Health Care Reform

Snippets from a piece written by President Obama and now appearing in the NY Times.

There are four main ways the reform we’re proposing will provide more stability and security to every American.

First, if you don’t have health insurance, you will have a choice of high-quality, affordable coverage for yourself and your family — coverage that will stay with you whether you move, change your job or lose your job.

Second, reform will finally bring skyrocketing health care costs under control, which will mean real savings for families, businesses and our government. We’ll cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid and in unwarranted subsidies to insurance companies that do nothing to improve care and everything to improve their profits.

Third, by making Medicare more efficient, we’ll be able to ensure that more tax dollars go directly to caring for seniors instead of enriching insurance companies. This will not only help provide today’s seniors with the benefits they’ve been promised; it will also ensure the long-term health of Medicare for tomorrow’s seniors. And our reforms will also reduce the amount our seniors pay for their prescription drugs.

Lastly, reform will provide every American with some basic consumer protections that will finally hold insurance companies accountable. A 2007 national survey actually shows that insurance companies discriminated against more than 12 million Americans in the previous three years because they had a pre-existing illness or condition. The companies either refused to cover the person, refused to cover a specific illness or condition or charged a higher premium.

We will put an end to these practices. Our reform will prohibit insurance companies from denying coverage because of your medical history. Nor will they be allowed to drop your coverage if you get sick. They will not be able to water down your coverage when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime. And we will place a limit on how much you can be charged for out-of-pocket expenses. No one in America should go broke because they get sick.

Most important, we will require insurance companies to cover routine checkups, preventive care and screening tests like mammograms and colonoscopies. There’s no reason that we shouldn’t be catching diseases like breast cancer and prostate cancer on the front end. It makes sense, it saves lives and it can also save money.

And Uwe Reinhardt, economics professor at Princeton, has an excellent piece on whether or not we should be trying to save employer-based health insurance. (Short answer, we shouldn't.)

My thoughts: (I'm bullet pointing this as it's 1:21 in the morn.)

• Everyone should have health coverage and it shouldn't be linked to your employment so that you lose it if you ever have the misfortune of losing your job.
• You shouldn't be denied coverage because of a previous illness.
• I'm willing to wait an extra week or two to get an appointment with my doctor if it means we can cover the 46 million folks who are currently uninsured, particularly if we're talking about normal office visits. On the other hand, if I'm bleeding out when I show up at the E.R., I expect to be seen relatively quickly.
• As a whole, we should focus on preventative care as a means to save on costs.
• We shouldn't just focus on reducing the amount seniors pay for prescription drugs but on reducing the cost of prescription drugs for everyone.
• Are there subsidies for the insurance companies? Because if there are, Jesus tap-dancing Christ those need to stop. Are you kidding me?
• If Medicaid and Medicare are run anything like OHSU's accounting office, one way to reduce costs would be to stop sending payment envelopes with mailings that do not include a bill. (Seriously, why do they do this? I must have received over 100 envelopes with statements that say "THIS IS NOT A BILL". If it's not a bill, why the heck are you sending me a payment envelope.)