FURTHER REFLECTIONS ON HEALTH CARE REFORM

• First of all, the House of Representatives has been debating a bill that is 1,017 pages long, with 2,541 sections (HR 3200).  World magazine has done an important service in itemizing several key elements in HR 3200.  Quoting extensively from the bill, these are the salient elements of HR 3200:

1. The government will define your “health benefits.”
2. The government will annually ration your health care at $5,000 per individual and $10,000 per family.
3. The government will define how doctors will manage their time.
4. The government will order you to get end-of-life counseling and show proof. 
5. The government will limit readmissions by penalizing hospitals. 
6. The government will not permit you to sue over coverage limits and cost decisions.
7. The government will mandate what physicians make.
8. The government will have access to your bank accounts. 
9. The government will issue you a health ID card.
10. The government will enlist or create outreach programs like ACORN to sign up individuals to the government-run plan.
11. The government will not protect the conscience of health care workers who might refuse to perform questionable procures (e.g., abortion).

In addition to these rather frightening portions of HR 3200, there is significant concern that the Health Benefits Advisory Committee stipulated in the bill would determine what procedures are covered under a public insurance plan.  The bill requires every American to have insurance that meets certain standards.  Those who are pro-life in Congress have raised significant concerns that unless the legislation being considered explicitly excludes abortion procedures, abortions will soon become part of the required insurance package.  Further, unless clearly prohibited, such legislation would require taxpayers to foot the bill for such abortions.  The 1976 Hyde Amendment, which prohibited public-funding of abortions, must be the model to include in any health care reform legislation.

Finally, columnist Peggy Noonan recently asked some basic, common sense questions about health care reform legislation:

1. Will whatever health care bill is produced by Congress increase the deficit?
2. Will it mean tax increases?
3. Will it mean new fees or fines?
4. Can I afford it right now?
5. Will it make the market place freer and better?
6. Is our health-care system in crisis?
7. Will a health-care bill improve the economy?

Common sense dictates that at least our Congress in the various town hall meetings this month and our President must answer these questions with evidence and with credibility.  Otherwise, passage of such a bill is not possible or wise!

• Second, columnist Charles Krauthammer has suggested two fundamental changes that the government could enact that would produce significant reform and reduce significantly health care costs:

1. Tort reform.  He writes:  “. . . our crazy system of casino malpractice suits results in massive and random settlements that raise everyone’s insurance premiums and creates an epidemic of defensive medicine that does no medical good, yet costs a fortune.”  A recent authoritative Massachusetts Medical Society study found that five out of six doctors admitted they order tests, procedures and referrals—amounting to about 25% of the total—solely as protection from lawsuits.  Defensive medicine, estimates the libertarian/conservative Pacific Research Institute, wastes more than $200 billion a year.  Just half of that sum could provide a $5,000 health insurance grant--$20,000 for a family of four—to the uninsured poor.  Krauthammer therefore recommends that the US abolish the entire medical-malpractice system and create a new “social pool from which people injured in medical errors or accidents could draw.  The adjudication would be done by medical experts, not lay juries. . .” 

2. Real health insurance reform.  Krauthammer suggests taxing the health care benefit and then returning that tax to the employee who then buys his/her own health insurance.  I am not certain I agree with this option but his point is well taken.  Through health savings accounts or some variation thereof, empower the employee to make their health care decisions just like they do anything else they buy.  Empower the citizen to look at their health choices as a consumer, shopping for the best deal with the best quality care for the dollar spent.  Instead of creating a massive government bureaucracy envisioned by the current health care proposals before Congress, empower US citizens through the Health Savings Account to shop for their health care. 

Why do we believe as a nation that the government that has given us Medicare, Medicaid and Social Security and mismanaged them all can effectively mange the health of all 330 million American citizens?  It is time for some common sense to enter the debate.  Meaningful tort reform and empowering citizens to act as a consumer into their health care decisions is a good, wise and prudent place to begin.

See World (15 August 2009), pp. 36-37; Peggy Noonan in the Wall Street Journal (25-26 July 2009); and Charles Krauthammer in the Washington Post (7 August 2009).

Print