kid, and you would go to the doctor's office and he would the there til 11 or 12 at night seeing a room full of sick patients. And then maybe get out of bed early the next morning for a house call to see a sick kid. And charge fees that you didn't need insurance to pay. Those days are gone. And I am sure it is better now for doctors (justifiably so). But there are a lot of problems for the rest of us - and I didn't just make that up.
Dwight C. Harvey