About Healthcare Reform
I’ve had a number of patients in recent weeks express strong feelings about proposed “health care reform.” Most are quite surprised that I’m in favor of some major changes in the way health care is provided and paid for in this country. I feel that there are many abuses to our current system, and that many people are unable to obtain insurance, forcing them to face possible financial disaster if they become sick or injured.
The bible enjoins us to care for the sick and the poor. It is not such a great leap to feel the need to insure that all who need medical care can obtain it.
Polemics aside, can we at least agree on some points? How about starting with these as ideals:
All who need care should be able to obtain it without the threat of financial ruin? Health insurance should be available and affordable for all. Those too poor to afford it should be subsidized to some extent, depending on their financial situation.
Losing one’s job should not mean losing healthcare insurance. Insurance should be transportable.
Costs should be kept as low as possible and competition should be encouraged by allowing consumers to purchase insurance across state lines.
Preexisting conditions shouldn’t disqualify people from being able to purchase insurance.
Providers should have incentive to keep costs down. Just the opposite occurs now. If a doctor orders a diagnostic test or a surgical procedure, he directly benefits from it. The American College of Cardiology has published “Appropriateness guidelines” for tests and procedures. These represent current thinking from the best and the brightest in our field. Yet there is no monitoring to insure compliance with these guidelines. I can only guess how much money is wasted in this way. Audits of physician ordering practices should be encouraged for both Medicare and private insurance.
These principles don’t cater to those who want the government to run healthcare, and they are equally unpopular with the crowd who wants to keep the current, unsustainable status quo. Which is probably why they have no chance of being given a proper airing.
If you have a comment or question about this blog entry, email Dr. Roffman at firstname.lastname@example.org.
Dr. Joel Roffman has spoken to many church, synagogue and support groups. His book, Coping with Adversity: Judaism’s response to illness and other life struggles is enjoyable, uplifting and informative. It is meant for people of all faiths and can be viewed at http://www.copingwithadversity.com/. It is available at Barnes and Noble, Borders, and Amazon.com.