August 9, 2009

An Email to flag@whitehouse.gov

I don't know the person in Vermont that wrote this, but it is worth the read because of the clever rebuttal of TeamObamaCare. Click on the link to view it.

2 comments:

Rick said...

Actually it is easy enough to take the address specified and turn it back into a name using www.whitepages.com.

I'm no fan of TeamObama's healthcare reform (as much as I understand the framework). But general
impression of this letter is that it is mostly devoid
of facts. In particular, (2) and (4) are statements
that need more factual support. (12), (13), (14)
strike me as emotional fear mongering, again reading
way too far into what few details are available. I'd like to see support for (8) which leads to the
conclusion. (10) is obviously untrue, since other
countries with single-payer have doctors and
other paid medical personnel. With (16) I would
add "hastily written" as the primary concern.

I am a libertarian by nature and am generally sympathetic to (9), but I think the author generally
misunderstands the nuances of people who do
not carry insurance. When these people show
up in the emergency room, I suspect many of
them with expensive care requirements end up
as a bad debt. This, in turn, shifts the cost to
those of us who either have insurance and/or pay
our own way. So like driving a car, people must
be contributing some of their income towards
inevitable need for medical care. I find it appalling
that I end up having to pay for folks who have
elected to forgo medical insurance & routine
care!

With (15) - there are bad actors in any profession. I have personal experience with medical professionals who are guilty of ordering otherwise
unnecessary tests and procedures. Then, too, the
litigation issues I believe drive many otherwise
very good physicians to order tests and treatments
that may have ultimately been unnecessary. Better
Information Technology and understanding of
treatments & outcomes can help here.

So, in summary, the article, at least IMO, is mostly
the familiar smoke that surrounds the healthcare
reform issue. I think we do need reform, I think
I prefer to keep the ins industry running, I do
strongly believe that we need to break the
industry of certain bad practices like ricission, and
get them back into the business of properly
spreading their risk among participants. People
being people will seek to pay less, and gravitate
towards cheaper policies - these companies will
tend to end up with the relatively healthy folks who
need little coverage. To assure the industry fairly
distributes risk across all companies, I think there
is a legitimate role of government to "load" companies with relative healthier populations with some of the cost incurred by companies having to pay for care for the relatively less well people.

As for rationing, I think the case is easily made
that this already exists in one form or another,
it is just not visible because it lives within the
private ins community. As an example, I know of
one patient who has MS and has been told by
their insurer that their condition is hopeless, and
as such, no more physical therapy will be paid
for.

David Usher said...

>"I think we do need reform, I thinkI prefer to keep the ins industry running, I do
strongly believe that we need to break theindustry of certain bad practices like recission, and
get them back into the business of properly spreading their risk among participants. People
being people will seek to pay less, and gravitate towards cheaper policies - these companies will tend to end up with the relatively healthy folks who
need little coverage. To assure the industry fairly distributes risk across all companies, I think there is a legitimate role of government to "load" companies with relative healthier populations with some of the cost incurred by companies having to pay for care for the relatively less well people."<

Thanks for your thoughtful and extensive comments. I, too, believe we need fundamental reform in health care. The key issue for me is cost control (for others, it's insurance coverage and access) because the system is eating far too much of our national productivity and GDP.

However, I do not believe that health care is a "basic human right" as some contend. Also, I believe that we should not dismantle our private insurance system in favor of single payer, which is the goal of this legislation. We may get there at some point, but now is not the time.

I think a national solution is needed, but the right approach has yet to be found. Those who blindly oppose reform are ostriches.

A series of rational steps to control costs is the first necessary action. Many things that can be done, e.g., tort reform, electronic health records, change in incentives for doctors and hospitals, etc., to move along the reform path.

Health care is far too costly and we can reign in costs without a massive overhaul from a 'steamroller' bill that no one understands.

I also believe that decoupling health care insurance from employment is essential.