Health Care Reform – Really?

Last night, President Obama spoke to a group assembled at the White House on health reform that aired on ABC TV. At the beginning of the session, the host, Charlie Gibson, asked how many agree that we need to change the health care system in America. Everyone raised their hand indicating unanimous agreement. He didn’t ask the next logical question "How many of you think we will actually pass significant health reform that meets the President’s goals of universal coverage for all Americans, maintaining freedom of choice for people regarding selection of health care providers and treatment options, and reining in costs?"

Based on the backlash from those who are weary of a government run system and of the cost of a universal health plan, and those very powerful players who have a strong (although unstated openly) vested interested in the status quo, I am afraid that the answer would not be unanimous, in fact far from it. While all agree that we need to change, there is such a divergent view of how that change should occur. This is exactly the same place we were 16 years ago when the Clintons tried to change the system, and we see how that turned out.

So what is different now? As the President said, if we don’t change we will bankrupt the American economy. This may be on overstatement, but I think more people will suffer from lack of access to health care and will have to live with painful conditions and probably die sooner. Given that we have accepted a 15% uninsured rate for many years, it appears that we may be able to tolerate that for a longer period of time. What I am saying is that I am skeptical that we will see much change other than some form of insurance reform that opens up a market for individuals to purchase health insurance through a controlled market. This will accelerate the process of disconnecting health insurance from employers, which can be a good thing.

With respect to the cost issue, I still don’t have an answer, and I don’t think the President does either. The only thing I can figure is that new insurance policies will have high deductibles and co-payments that will deter people from accessing care, thus reducing demand. Reduced demand should reduce volume of care which will reduce costs. There are some strong arguments that we as a population are over treated and that less care may be a good thing. What do you think?