Some Thoughts on Health Care Reform
July 29th, 2009 | 
Author: 
Yesterday I caught the tail end of a show on NPR’s Marketplace on health care reform. There is of course lots of talk about this right now with all the potential changes coming down the pike from the American Congress and President Obama. I found this interview particularly interesting because it was with George Halvorson who is the CEO of Kaiser Permanente. I always like to hear what people who are in the health care industry think about the nationalization of health care so my ears perked right up when I heard what they were talking about.
I am usually against nationalizing health care but I want to remain open minded and rethink things as much as possible. My main interest is more pragmatic and I would like to be able to have a health care system that is capable of giving the highest quality of care to the most people. I realize that in any system there are going to be downfalls and problems but we need to think of which is the best system which gives us the most upside and the least amount of downsides.
Halvorson makes a few points which I thought were interesting. In answer to the question, “Whats in it for the health care industry if we do this health care reform?” he said:
What’s in it for health care is if we can cover everyone in America, we can do a much better job of taking care of people. Right now, a majority of kids do not get right care for asthma. And because kids have coverage, and they lose coverage, they go to a care site, they go to a different care site. There’s no feedback from the emergency room to their primary care doctor. There is no consistency in asthma care, and that can’t be fixed until the kids have continuous coverage and a continuous database. So if we’re really going to fix care, we need everyone covered.
That is a good point. This is also exactly what many people are afraid of, the government having a centralized database of all of our medical records. I guess it is similar to the government having driving records on every individual in a way. Sure it might seem a little invasive that my entire driving history is in this database, but it does enable law enforcement to be much more efficient in dealing with bad guys. In the same way, with medical records being centralized and care being universal, it does seem like there will be a greater efficiency in dealing with health problems and followup.
In answer to the question of whether a national system will create a rationing of care and limit what a lot of people would truly want he says,
I don’t think that’s true at all. The issue is not that we need to ration care. We do not need to ration care. Right now, when you look at diabetes, 32 percent of the cost of Medicare is diabetes. It’s the number one cost of blindness, it’s the number one cause of amputations, it’s the number one cause of kidney failures. And when you look at the care delivery patterns in America, we only get care right for diabetics 8 percent of the time. If we got care right for diabetics 80 percent of the time, we’d cut the number of kidney failures in half.
He discusses the things that Kaiser is doing right now which are creating better efficiencies like electronic medical records and even doctor visits and follow-up visits online. I agree there are a lot of ways that health care can be made more efficient and that a lot of this can be done in the private sector but is a national health care system or at least a subsidized model of care delivery a more efficient way of doing things? And would we be able to get to where we want to be with having better coverage for all if we were on a national model? It seems that it may be. I figure that because Obama is in office and both houses of congress are democrat controlled, we are most likely going to get some kind of universal health care. And so I want to truly understand it and know what is good and what is bad about it. This interview made me think a lot about the whole subject.
The MP3 and transcript of the interview can be found here. The MP3 audio is much longer than the transcript for some reason so definitely listen to it.
Similar Posts:
- Now that Obama is President, What If…
- Christianity and Pseudoscience
- The Jesus Project
- THE DEATH OF THE AMERICAN IDEA
- Book Review: Losing My Religion by William Lobdell
- The End of Faith: Religion, Terror, and the Future of Reason by Sam Harris
- 7 myths about Detroit automakers
Posted in 
Tags: 2 Responses to “Some Thoughts on Health Care Reform”
Leave a Reply
Thanks for the thoughtful post about this subject. Too much ranting going on in other places. One way to explore it, and you get to that here in some ways, is to list what are the fears expressed about a robust public option, a single payer system, or even just more government involvement in some other way. I find that the fears mainly revolve around distrust of government to 1) provide efficient and effective services, 2) use public records in insidious ways, 3) not bankrupt the nation. Well, there are also some obstinate folks out there who seem to believe the government is just plain evil, but I think those three above are the main claims floated.
The thing is that none of those concerns are government-only problem, nor even government-driven. We stand at a moment of fiscal crisis because of unrestrained private sector greed and exploitation. Government certainly had a role to play in that, and could have done a better job, but the idea that the private sector is wonderful and government is horrible has over the course of U.S. history being shown to be at best Pollyann-ish, and at worst, just demagoguery. A quick perusal through the U.S. corporate crime blotter would open people’s eyes. From corruption, discrimination, outright lying and manipulating, exploiting, acting to undermine communities, and other nefarious activities, I mean, it’s all there. Private industry is not as efficient as people would like to claim either. My stints in the private sector showed an incredible amount of waste. Somehow though, the idea is that the private sector is very good and government just can’t pull it off.
Yes, government could use public records for nefarious purposes. But that has always been a possibility, and we’ve seen it happen from all sides. Private industry has done this, continues to do it, and we don’t seem to argue as much about that. Heck, even considering how often private industry loses records, shares private data, is hacked into and compromised, sells those for profit, etc. should realign folks’ perspective. We already live logged into tons of databases that collect all our information. The #1 collectors of information and profiles on Americans is not the government, but private industry. From what we buy at grocery stores, to where we shop for clothes, to what malls we visit most often, to how many miles we travel and to where… and if RFID tags ever become a reality… that project is not government driven. Safeway down the street probably knows more about us than the state or federal government, and is likely to use that information in far more intrusive ways.
About bankrupting the nation… well, the concern is warranted. I’d worry also. But costs will keep going up on health care, the private industry does not have a plan to keep cost down or even to cover the uninsured while keeping cost as they are. That’s just not the way it works. What’s more, it is a for profit system. The equation to keep costs down is tied to their profitability. That connection is dangerous. A private system like the one we have is ultimately not as efficient as a single payer, and much cost is added precisely because of the layer upon layer of insurance and administrative stuff associated with all the hoops to jump between all the players. The government can be a good faith player here, and they can and should use their power on behalf of the wellbeing of its citizens. That won’t happen if we just demonize them. The key is to work hard at making government’s role be transparent, efficient, cost-effective, and dedicated to helping as many Americans as possible. The focus should not be the profit or viability of the insurance or pharma sector.
Ultimately, I think most Americans are uninformed and unwilling to be informed. They tend to stay partisan, or uninformed. There is clear reform needed. My parent’s experience is certainly proof of that, but there are countless stories out there. Delaying that reform only passes the buck and makes our children’s lives worse. Refusing to take on this task on partisan grounds (like the GOP is doing) is not just insensitive, but amazingly short-sighted and morally and intellectually bankrupt. Neither of our political parties are representing us well.
Perhaps a single payer system is not in the cards, but a robust public option would go a long way to helping us all. The competition would be healthy in this market. Ultimately, I think Rep. Anthony Weiner (D-NY) has an interesting question he has been asking everywhere: “what value does the insurance industry bring to Health care? It doesn’t provide care, it doesn’t facilitate the provision of care. It does not make coverage cheaper, it does not… I’m sure there are some answers, but part of the reason why so many folks struggle to answer it is because we live ideologically bound to this idea of a for profit, private system as the best thing in the world. I’m sure it has its place, but the more in thrall we remain to that, the less we can act with clarity of mind and purpose on behalf of us all.
Thanks again for your thoughtful post, and thank you for letting me post this much!
N
great comment Nacho. Much more thought went into that than my original post