Friday, August 21, 2009

Getting Closer

Health care reform, so we are being told, is being debated hotly all across the country. From town hall meetings to lunch rooms everywhere, people are arguing (sometimes forcefully) about how to remake the health care system better and reduce costs while still having a viable system. We have heard everything, from the arguments that “Obama Care” will kill grandma, to those that say anyone in the U.S., even illegals should get whatever they need for care.

I have been arguing for reform for a long time. Many of my friends and coworkers in the health care field disagreed for many years about what things should look like in any reform of the system. One friend in particular and I used to spar over what each of us thought should be included, and what the likelihood was that anything would ever really change.

My friend Mike is an ER physician. His career has involved taking care of people with life-threatening injuries, conditions and traumas as well as those with nothing more than a hang nail they feel needs to be evaluated. While he would be the first to tell you he has not seen it all, he has actually seen most of it and the rest is really just more of the same. His opinions, however, are not always based on his professional experience. They are often based on his ideological slant. He is a financial conservative who abhors large government spending and waste. Thus, for years he has argued against any government run single payer system due to his fear of spiraling cost and added bureaucracy that would stand in between his patients and himself. His biggest argument to me was often that the population would never accept any system that made patients more responsible for their own outcomes and limited care to reasonable levels.

We have been going back and forth on this for years. But last week, all that changed. When I started to talk to him about the proposals being considered in the House of Representatives, he became frustrated. He had actually tried reading the bill online and after more than 300 of the 1017 pages, he turned to me and said, “You know, you and I could fix this whole thing in about 10 pages and have a better system than the mess this is going to create.” He is right, of course. He looked at me and then told me that the only way to really do this and do it right would be to cover the basics for all citizens (preventative care, office visits, necessary tests and hospitalizations, medications, etc.), figure out how much that will cost, and then tax something everyone needs or uses so that no one escapes paying in something to keep the system solvent. Then the legal reforms would need to be put in place to protect providers from unreasonable lawsuits.

It was simple. It was brilliant. It would work. It was exactly what I had been saying to him for several years. The difference now, is that he believes the public will go for it. I don’t know what really changed his mind, but he has become convinced that not only is it possible, but now the above plan is the only real option.

I smiled and told him he was starting to sound like a Democrat. Not because he was really, but because it made him mad. That’s the kind of friend I am. Then I sat back and thought, “Hell, if the two of us have come to consensus, the debate is really not all that hard”. If a staunch fiscal conservative and a borderline socialist can agree on how to fix this mess, we need to hold the policy makers accountable – or go after their jobs.

So here’s your warning politicians – get your act together and get it done or else you won’t be getting emails and letters from people like me, you’ll be getting challenged for your coveted positions. Now shut up and get back to work.

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