Viewpoint: Congressional leaders need to answer basic healthcare questions

Talk about it

The health care debate surely brings out the worst in us. We’ve been hammered with inaccurate information from both sides. Many people on both sides have been vilified, often personally, as motives are examined and allegiances are claimed.

One side has remained in a continuous campaign mode, claiming sweeping reform to solve all health care issues, while the other side has attacked nonexistent problems, such as how a provision to cover life counseling is death panels in disguise, or how covering controversial procedures with public money would be the end of civilization as we know it.

For me, Thomas St. Martin’s reader viewpoint is right on point. If we don’t examine the real problems, especially those related to costs, we will only push this set of issues down the road, whether we get a new health care plan or not. It is undeniably true that the aging population has a distinct and expensive impact on our health system, and it is also true that in addition to the impact of defensive medicine and malpractice insurance, there are the cost issues related to developing and delivering technology: new imaging devices, new monitoring devices, new and costly training for health care professionals, and expansion and deployment of health points of service, such as hospitals, clinics, etc.

What I would propose to our leadership, on both sides, is an acknowledgement of the goals and answers to basic questions:

1. If we are to provide “affordable health insurance” for all, let’s quantify it:

a. What is the definition of affordable?

b. How many of the uninsured are we talking about?

c. What is the net cost of enrolling them? (Premiums – care)

d. Does this include a mandated coverage for all Americans? (Thus we can count on the premiums?)

e. Can we create a basic set of services for a basic plan? (Sort of like the Medicare Supplement insurance providers have a government-set basic plan, then more costly plans that cost more, thus reducing co pays and improving coverage)

f. What do any of these provisions do to existing premiums (private, Medicare) and co payments?

2. If we are to add pre-existing insurance waivers and right to portability for insurance, how much is that expected to cost?

a. Who covers the differences between employer-provided premiums and personal premiums while between jobs?

b. Is there likely to be a premium adder for people with pre-existing conditions? Like with auto insurance, those who have accidents pay more than people who don’t. There is an assigned risk pool for those with accident and arrest problems, but insurance is mandatory, although expensive.

c. If people are to retain insurance unless they stop paying premiums, what happens if they do stop paying? Who picks up the cost for health procedures?

3. There are pending cuts to Medicare authorized payment schedules. Will future “savings” include any further cuts?

a. Will these cuts likely result in fewer services? Will they likely result in even less doctors and hospitals accepting Medicare patients?

b. Exactly what are the proposed cuts ($500 billion or more) in Medicare? Just saying “waste and fraud” seems like a noble goal, but can be taken care of without reform.

c. If Medicare Advantage provides better-than-Medicare services and lower co pays for participants, what happens to these patients as the program is decimated?

4. Can we accomplish the two main goals of extending coverage without a major restructure of the entire health system? Exactly what does that cost? Just that number, not with a new “public option” not with “preventive care” not with “IT technology improvements”, just the number, please.

5. Medicaid is a bad deal for the really indigent. While coverage and care is available, spend-down and co pay income requirements haven’t been updated in years, and those that need the most, have little support. What is the cost to bring this program up to standard?

6. Please tell us the cost and benefit of adopting each of the following cost impacting changes:

a. Insurance availability across state lines

b. Government-negotiated drug prices for Medicare and others

c. Tort reform

d. Public option as an alternative to private insurance

So, let’s work on the details, and get at the real issues. Let’s stop calling one side or the other dumb, in the pockets of special interests, or wed to an ideological position. (True or not) We are all Americans, smart enough to know that we must do something. Let’s do it with our eyes wide open.

Wells is a Woodbury resident.

Tags: lee wells, opinion, viewpoint, healthcare, daily updates