I've read newspaper accounts and seen television interviews and heard people talk about their opinions and views on health care. It seems to me that most of the talk is about how to provide insurance coverage to more people or how to reduce the cost of insurance coverage for everyone.
There is much talk about how to "solve" a problem that no one seems to care to describe. I'm not saying there are no problems with the delivery of health care. I'm saying I don't know what the problems are and it is a little scarry to think - and I'm starting to think this - that very few if any of the people jumping into the fray really know what the problems are either. They just have an "agenda" item and a "goal" to pass some form of legislation so they can say "look what we did" - aren't we great!
H.R. 3200 is "A BILL" proposed for this pupose: "To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes." The bill is 1017 pages long. I wonder how many of those who are stomping around promoting this bill have actually read the entire bill. Of those who may have read the entire bill, I wonder how many actually understand it. My guess is that it was "cobbled" together by various interest groups - meaning that one section of the bill was written by and for the benefit of insurance companies, another section was independently written by and for the benefit of hospitals, etc., etc. - a mish, mash of special interest groups with lobbyists and lawyers making sure that they get their piece of the pie.
H.R. 3200 is in part suppose to build on what works and repair what does not. If that is the case, tell me what is working and why, and then tell me what is not working and why. And I mean, tell me some specifics, not just high level meaningless politically correct jargon like PROBLEM: 45 million Americans don't have health insurance. Proposed fix: "This bill will allow everyone to have affordable health care insurance". These are the sound bites we hear from politicians and there supporters.
Before we rush off to pass a "health care reform bill" so the Obama Administration - and others in Congress can claim "victory" over someone or something, it would be nice to see information about how the "system" (if we want to even call it that) we have now actually functions. I am not an expert on the topic, but it seems to me that simple logic at least raises a few questions that someone should be able to answer.
I read and hear statements to the effect that health care costs have doubled in the last ten years. No one ever has an explanation for why this has happened. Are doctors charging more? Are manufacturers of health care devices charging more? Is the field of health care losing providers and thus becoming less competitive leaving the survivors with the opportunity to increase prices? Are lawsuits, or the fear of them, driving up costs? Perhaps a contributing cause is that we have too many laws regulating the delivery of health care now! The health care costs are becoming a greater burden on the federal budget? How so?
Here is a thought - I'm sure someone has had the idea before. Patients are the consumers of health care goods and services. However, patients covered by insurance (and while there are many without insurance, there are many, many more who have insurance) DO NOT PAY the health care provider. Essentially, the patient is removed from the financial process. Thus, if the health care provider is not charging a "competitive price" or is double-billing or providing more care/goods then is really needed, the patient either doesn't know or doesn't care because the patient has no responsibility to pay the bill. It is hard for me to identify any other consumer transaction that works this way.
When people go to the grocery store (or any other store for that matter), they often shop for the best deals - they look for sales or use discount coupons offered by the seller. If the checkout clerk rang up something twice, most shoppers would probably say something like "you charged me twice for this item, please credit one charge back.". If the clerk threw in an extra gallon of milk, most people would probably say "I don't want that, and I'm not paying for it." On the other hand, if you bought groceries like we now buy health care, it is probable that most shoppers would not even be paying attention. They would pay their $20 "co-pay" and that would be it - double charge or extra milk, who cares! Or worse, even if you do care, there is no telling how you could do anything about it.
Can we focus on ways to engage the patient in the shopping and payment process? If patents could shop around and look for the best deals, and if they had some means for controlling payment based on the quality and quantity of the goods/services delivered to them, it seems to me that health care providers would be put right where we want them - in a free market system. They would have to be competitive to survive. They would have to deliver quality goods/services. They would be held accountable by the patient who is receiving the goods/services.
Maybe I'm wrong about this because of my lack of knowledge about how the "system" really works now. But, I don't understand why I never hear anyone talking about this aspect of the process.
If there is anyone out there with some insight on this, I would love to hear more about it.