Every man/woman for him/herself–the opposition to health reform

It’s fascinating to watch the public reaction to health reform.

It was a very difficult byzantine process complicated by the republican do nothing attitude and very unpleasant legislative maneuvering.

But what’s astounding and revealing is the public’s lack of enthusiasm which ultimately may doom the whole process.

Consider the situation.

  • Health care is not absolutely essential at any given time in most people’s lives–most of us are healthy and simply do not understand the difficulties and costs incurred of those who are.
  • And anyway most of us, have some form of health coverage. Those with coverage wonder what reform will offer them.
  • Reform will certainly add to the complexity and who knows whether it will add to our costs.
  • There are a large number of people in our country, around 50 million, with no coverage at all. In this group most are quite healthy and aside from an occasional visit to a doctor have few needs.
  • Those without health insurance either deny the possibility of illness or count on their savings, if they have any, or public payments in one form or another for their catastrophic illness care.
  • Preventive medicine is an unnecessary unaffordable, for the most part, luxury for these people.

Health reform rocks the boat and requires most of the “uninsured” to have coverage. I believe it will ultimately cut costs but can understand the skepticism. Our long national history of exceptionalism makes these folks unwilling to consider that health reform might be a positive. To them it’s a mandated enforced expenditure, a tax on their hard earned money.

On the other side of the argument are facts that:

  • Every single one of us, sooner or later will require medical care.
  • Health care spending over a lifetime is our largest expense.
  • To have rational system in which insurers provide coverage to those with illness and to prevent gaming of the system (only getting coverage when you become sick) universal coverage is necessary.
  • Costs will have to go down as we cannot afford our current health care expenditures and yearly inflation. Efficiency and value are concepts that must be applied to health care, like other business ventures.
  • Our current non-system of mandating access to emergency rooms for free care is inefficient, medically unsound and extremely expensive–guess who pays?
  • The more people covered the lower the premiums and ultimately the lower the costs
  • Our health outcomes are mixed. In some areas we do as well as other countries in others our outcomes are significantly worse.
  • Preventive medicine is underutilized in our system by those who need it most, the poor and the uninsured–ultimately tax payers pay their emergency room costs and other associated medical expenses.

Somewhere along the way Americans lost the notion of community and replaced it with a nasty NIMBY attitude. Companies, farmers, bankers and many other businesses baldfacedly accept and encourage all manner of subsidies, price supports, and bailouts that keep their business solvent. The idea that a benefit be available to individuals however, is “socialistic” and “un-American.”

That’s hardly the case since for the last 70 years we and our economy have benefitted and had wonderful years of growth and prosperity in a system with numerous social support programs. Abandoning these principles for a non-system in in which it’s every man for him/herself is a non plan leading nowhere. And that’s exactly where we’ll be if health reform is repealed.


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