(Thanks to Dan Roam and C. Anthony Jones, MD, it’s really simple.)
IT MAY seems simplistic, but Roam and Jones really hit the issues square-on and adeptly explain the basics of what’s going on right now with health care reform.
There’s no one who isn’t at least a bit confused by this, so shake off that purple haze by clicking through the slide show above, and then (for good measure and reinforcement) read the summary below, which of course is peppered with my own drivel.
There are four chapters in the “Book of Napkins”.
Chapter 1: American Health Care is a Business
Health care is business in the United Sates comprised of three participants: patient, doctor and insurer.
These three provide the tension in the system cause the doctor is running a business and wants to max earnings via insurance payments, the insurer is running a business and wants to max earning by paying out as few insurance claims as possible, and the patient wants to get fixed but really doesn’t take much responsibility for his health (“Can I take a pill to fix this”?) which augments incidences of chronic disease which costs a whole lot for a long time. (Think diabetes, obesity, heart disease.)
Chapter 2: It’s Really insurance reform, not health care reform
The proposals were hacked at town hall meetings by the over-caffeinated, whilst the passive sat at home and polled overwhelming for health care reform. But what’s being tinkered with is really insurance reform.
Why focus on insurance? Because private insurers have completely failed at keeping costs down; in fact, costs have skyrocketed and will continue to do so unless something structurally different is instituted.
If you’re employed and covered by health insurance, you will be paying for reform, which is not to say that it’s not a good idea. Because with or without health care reform, it’s going to cost you more.
The key question is… in the future will you be paying more for:
1. More profits for private insurers;
2. Funding non-profit insurance exchanges; or
3. Funding a new government non-profit insurance plan?
Chapter 3: What are the three options on the table?
Option 1. Less restrictive private model whereby everyone must be covered and no one excluded because of pre-existing conditions.
Option 2. Keep private insurance and add private, non-profit co-ops that everyone without insurance must buy.
Option 3. Keep your private insurance if you like it, or buy insurance through a government-managed insurance like Medicare.
Who likes what?
Conservatives like the status quo (#1 above), but are being pushed to do something which is mostly undefined at the moment.
The Administration, along with its supporters in Congress and many Progressives want the private/public option (#3 above).
Various “others” either leaning left or right want something in between (kinda like #2 above).
Insurance companies would like all this reform business to quickly die, degrade to dust and blow away. But the least worse option for them is Option 1, so their money is lobbying for it.
Chapter 4: What’s It Mean To You?
If you’re employed and insured, all options will cost more. Your portion of this cost would be dependent on your employer’s deal with you re health insurance compensation. Or, depending on what happens legislatively and your income level, you could wind up paying the additional costs in direct taxes or by losing the presently untaxed employment health care benefit. But, remember, you’re going to pay more even if no reform happens cause health care costs are skyrocketing and will threaten the solvency of the U.S. government.
Conclusion: health care reform is coming. It has to because it’s not working even for those insured and the cost escalation will ruin the current system anyway. So, what needs to be decided is:
1. Does health care work best as a profit-driven business.
2. Since change is inevitable, how should it be paid.
3. Will the best approach be had by shouting or thinking?
Your comments are welcome.
Last Updated on September 17, 2009 by Joe Garma