Sunday 26 July 2009

Reforming health care

BBC News









Opinion by Sarah Garrecht Gassen

Debate about national health-care reform is often an exercise in abstract descriptive terms like "efficiencies" and numbers of people and dollars so huge they cease to be real. Political rhetoric clouds the real problems that must be fixed:



• Americans who most need health insurance coverage can't get it because of policy exclusions or cost

• Health-care fees are unsustainably expensive

• An estimated 46 million Americans do not have any health insurance

In Washington D.C., committees in the U.S. House and Senate have passed versions of health-care reform legislation. The bills are massive — 1,018 pages in the House and 615 pages in the Senate. They're being picked apart by politicians, interest groups and pundits eager to jump on one facet or another of the legislation to spin their message.

President Obama has made health-care reform a cornerstone of his administration and has challenged members of Congress to act with urgency. The process can't be rushed, but it needs a deadline. Otherwise political procrastination takes over, malaise sets in and nothing happens.

Outraged cries of "too fast!" from the Republican party ring false. The party had control of the Congress and the White House for six years and nothing happened to improve the American health-care system. Slamming the Democrats, and Obama, for pushing for action, and trying to make political hay is inexcusable.

Obama gave our nation an update on Wednesday night during a televised press conference. He said that health insurance premiums have doubled over the past 10 years, and that they've increased three times faster than real wages — raises are eaten up by insurance cost increases.

The Senate and House bills are enormous and complex. They're also still in flux. The legislative committees are working through details, but some of the provisions are encouraging.

Pre-existing conditions

Under both House and Senate versions, insurance companies could no longer exclude people with pre-existing conditions from coverage.

This has been the Catch-22 of the private insurance system: Insurance companies can legally refuse to cover people who have chronic conditions or have a history of illness, even if they're not sick when they try to purchase an individual policy.

Insurance companies want to sign up young, healthy people, not those who will need to use their medical coverage; insurance companies use high price tags and exclusions to thin out their risk pool.

Public option

Neither bill includes a single-payer universal plan, but both include choices beyond private insurers through a "public option." This alternative must be a strong, affordable plan available to everyone.

A public option is a far cry from the false "socialism" or "Washington takeover" tags many Republicans keep trying to attach to the reform effort. Scare tactics about "rationing" ignore the reality that the existing system limits who can receive what care — or if a person can receive health care at all. But the criterion isn't which medical approach works best, it's who can pay. Americans should see through the rhetoric. It's personal

We've all heard stories of people not filling prescriptions or not consulting a doctor when they should because they simply can't afford the medical bills, even with insurance.

Despite the millions of uninsured people and the billions of dollars spent on health care, the problem is inherently personal.

I'm extremely fortunate to have health insurance through my employer; I wouldn't be able to find an affordable individual insurance policy because of pre-existing conditions. I've also skipped doses of medicine, not filled prescriptions or not gotten recommended medical tests or necessary equipment because of their high cost.

It's a scary situation, and there is something inherently and morally wrong in a system that treats a person's health as a commodity.

The pitfalls in our system aren't always obvious until you or a family member needs medical care. Then the full weight of a system built on boosting commercial interests instead of good health falls on people who are sick, need surgery or can't get health care — and they're in no position to fight back.

Health-care reform is urgently needed. Don't let politicians put off until tomorrow the hard work that must be done today.





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