Health Care Reform

When you hear the term “health care reform”, what is the first thing you think of? If you live here in the United States of America, you probably think of the looming changes that await us with the ushering in of President Obama’s new plan. Well, aside from the obvious political wrangling that will ensue with any article or site involving such issues, there are other considerations to take into account. At the recent speech earlier this month (September 2009), President Obama talked of what his plan was to include and what it was not. There were the expected inclusions, high points and remarks, as well as the famous “you lie” statement by the good Senator Wilson of South Carolina. Obama was also either celebrated or chastised, depending upon your political persuasion, regarding his heartfelt or emotionally driven angle on the ‘moral’ aspect to all of this. Well, all this dialogue is fine and good, but it is only aimed at the political aspect of this whole debate. The President was getting at something a bit deeper, and that is what this site here is all about.

Consider for a moment how our country ranks in terms of its overall health. When a recent study was performed by the World Health Organization (WHO), with regard to many aspects of how a country is judged in terms of health, the U.S. was ranked 37th. Yes, this is an atrocity. To some, this is terrible because they cannot fathom that our nation is not number one. Not sure why, but there seems to be some more conservative weight behind this one. The conservatives afoot here seem reticent to accept our status as a nation that exists within the larger context of the world. It is all or nothing and “we must be at the top”. Why this is is beyond me, but I’m anxious to hear any replies in the comments below.

More to the point, how does reform of our healthcare system happen in a way that gets us what we really want? – which is not more government invasion of our lives, by the way. Well, you can believe what you like, but it will not come from a government run and mandated program. The reason why it has come to this place in the first instance is because there have been other areas neglected for too long. Much like the health care dilemma we are in, consider it like a disease process that we have faced as a country. We have (wrongly) assumed that more technology and more treatment means better outcomes and healthier, happier people. This is not the case. This is not opinion, it is what the studies and statistics point out. True, you can use statistics any way you like to make a point, but just consider that ranking mentioned above. We rank 37th in overall performance and 72nd in terms of overall level of health! Even if you give or take some percentage points away, we are still nowhere near the top of that list. But, it gets even scarier. We spend trillions (more than any other country in that 191 country study by the W.H.O) and are first in responsiveness. Woo-hoo there!

This could come off as some type of complaint or rant about the poor quality of our system here; it is and it isn’t. Let me put my agenda clearly in front of you….on second thought, that might just give you more reason to have a clouded vision of what you are reading. Let’s just keep it factual and on point. My political bent or medical leanings will be more than obvious somewhere along the way if they aren’t already. Oh, what the heck – I am not for socialized medicine or subsidized health care, there I said it. Having said that, I’m finding it harder and harder to see a solution that will work outside of the mind of our culture shifting.

Let me explain. Subsidized medicine will only work if there truly is a level of competition that is available. The problem is, when the government gets involved, the capitalist principles upon which our country is based and thrives is altered. You cannot compete with a monopoly….er…government like that. A similar thing happens in other industries, most of which I am admittedly ignorant of, but let’s take farming for instance. We’ve all heard of the subsidies given to farmers to say not grow something. If another independent local organic farmer were to try to get into that market to make a profit, do you think it would be a fair place to do business? I think not. You see, I am also a fan of capitalism, I just happen to think it is the way that the world order of business works best: people coming together to meet and exchange money for products and services. The prices find their own balance point between profit and fairness when a competitor can provide the same (or better) product or service for a better price. The problem with this is that it is rarely a perfect capitalist world. There are so few places left, it seems, where unbridled capitalism can reign. It is certainly not happening with respect to health care reform or Obama care as some are calling it.

The thing is, what do we do about it.  Well, the first thing we must do – all of us – is to evaluate what we consider to be health.  Health care in this country could be nothing further from the truth.  Do you actually go to the doctor to get healthy?  Of course not, you go there when you are at wits end because everything you’ve tried didn’t work and now you hope someone else with some expert training and study can fix your problem for you.  This is what doctors do, right?  Yes, it is what they do here.  Now, there are things like “preventative medicine”, which are great ways to catch major diseases in progress, but this is really not about health still.  Health is really a term that stems from an Anglo-Saxon word the root of which is ‘hal’ or ‘hol’, meaning whole.  So, to be healthy really means to be whole in all aspects of our bodies – this includes physical, as well as mental and emotional.  Some in alternative medicine also include spiritual elements to healthcare.  No matter your stance, you must appreciate that health is more than simply the absence of disease or symptoms, but is a more inclusive matter of what makes you happy and whole. 

This is why alternative and complementary medicine has enjoyed such large growth over the last decades.  More and more people are recognizing that simply taking drugs and doing surgery just don’t live up to their promises long-term.  This is at the heart of this whole issue.  The long term solution to our health care crisis is to shift our focus from that of trying to just treat disease and to master the art of maximizing health.  This may sound somewhat like playing with a semantic issue, but it is much more than that.  If I asked you to do things for one month that maximized your enjoyment of life and were things that contributed to healthy living practices, you would find that little if any of them had to do with taking drugs or planning a surgical procedure.  In and of themselves, medicines and other drugs can have life saving effects for millions of people.  Again, this is simply not the issue at hand.  What we are faced with in our country is a crisis of cost and mindset and nothing more.

Let us pretend that we did not have health care insurance here.  What would happen is that a price would be set – among competing doctors and hospitals – for what a particular exam, procedure, medicine, surgery, etc. would cost you before you did it.  If this was acceptable, you would pay for it out of pocket.  Without the 3rd party middleman we call the insurance company, there would need to be more accountability for the pricing structure of healthcare procedures.  Any clinics or other medical facilities whose services did not warrant the costs would not survive in that environment.  Services that were valued and utilized could support the health care businesses that existed – let’s make no mistake about that either, THEY ARE BUSINESSES.  This is not a knock or jab at the system, it wouldn’t well if it were anything less to my mind.  This is where some feel that health care reform and Obama care will create poor quality health care.  I’m not sure exactly what that means, but I can see the point.  Some people’s take on quality may be different than mine or yours, but does it really cost $150,000 to do a surgical procedure – really?  There are Harvard trained medical doctors, just like the one you see at home, who have moved back to their native India who can perform those same procedures for nearly 10% of that.  That one is going to get the comments moving.  The point is not that you should fly somewhere else to get your procedure (you could if you wanted to) but that our health care costs have escalated to a point where they are not in line with the services that are provided. 

You know that something is fishy with our system if you have had to deal with the health insurance industry here at all.  You can see it on your “Explanation of Benefits” statement.  Your doctor or facility charged $976.54 for that exam and procedure with all the ancillary care and what not.  Then, your insurance company allowed $633.47 of that charge (if your doctor was lucky).  Then, with your co-pay, deductible and co-insurance taken out….your doctor got a whopping $228.35.  Now, realize that even that amount is making a profit to some degree.  Again, not a gripe, I like this profit factor, it is how doctors are compensated for their time, skill and energy it took them to do what they are now doing.  The point to be made is in the pricing.  If it ‘really costs’ somewhere in the neighborhood of $300 USD to do the procedure, but it needs to be billed at somewhere near $1,000 to the insurance company in order to get that, isn’t something wrong?  My argument is yes, very wrong.  But, the problem beyond this is that since you only have to pay your $15 or $25 copay for that, you really don’t give much of a hoot, as long as you get what you want.

This is the other problem with our system.  You will need to be responsible and accountable for your healthcare dollars in the true new and improved health care reform scenario.  If you are only focused on disease, you will be spending far more money and in a short period of time to change your ‘health’ situation, at this point, somewhat of a crisis for you.  There are some estimates, the details of which escape me at this exact moment, but it is something along the lines 80% of health care dollars are spent in the last month of your lives.  Basically, that last run at death prevention is extremely expensive, yet so is lengthy treatment of chronic health conditions. 

So, what do I propose.  Well, it is more like what I would like to see.  I would like to see a balance between a system that has an element of fair market competition, but with personal responsibility involved.  Is it much different than car insurance.  You know that if you are in an accident, you will be responsible for some deductible and your insurance will pay the other damages – up to some limit that can at least be known prior to any incident.  But even this has been abused by those windshield repair ads and companies.  They give you free dinners and passes to movies in order to let them repair your windshield.  They bill your insurance company plenty to cover those two free movie tickets.  Basically, I’d like to see a system in place where a true capitalist, free-market health care system could live. 

In addition to this – and not to exclude this in any way, shape or form – we would change the concept and culture of what health care really is in our country.  The model we are currently operating by is broken and in dangerous need of repair.  It is now estimated that around 30% of children under age 8 in our country are considered obese.  This is an embarrassing and dangerous trend.  No amount of political rodeo and power tripping will change how we think.  We have dug ourselves into this health care dilemma through our poor choices regarding how we take daily care of ourselves in those physical, mental and emotional realms of health.  We have sidestepped our role in this process long enough and we are now seeing the devastating effects.  Unfortunately for some, it comes down to looking outside of themselves yet again for a solution.  Please, if you want your dear country and fellow Americans to solve this potentially nation-destabilizing problem, wake up to the new model of health.  Choose to make your health a priority.  Make well-being your focus.  Act each day to enhance your body’s internal and innate level of healing and well being.  When you reclaim your inner resourcefulness this way, you will be contributing to a system that has us all on more solid and healthy grounds.