Thursday, October 15, 2009

Q. and A. about Health Care Reform

By Shawn Vuong

This week Dr. Holm writes a short Q & A about the current health care reform and debate.  It's a nice concise summary of the basic problems of the reform, and I have nothing to add.  Hopefully, we find a workable and solid solution to our healthcare system problems.  So without further ado, the Health Care Reform Q & A.  

By Richard P. Holm MD

Q. Do we really need health care reform?

A. The answer is a clear yes, because of ACCESS and COST issues:
1. Without reform, insurance companies will remain free to increase profits by cherry-picking only the well people, leaving too many Americans without access to health insurance. What’s more, many people will continue to be unable to change jobs for fear of losing insurance. These are problems of ACCESS;
2. Without reform, health costs will continue to rise, and health insurance will become more unaffordable for many businesses, let alone many individuals. Unchecked, by 2017 Medicare will bankrupt social security. This is a problem of COST.

Q. Why is US health care twice as expensive as any country in the world?

A. There are many reasons, which is why this is so hard to fix. Here are the most significant.

1. Payment for health care rewards hospitals for making available and encouraging the most expensive technology which does not necessarily improve care;
2. Physicians, especially in the emergency rooms have every reason to order the most complete and often most expensive tests or treatment because the patient wants it; the hospital wants it; and there is a risk of law suit if every test or treatment is not done and something bad happens. This again, does not necessarily improve care;
3. Patients expect the most expensive care for their family and for themselves, someone else is paying for it. Studies show the most expensive does not necessarily mean the best care;
4. Too often we do not have our personal doctor directing care, but have turned to that which is specialist driven. This kind of care can become very disjointed and very expensive.

Q. Will the solutions working their way through Congress right now solve the access and cost problems?

A. Both problems are being addressed. Ethically, I believe the access problem must be solved first. Although the more complex challenge of reducing health care costs will require a great deal of political will, it is a problem that also must be solved.

Both parties, of course, are playing their political hands with this issue, but I believe that without health care reform the consequences will be too dire for the any of us to tolerate. Our Washington leaders will have to find a way to make it happen.