BRIAN DEATON: Too Much Misinformation Circulating on Health-Care Reform
It is time to separate fact from myth in the discussion of the health-care reform proposals being considered by Congress.
There is too much misleading information being bandied about, including in a recent weekly bulletin of my own church.
First, none of the proposals encourages euthanasia or allows federal funding of abortions. The Hyde Amendment of 1977 prohibits the use of federal funds, including health-care benefits to federal employees and members of the armed services, to pay the cost of an abortion.
This will not be changed under any of the proposals. There is a provision allowing the use of Medicare funds to pay the cost of a consultation to discuss end-of-life issues, ideally while the affected party is mentally capable of expressing desires. This is not a requirement for any Medicare recipient and in no way can it be equated with an actual euthanasia procedure.
These points are not disputed by any member of Congress who is participating in the Committee deliberations.
Second, there is strong agreement that the underlying economics of our health-care system are not sustainable.
Most Americans who have health-care coverage may be happy with their current plan, but there is no guarantee that you will continue to have that plan with or without health-care reform. Almost 48,000 individuals lose their coverage each week.
Your plan, and its desirability, comprises three components: the care-related services that are covered, your premiums, and your co-pay or out-of-pocket costs. The better-coverage, lower-cost plans are associated with larger pools of insured. When people are moved out of large insured pools, through company downsizing or job loss, their coverage becomes more limited, more expensive or both. For many, the ability to pay for health-care services becomes more uncertain.
Uncertainty of payment creates a real dilemma for the medical profession, whose mission is to provide care whenever and wherever it is needed. Its highest costs are associated with customers who cannot pay and/or seek care on a crisis basis.
I recently heard an administrator discuss the challenges of his hospital's annual budgeting process. As he described it, the hospital makes a lot of money on some care-related services and loses a lot on others. The goal is to get a positive total net, across all services, of 3 percent to provide enough funds for needed facility and equipment investments.
The existence of "unprofitable" services means that people receiving the profitable ones are paying more than they should. This creates the unproductive cycle of haggling among insurers, providers and customers over service and cost allowances. And contributes to even more economic uncertainty for the industry.
The viability of our health-care system cannot improve without a major shift in economic power from the insurance companies to the consumer.
Today's health-insurance industry is more characteristic of an oligopoly than a free-market system. According to the American Medical Association, 94 percent of insurance markets in the U.S. are highly concentrated, i.e., controlled by a few firms. Premiums, and industry profits, have skyrocketed in the past eight years.
A public-option provider will not destroy the insurance industry; it will bring the benefits of free-market capitalism back into play for consumers, including small businesses, by creating some real competition in coverage options.
Third, there can be little dispute over the relatively poor outcome performance (e.g., infant mortality, life expectancy, obesity) of the U.S. health-care system. We have overfocused on sophisticated technology and medical procedures vs. a lifelong approach of regular checkups and preventive care.
We are rapidly evolving into a system in which the number of overpaid specialists is increasing and the number of primary-care physicians -- the linchpins to early diagnosis and avoidance of costly crisis interventions -- is declining. This trend must be reversed, and that can only be done through a system in which the full population can access affordable coverage. Preventive care is a key element in that coverage.
Some ask, "Why rush?" Or say, "Let market forces work."
The need for reform has been recognized for 50-plus years. With each passing week, the trends get stronger and harder to reverse. The market has not responded in an effective way. Throughout our history, government intervention has been required to redirect dysfunctional market behavior. We are at another one of those critical points in time.
Brian Deaton, a former chairman of the Moore County Democratic Party, lives in Pinehurst.
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