Common Sense Reform

The results of the governor’s and selected legislators’ emphatic effort to “reform” the health care system, ABX11, was defeated in committee, thanks to those with the intelligence and good sense to see the error in this measure. Once again, the insurance industry’s attempts to control the direction of this very important issue have been thwarted.

Arnold obviously has no awareness of the the issue himself, but he should at least seek the wisdom of those who do. Simply review the program and the math: SB840 would provide universal, affordable, choose your own doctor, comprehensive coverage to all Californians and save us $320 billion over ten years in the process.

Seldom, if ever, have we experienced individuals in the upper management levels of the health insurance/managed healthcare industry who speak out with the voice of reason, common sense and intelligence on the subject of “healthcare” vs. health “insurance.” Thus it was with extreme surprise and appreciation that I listened to the comments on this subject recently from Georganne Chapin, JD, MPhil, CEO of Hudson Health Plan in New York. The webcast is available at: http://www.medscape.com/viewarticle/559758?src=mp.

The text of her comments follows:
I am a health insurance and managed care executive so you may find this editorial a bit strange. I believe that the way to fix our healthcare system is to stop relying on insurance and focus instead on healthcare.
So, what’s wrong with health insurance?
Well, first, it’s temporary. This may work for auto policies, but not for human health.
Second, health insurance is mostly contingent on where you live and whom you work for. It’s easy to transfer car insurance, but not health insurance.
Finally, insurance companies make more money by minimizing pay-outs than by keeping people healthy. Human beings — who need preventive care, who have babies, who may lack living wages and job security, and who get older–find the house rules stacked against them.
Plans in Massachusetts,[1] California,[2] and soon New York[3] propose to strew the same old red tape over even more people. Members of the same family could end up with separate policies, with different benefits and different expiration dates. This will make it even harder for doctors and hospitals to figure out whom to bill, which services are covered, and – worst of all – whether coverage will last long enough to complete treatment for a sick patient.
Other developed nations have universal healthcare, not “insurance.” They give healthcare to everybody, they spend less, and they are healthier for it.[4]
But, we have an example of success in this country, too. It’s called Medicare. And while flawed, Medicare meets the most important criteria for a universal healthcare system: it’s permanent, it’s portable, and it’s simple and inexpensive to administer.
The health insurance model is flawed because it depends on people falling between the cracks after they pay their premiums and before they collect their “benefits.” Rather than insurance, providing healthcare to everyone would cost less and deliver more in the long run.
That’s my opinion. I’m Georganne Chapin, President and CEO, Hudson Health Plan.

References
1. Fahrenthold DA. Mass. bill requires health coverage. Washington Post. April 5, 2006;A01
2. Steinhauer J. California plan for health care would cover all. New York Times. January 9, 2007;A1
3. Holahan D, Hubert E, Schoen C. A Blueprint for Universal Health Insurance Coverage in New York. New York: United Hospital Fund and the Commonwealth Fund; December 19, 2006
4. Davis K, Schoen C, Schoenbaum SC, et al. Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care. New York: Commonwealth Fund; May 2007: pub. no. 1027

Michael Moore has taken a lot of heat and praise for his documentary works.  This one will be no different.  But in SICKO, Mr. Moore has taken the message up a notch.  No longer is a political party, specific politician or business leader a major focus.  Now the finger of reproach is pointed at all of us – us Americans, that is.  Because for seemingly practical and innocuous reasons, we have let the delivery of health care in our country become yet another vehicle of greed, inefficiency and basic lack of common sense.

 
I daresay that the average American on the street cannot even begin to fathom the depths to which our “non-system” of health care has reached.  And that same American is brainwashed into believing that any approach as rational, economically sane and compassionate as a single payer, universal health care system is ultimately “bad medicine” if not an outright communist plot.  (Communist plots are rare these days, so I thought I would start the trend again.)

 
To what high level must our national cost of medical care and low level of effectiveness attain before we finally will say, “Stop – there must be a better way!”

 
I don’t know the answer.  I’ve supported positive measures, primarily the legislation developed by Sen. Sheila Kuehl in California, SB 840 (see post below); but our notable governor, for reasons only he can know, vetoed the measure when it passed in the state legislature last year and will, no doubt, do so again this year.  Placing the issue before the California voters would only mean more wasted dollars – in the multi-millions – that would be spent by the “health plan”/insurance industry to preserve their grip on the veritable gold mine they continue to run.

 
One can only hope that enough intelligent people will see SICKO and take the action necessary to educate our leaders and citizenry in general and get us into the modern world of organized health care delivery for all – a right, not a privilege of working status.