How about a rational discussion of health reform?
Over the past six weeks, I’ve read some silly and even outrageous articles on health care reform – especially about the “public option.” These fact-free commentaries are a terrible disservice to the American public. Health care affects every single one of us, and the costs will eventually bankrupt our country. It’s time for an intelligent dialogue about health care. I’d like to start the ball rolling with this column. Who knows? Maybe rational discussion will become contagious!
There is a lot of confusion between how medical care is provided and its financing. Medical care is delivered through roughly 4,000 hospitals and 600,000 physicians (as well as other professionals and facilities). None of the bills in Congress propose that government take over private hospitals and physician practices. Of the major industrialized countries, only England under the National Health Service actually runs hospitals and employs doctors. In other countries, hospitals and doctors’ offices are actually operated by the private sector.
All of the various proposals address only the financing of medical care – currently a mixture of private and public insurance. Readers may be surprised to learn that almost half of all health expenditures in the United States are already covered by public insurance programs. So what is this public option all about?
Under the America’s Affordable Health Care Choices Act of 2009, most employers would be required to provide health insurance. Individuals would also be required to buy health insurance (similar to requiring car insurance). People who don’t have health insurance could purchase it through the Health Insurance Exchange. Coverage would be subsidized based on level of income (up to 400 percent of federal poverty level). Individuals would have a choice of plans. One of these choices will be a government-run program.
Right now, there are few details about what this public option will look like. However, we already have a very popular government-run health insurance plan – it’s called Medicare. It’s pretty likely that Medicare will serve as a model.
Medicare is run by the Centers for Medicare and Medicaid Services – a branch of the federal government. CMS develops the regulations, procedures and policies for Medicare and contracts with private insurance companies to pay claims, offer customer service, etc. (This is probably why many seniors are confused about Medicare being a government program.) The CMS strictly controls administrative costs and profits, and conducts routine audits to make sure that the benefits are being paid correctly. They contract with independent nonprofit health organizations to monitor the quality of care.
Are there problems with the public option? Absolutely. Is Medicare a good model, given that it’s going to be insolvent in a few years? Excellent question. My point is that there are real and substantive problems that we need to address – rather than focusing on nonsensical issues like “death panels” and “socialized medicine.”
I would like to think that this small outbreak of rationality might actually turn into a pandemic!
Maria Ferrera a 19-year Oak Park resident, has spent more than 25 years in the health benefits field where she has advised many large corporations on selecting health plans for their employees and negotiating with large insurances companies.