Elections and Healthcare Reform

While next year's election has much bigger issues at hand than healthcare reform (i.e. Iraq!) I have had quite a few people ask me about my views on candidates, their healthcare plans, and what the issues are in the healthcare system. Remember that I do live in the capitol of Iowa and we are one month away from the Iowa caucuses that will make or break many of the campaigns. In fact, two presidential candidates (Joe Biden & Mitt Romney) have spoken at my school regarding their healthcare plans. Being a political junkie this is like candy for me.

So here's the short, sweet version of the healthcare reform issues:

1. Democratic universal healthcare concepts are NOT socialized medicine like Canada and Europe. All of the major democratic candidates are proposing a national health insurance payor AS AN ADDITIONAL OPTION to private insurance companies.

2. How do we get the 47 million uninsured people in this country insured?
-We need to deregulate the health insurance industry to allow more competition and the reduction of insurance prices. Adding a governmental national payor to the mix can drive competition and drive costs down.
-We need to require insurance companies to insure everybody regardless of pre-existing conditions for a fair and equitable price.
-We need consumers to have access to these different companies' pricing structures
-We need to have regulations in place regarding employers carrying catastrophic insurance so that major medical costs for one member of a group plan do not raise rates for all members.
-We need to require those individuals who can afford health insurance (at the newer competitive rates) to buy insurance like we require car insurance.
-We need to ensure that every person who qualifies for medicare/medicaid is aware that they are qualified and are enrolled.
-For those that do not qualify for medicare/medicaid and do not make enough to buy private insurance (about 15 million people) we provide a stipend for that insurance (and ensure that they use it to buy into the national payor program. Our government currently pays hundreds of millions of dollars annually to hospitals to cover the cost of free care given to those who are not covered under insurance. We can redirect this money to the stipends and get everybody covered.

3. We need tort reform in medical liability and legal reform in medicare reimbursement. Did you know that a family practice doctor has to spend tens of thousands of dollars annually for malpractice insurance (an anesthesiologist may pay $100,000 annually!)? Setting liability limits and monitoring liability insurance companies will reduce this single largest expense of physicians which we can pass on to the patients. Also, our government keeps allowing medicare/medicaid reimbursements to physicians to decrease (10.1% next year unless congress acts to change it) leaving physicians to be forced to increase rates to non-medicare patients and subsequently higher health insurance rates. Health insurance companies follow whatever medicare does and drops their reimbursements along with medicare.

4. Prescription drugs. I hear all this talk about the government buying drugs from Canada so we can get the cheaper rate. Why don't we look at the pharmaceutical companies??? These companies create a phenomenal product, but they spend billions and billions of dollars annually on marketing paraphernalia (pens, notepads, etc), free lunches for physicians/nurses/etc, and paying physicians $500-$1000 to give a one hour lunch talk to other physicians about a drug. Granted these physicians are making a questionable decision regarding medical ethics, but when a pharmaceutical company is offering you $30,000 a year just to give 30-35 free lunch talks... how hard would that be for you? Some of us are fighting this infiltration of pharm companies into medical ethics (http://www.pharmfree.org/)

So which presidential candidates do I think have it right in their healthcare plans? Barack Obama on the Democratic side and Mitt Romney on the Republican side. What I've described is the Obama plan, and also very similar to what Mitt Romney put in place successfully in Massachusetts, however he doesn't believe the federal government should mandate this system nationwide ("Let the states decide"). So that's the long and the short of it. Check out:

http://www.ama-assn.org/ama/pub/category/17712.html

http://www.barackobama.com/pdf/HealthPlanFull.pdf

http://www.nytimes.com/2007/11/25/magazine/25memoir-t.html?_r=1&ei=5087&em=&en=14f86674a4b9bfd7&ex=1196226000&adxnnl=1&oref=slogin&adxnnlx=1196486558-vP9f3Z6CHCRLvNIQN5uSBQ

Thanks for reading and God Bless! E-mail me at richard.w.rapp@dmu.edu with any questions!