Fri May 18, 2012
Sheinei Saleem
Making Healthcare History
By Sheinei Saleem, Virginia – January 2010
In just the past decade our generation has seen our world turned upside down by terrorism, financial greed, recession and war. We have also seen how we have the power to change the course of history. Without our vote, Barack Obama would not have become the first black President of the U.S.
Lately, however I’ve been wondering how many of us realize that we are about to experience another earth-shattering transformation in America. That experience is embedded in one of the most sweeping pieces of proposed legislation – a more than 2000 page read that is destined to be a life-changer in the way healthcare is delivered to our generation and that of our children.
While most of us are university students, unemployed young professionals, or graduates lucky enough to be in an established career, most of us simply have not focused on healthcare or made it a priority – relying, I suppose, on the myth that because we are young, we are invincible.
But even if we assume responsibility for our own health – and do everything right – eat better, sleep more, and stress less – our health can nonetheless change in an instant and so the proposed reforms in healthcare do matter.
Further, healthcare reform affects every single one of us whether we are currently in medical school, pursuing a career as a healthcare professional or if we are currently healthy and don’t believe we need healthcare insurance.
What should capture our interest immediately is the fact that our generation will be picking up much of the tab for the proposed reforms – indeed the new healthcare system will not work without our financial input.
In fact, the bills that passed both the House and the Senate mandates that anyone over 21 years of age must buy health insurance – whether we want it or not. If we decide to opt out of buying healthcare insurance then we are obliged to pay a penalty fee.
So while everyone must pay into the healthcare system – want it or not – the question remains whether what we are paying for will actually lead to an overall improvement in the quality of our health or will this well intentioned attempt to cover the indigent, the sick, the people with pre-existing conditions, the elderly, and others not currently covered or under-covered, be worse than the system we currently have.
Reactions from my friends in medical school are not typically favorable to the new legislation. Many are very concerned about the fact that the new legislation gives extraordinary powers to the Obama administration which intends to designate a post to a government panel of experts and a healthcare czar who will determine what procedures and tests we can have that will be reimbursable. In other words, the government will dictate what kind of treatment physicians can provide and we can receive.
As models of what reform might look like, think of government run plans, Medicare and Medicaid which make it difficult for doctors to perform certain desired procedures that government deems too expensive or unnecessary.
Further, low and slow reimbursement for procedures government agrees to reimburse causes many physicians to see as many patients in a day as they possibly can in order to make it financially worthwhile or not accept such patients altogether. Certainly if low and slow reimbursement schedules are the way of the future, it will be very difficult for young physicians to payback school loans and establish a practice.
And while many young physicians pursue a career in medicine for both financial and societal gain, others choose to take on such a responsibility exclusively for the personal fulfillment of helping others. However, if a physician is paying out more than he can make by taking adequate time with his patients, he or she will be almost forced to see patients on a revolving door basis.
This get-in-and-get-pushed-out-the-door “care” is quickly becoming today’s approach to medicine. The patient is often not seen as a human being but rather as another file to be shoved into a slot. This concerns my peers deeply as they argue that the quality of care they want so much to provide is likely to be severely compromised.
Will the new healthcare system just be an expansion of this, or worse?
To be fair, insurance companies are often at the root of this problem, indicating what procedures doctors can perform for reimbursement for patients not on Medicare or Medicaid. But not all doctors are saints. If insurance refuses to cover what a patient needs, I wonder how many doctors would fight for their patients’ care. Would following explicit cost efficient protocols – which sometimes call for treating patients with procedures and medicines they may not need – supersede following the Hippocratic Oath?
Further, physicians must prove to insurance companies that a particular procedure or medicine is necessary – if not for one patient then for another. To prove the benefits of this medical intervention, some patients can end up receiving and paying for unnecessary treatment. Perhaps a healthcare czar and government-selected panel of experts would understand the obvious benefits of the medical treatment and thereby take this onus off physicians.
Certainly the fact that insurance companies can get away with denying coverage to patients with pre-existing conditions is unconscionable. In this regard, the government must step in and regulate healthcare.
But rather than overhaul the entire structure and culture of the current healthcare system, why not make incremental and realistic steps? Why change the entire system if it’s just a matter of enforcing current legislation or drafting amendments to existing healthcare law?
For example, there’s no question that health insurance companies need to be regulated in certain instances and there needs to be greater oversight for fixed rates for procedures and medicines. Cost of research and translational medicine must be changed so that companies do not increase the cost of their products to make such large profits. Something must be done to help the 28% of working young adults who don’t have health coverage because their employers are not able to provide it. And, somehow allowances must be made for the 41% who are already in debt because of medical intervention and are further burdened by the rise of their premiums, deductibles, co-payments and out of pocket medical expenses. (See report at www.healthreform.gov)
So healthcare reform is needed. However, if government wants to make constructive changes in healthcare, then let legislators address such things as the issue of medical school tuition as well as the amount of financial aid awarded to students who will become the prospective physicians, drug and device developers, nurses, physician assistants and others.
If government is eager to regulate, let it regulate the compensation to physicians who profit from relationships with pharmaceutical and medical supply companies. Government should also investigate the hidden costs passed along to consumers of healthcare for pharmaceutical companies’ advertising.
The revamping of our healthcare delivery system is noble and it is complicated but legislation should not be rushed through just to make a political statement. With all of the political arm-twisting and so-called “sweetheart deals,” the public is beginning to believe our government is too eager to make history at our literal and figurative expense.
Regardless of one’s stance on issues like abortion and Medicare, it’s hard to believe how such backroom negotiations can make people in the congress feel anything but shame and these actions are causing their constituents to be very angry. Indeed, how is it fair or constitutional that a deal can be negotiated to favor the state of Nebraska that does not have to contribute to Medicare after 2016, as the other 49 States pick up the tab?
Furthermore, what about providing healthcare for illegal immigrants? Although the administration has made an exception for children of illegal immigrants, little is being done for adults illegally residing in United Sates.
If illegal immigrants receive care, will they also be fined for not buying coverage when others are mandated to do so? As Medicare is running out of money, will new taxes be imposed so the administration can continue and expand the system? If there is some sort of public option, will private insurance be competed out of the healthcare market? Will we end up with long waits for treatments and procedures, as is the case in many countries with public option plans? Should wealthier Americans have access to better care than those relying on government-supervised programs?
Clearly these are questions that need further elucidation and neither the congress nor the administration has taken the time to honestly explain how any of this will work.
Therefore, it is up to us to be proactive even if government has been remiss in explaining the details of healthcare reform to us. We need to investigate the pros and cons of how this legislation will change our lives.
We need to help bring about changes that will not only eliminate the corruption in our current healthcare system but we must also be a part of the process of paving the way to improve the overall quality of our lives in the future. In other words, we must make history once again.
2 Comments
Leave a Reply
world headlines
U.S. headlines
editorial headlines
Right now the health care system is too big and it is also filled with unnecessary costs and expenses that we can easily do without. The fact that we can get the same and maybe even better care overseas needs to be better reported to the public.
Improving our current healthcare system is important and part of that importance is making care available to people who are too poor and can’t afford to get back on their feet without proper care. If the poor cannot get proper care they are forever locked in a circle of bad health and this comes at an even greater cost to the economy and in the end, the tax payer.
Also, if we really cared about healthcare we would try to get our priorities straight and stop spending money on ineffective wars. If we didn’t have to pay for these wars we could afford excellent healthcare.
As for the young, unfortunately we typically don’t think too far ahead. If we did, we would understand how important this healthcare issue is and how it affects our current lives. I don’t think this will change until we realize that we are not getting any younger. Also, where are the campus groups discussing healthcare? I think this discussion is just not reaching the young.
nice one keep it up