PAUL R. DUNN: America Can Achieve Health Reform That Transcends Politics
America deserves a vibrant health-care debate predicated on hard facts and not rumors and lies. It needs a civil discourse devoid of lobbyists' influence. America has not had such a debate.
Unfortunately for Moore County residents, neither Rep. Howard Coble nor our U.S. senators have held public meetings here. Instead, one sees rowdy televised town hall meetings devoid of civility, hardly the way to address a critical national issue.
We all come with unique lifetime stories: insurance claims denied, horrific experiences in hospital or ambulance, lifesaving events, caring nurses, wise physicians, inept surgeons, a terribly wrong diagnosis, wonder drugs that cure and some that maim or kill. Our system is vast, complex, miraculous yet sometimes deadly, fair and unfair, in all terribly human.
An undeniable fact: Americans would live longer and healthier lives if they had insurance and care systems more like the best ones found overseas.
My prescription might be written this way: America, to be competitive, needs more cost-effective, universal health care. We deserve to be a far healthier nation. Surely we've the imagination and wisdom to achieve that goal. To create a viable new system via congressional mandate, when one party is basically against health-care reform, is barely possible and hardly ideal, yet it is better than continuing with no health care for millions of uninsured citizens.
As a businessman, whose largest spending decisions were always predicated on prior research, I'd prefer to see a comprehensive prototype system developed that is tested with a statistically reliable number of citizens enrolled before any national plan rolls out. Testing will delay the start of any new plan, but it could pinpoint potential flaws in any system before it's adopted. This is not a radical concept. Small pilot government programs have been conducted for years related to Medicare reimbursement rather than quality of care.
Citizens scientifically selected to represent all demographic groups could be voluntarily entered into a test system. Those in such a test would be carefully studied to determine the pluses and minuses of any new system. How did enrollees like it? What worked and what didn't? Would it be affordable if expanded to cover all Americans? And most important, did it provide good or excellent health care?
To preclude the GOP saying "no" to health-care reform as a knee-jerk reaction, I'd recommend that any testing include two programs, a Democratic plan and a Republican plan. Let the nation see the results of two distinctly different approaches. When results are objectively analyzed by pre-approved independent observers, let Congress then vote on the plan that promises the best results.
As a retiree who has Medicare, I view it as a practical alternative model for wider participation by citizens of all ages. I've yet to meet a Medicare recipient who was unhappy with the plan. But even Medicare has serious shortcomings that must be addressed. Administrators are not the actual policy makers. Unlike the Veterans Administration, which gets bids on pharmaceuticals and medical equipment, oxygen, etc., Medicare, (due to lobbyists' influences on Congress), is forced to be price-gouged to the tune of billions of dollars.
The complex system used to determine fees to doctors is actually owned by the American Medical Association. The federal government pays to use it when determining doctors' fees. This practice should be ended before millions of newly insured enter any adopted system.
A good plan might lead to the establishment of a national formulary, removing caveats that there be no price negotiation with government-subsidized programs. It should eliminate all consumer advertising of ethical pharmaceuticals (which had been the accepted practice for decades). Establish sensible tort reform, placing sane limits on malpractice cases. (That would drastically reduce doctor reimbursements.) Vigorously regulate insurance company claim practices. Spend much more energy to eliminate rampant criminal fraud.
A total of 14,000 Americans lose health insurance every day, and patients are regularly denied reimbursement for doctor-recommended procedures and medicines. To take a know-nothing, do-nothing political approach is wrong.
Let's act with deliberate care and create a system that serves the republic well.
Will true reform finally happen? Not if Coble, Burr, Hagen and others in Congress prove more beholden to special interests than to your well-being. Let them hear from you.
Paul R. Dunn lives in Pinehurst. Contact him at firstname.lastname@example.org.
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