Four Problems any Health Care Plan MU...

I'm not sure why, but Obama seems to have the wrong approach to health care reform. This is an important issue but he seems to be allowing others to dictate the course reform will take. He is allowing Congress to write the bill, and taking a back seat in the drafting. He is trying to avoid the problems Hillary Clinton encountered in 1996 when she plopped a complete, complicated bill on the lap of Congress, seemingly with a "take it or leave it" attitude. Of course, Congress doesn't appreciate this, which was one of the many reasons why Clinton's health care reform failed.

Obama, on the other hand, has a very Congress-centered outlook and staff. He knows the importance of Congress in legislative victories and the influences Congress works under. But here, in health care reform, is he taking too much of a hands-off approach?

As of yet, I have not heard Obama articulate the goal(s) he is hoping to achieve with health care reform, other than achieving reform itself. This will leave him dangerously open to buffeting by the political winds as he attempts to get a bill passed. What could emerge may not end up helping solve the many health care problems facing Americans today but instead could be a patchwork of compromises and special interest payoffs that do little to improve the situation.

What he needs to do is to outline the goals he wants to accomplish, specifically, what problems health care reform needs to solve in order to get his final signature. That will keep the process goal oriented and problem-solving, regardless of the specific methods used to solve the problem. Thus, rather than arguing over single-payer or private insurance, mandates or no mandates, a government option or not, just ask if it solves the problems that need to be solved.

Four very important health care problems facing Americans include:


1. Bankruptcies Between 50 - 60 percent of personal bankruptcies in America occur - in part or entirely - as a result of medical emergencies. Many of these bankruptcies occur despite the fact that the patient had health insurance. High deductibles, maximum payout limits, and refusal to cover certain conditions, procedures, or tests leads to catastrophic levels of medical bills accumulating in a short time in many life-threatening situations. Medicaid will not pay until all assets are depleted, including the family home. Many believe they are covered and well-prepared for medical emergencies, only to find that their insurance fails them when they need it the most.

2. Preexisting Conditions Having a pre-existing condition can make it extremely difficult to find medical coverage. Asthma or ADD may be problematic, to say nothing of diabetes or HIV/AIDS. If coverage is not offered through one's work and particularly if there has been a gap in coverage of a few months or more, it can be nearly impossible to find affordable coverage.

3. Portability Related to the above is the problem of portability. Having to relocate means finding new medical insurance, forcing a confrontation over pre-existing conditions or other issues that make medical coverage hard to find.

4. Market Failures Of course, there are many issues related to market failures. The many actors in the field of medicine are trying to make a profit, not heal the world. So medicines are made that are expected to turn a profit for the pharmaceutical company that develops it (Viagra, Claritin) rather than affordable, life-saving AIDS or malaria drugs for developing countries. Private hospitals specialize in expensive, (often elective) procedures, relegating the less profitable procedures to the public hospitals. When private hospitals are held up as a model of efficiency and profitability, we must keep in mind that they are not always serving the needs of everyone.

If private insurance, hospitals and other programs can fix these problems, that's great. But I am not wedded to the so-called "efficiency" of private enterprise, when it comes to medical and health issues. These companies are good at maximizing the bottom line, yes, but not at maximizing the health of their patrons. That is not what they are meant to do. And while government options are notoriously bureaucratic, our private insurance is already overrun with paperwork and hurdles that must be jumped in order to receive benefits. Could public health options be much worse? However, no matter what solution the politicians arrive at - public or private - if it fixes the problems currently plaguing our system and costing lives and income we will be better off.