Wednesday, February 24, 2010

What Will Happen to Health Care Reform?

What will happen to health care reform? Nothing, or a worsening of the situation unless the politics are left out and the Republicans stop using obstructionist tactics to derail this and just about every other initiative the President undertakes.

The Democrats aren’t blameless either. Their willingness to stoop to backroom deal making and concessions just to get a bill passed have resulted in the loss of two vital provisions: the public option and the threat of serious limitations on women’s reproductive services which, I maintain, creates another pre-existing condition the bill was envisioned to eliminate.

The insurance companies and pharmaceutical companies will do anything to maintain their profit margins. Witness Anthem Blue Cross raising rates in California in anticipation of a bill's passage.

Here’s what else can happen if people are forced to buy coverage from the very companies ripping us off now. Without a public option, if you lose your job and have a family to support, perhaps the only insurance you can buy will be on a private exchange. Even if you can't afford it, you’re required to buy coverage. How will you pay for that, as well as mortgage/rent, utilities and food? If your spouse makes too much for you to qualify for Medicaid (or an exemption from the mandatory coverage) this is all too possible.

And here is an example of the convoluted way reproductive health services would work: In the military, where men no doubt can obtain condoms, women can’t get emergency contraception. Most health plans will follow the Federal guidelines and likely exclude birth control abortion coverage unless you pay out of pocket. The argument: "It's a rather small expense." My argument: "Pay for your Viagra, penile pumps and other treatments for erectile dysfunction. If you can't afford it, not having sex won't kill you."

Here's an editorial from The New York Times on this issue: Showing Respect for Women In Uniform

How about respect for women in general? I'm sick of my body being divided into pieces deserving of care and parts that are "my responsibility" or "my irresponsibility" depending upon whose opinion is being voiced. It takes two to tango, as they say.

Meanwhile, yet another hospital here in NYC (St. Vincent’s) is bankrupt due to bad debt and charity care and lowered insurance reimbursement. They just had a layoff and more are likely. If they close, surrounding institutions will have to absorb the volume-and that means longer waits, understaffing which endanger patient safety and affect infection control measures (more crowding, less cleaning).

What about tort reform and provisions to address the malpractice morass? Lawyers are still advertising no fee unless we win, wasting money on frivolous cases, many of which have not merit but are settled to avoid costly litigation.

I have a great insurance plan, and would likely have to give up some perks, like my health care spending account funded from pre-tax payroll deduction. But my optical benefits have already been reduced and I must go to one vision care provider. I must fill all prescriptions at certain pharmacies to get that benefit.

We’re all going to have to give up something. But unless the health of the American people is put first, not ideology, politics and vengeance there will be no meaningful reform.

Without a viable public option, protection for women's health care services, and changes in the legal system reform is not going to reform anything.

Finally, this is a very intelligent op-ed from The New York Times on how the GOP can fix health care.

It contains proposals for health care reform written by conservative Republicans. If they can write such reasonable suggestions why can't the House and Senate come to some consensus? The answer: politics.