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The real impact of current health reform plans

September 5, 2009

Kevin MD hosts a great post from Paula Hartman Cohen–a Masachussetts resident–on what individuals should expect if current health care reform plans were passed in Congress.

Here’s what has happened to us as a result of mandatory, universal health care:

1. We still go to the same doctors.

2. We’re still on the same medications.

3. We still use the same pharmacy.

4. All other medical facilities we use – imaging labs, hospitals, blood testing labs, physical therapy — have not changed.

5. As far as we can tell, our insurance premiums have not changed or have changed slightly.

6. Our co-pays are lower, but we’re on Medicare.

7. If I had stayed in the same HMO plan I had before Medicare, some of my co-pays would have increased, such as alcohol and drug treatment, and prosthetic limb fittings, not that I used any of those benefits.

8. We both have reduced our prescription drug regimen and increased our weekly exercise, in part, because our insurance now encourages prevention by paying a nice benefit for going to the gym.

9. We feel more comfortable being in crowds at the grocery store, movie theaters, or in close quarters at the barber shop and hair salon, knowing everyone there has access to health care. That means everyone we deal with is less likely to be spreading infectious disease than they were three years ago.

10. We’ll feel even better when this year’s flu season comes around, since school children, teachers, bank tellers, store clerks and others dealing with the public can get the necessary vaccines or treatment to contain this year’s flu, no matter how rich or poor they may be.

And that’s the truth.

I have no reason to doubt that the American public would experience similar changes if Obama is able to push through current health care reform plans.  Patients accessing the health care system won’t really see much change when they go to see the doctor.  However, I also agree with Dr. Jay Parkinson’s assessment of this post.  Obama’s current plan will provide some help in the short term by helping more people get health insurance.  However, this plan doesn’t do anything to address costs.  Health care costs have been rising 7-8% each year for over a decade and show no sign of abating.  This is insane and unsustainable.  The only way to address health care cost inflation is to begin looking at ways to cut costs through better delivery systems.

Unfortunately, this fact is completely lost on the American public.  The current resentment being displayed in most of the town hall meetings (at least the clips shown on popular media outlets) revolves around the perception that the current health care plan will somehow lead us to a socialist state.  Instead of being outraged that the government may play a greater role in health care (trust me the government already plays a significant role in our health care system), the American public should be outraged that these reforms simply won’t work. The plan doesn’t address the biggest problem facing our health care system.

The Obama administration should not be focused on a single solution but rather use federal funds to set up a program to fund experimental reforms in individual states.  Massachusetts has been a great example of how this can work.  The legislature in Boston passed reforms they thought would work for their citizens.  In essence, what they have done is create a test ground for what impact a “universal insurance” system will have on health care delivery and expenditures.  Along the way, health policy experts have learned how such reforms impact the delivery and financing of health care.  The federal government could fund other states to try other methods–mandated Health Savings Accounts or some form of de-regulation or a state-wide integrated delivery system–and see what happens.  Then, a cohesive national plan could be formulated based on the experience gained from these experiments.

But, I’m not going to hold my breath waiting for either the Democrats or Republicans to propose such an idea.  It would require cooperation and time, both of which are antithetical to our political system.

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