There are a lot of rumors and half-truths circulating about health care reform.
The media is awash with talking heads eager to impart their opinions on President Obama’s plan, often taking a hysterical tone to try to turn heads in what is quickly turning into a shouting match rooted in the opposing ideologies of America’s two-party system.
However, with the country’s public/private health care system holding the dubious title of “most expensive in the world,” and health insurance premiums rising 131 percent in the last decade – more than three times worker wages and four times inflation according to the Kasier Family Foundation – it’s clear the country’s health care system is heading toward a wallet-busting and wholly unsustainable future.
“The American people, Republican and Democrat, agree that we have a problem in our insurance coverage,” said Professor Andrew Coburn, chair of the Muskie School’s Health Policy and Management Program.
“There are two major problems we are trying to solve,” he said.
Coburn pins the country’s estimated 40 million uninsured and underinsured citizens and dysfunctional system of healthcare organization, delivery, and finance as the two issues most ripe for reform.
One central issue that’s slowed down the passing of a comprehensive health care reform bill is the so-called “public option” model, a divisive idea that would create a government-run insurance plan to compete with private insurers.
“There is a view that the private insurance market is not competitive enough, and if you offer a government option, there will be an assurance that people have choice and that it will be cheaper because you don’t have the same marketing and overhead costs you have in a private insurance plan,” Coburn said.
There are two healthcare reform bills currently being considered by Congress.
The United States National Health Care Act, a single payer health care system similar to Canada’s Medicare, proposes a system where all vital medical care agreed upon between doctor and patient would be paid for automatically by the U.S. Government, and funded through taxes.
This plan would essentially erase the niche of private insurance companies, who would continue to offer coverage for non-essential treatments and procedures.
The other proposal, and clear front-runner among Congress’s Democratic majority, is the America’s Affordable Health Choices Act of 2009. This policy of private insurance reform proposes creating a government-run group insurance plan to compete with the the private insurance companies, offering citizens an affordable alternative to private insurance, and in theory, driving down costs through competition.
Coburn says this plan is very much like the one Massachusetts already has in place, where insurance exchange systems allow insurers to offer plans that must meet certain requirements reinforced by law, and prevent them from selectively picking who they want to insure, or denying coverage to citizens with preexisting conditions.
“Tied to that exchange would be government subsidies provided to people at different income levels to offset the costs of the insurance plan,” said Coburn.
While neither of the proposals would dramatically change how the average American receives their medical care – except for giving them more options and competitive pricing – partisan fearmongering has generated some outlandish rumors that have been transformed into genuine talking points, which Coburn said is distracting from the more vital issue.
“The fear is that government could drive out the private insurers. they believe strongly there ought to be a private insurance market, and are worried that we should not move towards Medicaid-like system based on taxpayers contributions,? said Coburn.
“The cost of what is being proposed is clearly a concern,”he said. “But equally daunting costs to not doing it – not to mention the morality of allowing 40 million people to go uninsured.”
Fear and misunderstanding have driven much of the discussion surrounding healthcare reform, as Coburn said ?We are unique in this country in having such a strong fear of government, and it relates not just to healthcare but lots of other areas.”
Critics of reform have claimed that the new plans would have the government dictating which medical plan and doctor a citizen would be associated with, Coburn is quick to dispel this totalitarianism-tinged myth.
“There is nothing in the legislation that would lead to that, folks with insurance now through current employers wouldn’t need to do anything,” said Coburn. “Maybe there will be some changes in how much their health plan would be deductible under tax laws, but nothing would change in terms of getting insurance product and access to physician.”
While some see government-run healthcare as a giant step towards a decidedly more Socialist future, Coburn downplays the dramatic tone of the debate, noting, “this is no more of a government takeover than Medicare is; a public-private system where the government creates mechanism for financing coverage, and medicare delivers insurances but contracts with private providers.”
Protocol will need to change is citizens want to see real reform, says Coburn, who suggests that the U.S. healthcare system is only the most expensive because “how we finance care and organize the system is terribly inefficient. There is way overuse of the system, and there is a lot of money being made in the healthcare system that is going towards things that don’t make people healthier.”
While any government intervention of what is historically considered a personal concern is bound to be met with resistance, Coburn said common sense and moderation is likely to prevail in a better-organized system.
“If you provide patients with choices that clearly delineate the risks and benefits of various treatment options, more often than not patients choose less, not more, care,” he said.
Coburn warns that the economic implications of not settling on a comprehensive healthcare reform policy could hit people where they are most sensitive – their bank accounts.
If you project costs increases we’ve seen over last five or six years to 2020, that amount is going to double, while wages will increase by three percent.? said Coburn.
?The middle class is going to disappear under the weight of these cost increases.” he adds.
And as far as those oft-discussed, 1984-sounding death panels are concerned? ?That’s a totally ideological attempt to undermine the legislation, it’s twisting what is really important,” said Coburn. “We all consume an enormous amount of healthcare resources at the end of our life, a lot of money can be spent doing things that may or may not be consistent with patients wishes – ventilators, invasive surgery, etc.”
The plans allows medicare to pay for people to get help in thinking what they want at the end of their life, rather than thinking this as government rationing,” said Coburn.