the health care reform bill: a week later

One week ago, the House of Representatives approved a health care/insurance reform bill that had been passed last November by the Senate.  Since then, President Obama has signed that bill into law, issued an executive order related to abortions and government spending, and a bill to make some “fixes” to the original has passed both houses of Congress.  With all that, the topic of the past year or more, health care reform, has been adopted.

Since then, I’m sure you’ve been able to read, listen to, and watch a lot of coverage on this topic (not to mention all of the coverage that happened the months leading up to this).  You’ve likely heard complaints of those who seeks its repeal, those who are pretty happy with the results, and those who don’t think it went far enough — and any combination of those views.

In my writing on this blog, I try to be pretty balanced and pragmatic, and I hope I will hold true to that even today.  However, I also want to share with you my personal thoughts on the topic as best I can in a succinct way.  I don’t claim to know all the ins and outs of the bills passed, and I’ll probably not touch on all the topics you might be interested in.  However, I invite you to leave comments, short and long, and if you’d be interested in writing a guest blog this week, please let me know and we can be in touch.

So let’s get on with it.

From what I can tell, I first have to say that the changes that were passed are better than nothing.  If this bill will truly allow 30 million more people to receive health insurance, then it’s a step in the right direction.  However, by my calculations, that apparently still leaves about 15 million people without insurance, so obviously it didn’t go far enough.  And we’ve often heard that the goal of controlling costs only works when everyone is covered, so what’s the deal there.

That being said, another issue I have with the bill is that, using a phrase I’ve also heard a bit this week, it “further entrenches the state of a for-profit private insurance industry.”  As someone who ultimately believes in universal health care provided by tax dollars, continuing on with privatized insurance companies that seek to make money off of people receiving (or not receiving) health care is a sham.  Obviously to continue on making money, insurance companies are going to pass their rising costs of coverage on to customers in the form of higher premiums and co-pays, and with no public option that is not-for-profit (they left that out, you know), what is there to truly control rising costs?  I’d really love an answer, because I don’t have one.

I personally can’t get behind a system where people are making money from health-related issues, which is why I totally disagree with the for-profit model.  I think health care is a basic right that we as a society need to get behind.  This structure and system seems unlikely to give universal coverage while keeping costs down — though I hope it will — so unless the plan is to show that the private, for-profit system doesn’t work and we truly need a nationalized system, I’m worried this will simply be an experiment costing thousands of lives in the process.

Some other generalized concerns I’ve been thinking about, in no particular order:

I heard this week that Switzerland has a highly regulated, privately run and universal health care system where profits are capped and the government doesn’t run the system directly but holds extremely powerful oversight abilities.  If we’re so worried about government f-ing things up and straying from our capitalist roots, perhaps this would be a compromise?

We must recognize the interconnectedness of health and other aspects of our lives, such as the food we eat and the lives we lead.  If we had a system where we all were in the same pool, then ultimately those with healthy habits would be subsidizing those with unhealthy habits (smoking/over drinking/poor diet/no exercise/etc.).  How do we change the fabric of society to deal with all these issues?

Our food system is built most calories for your $ is unhealthy foods that lead to diabetes and other such diseases, so changes can’t just come in the health care system itself. No one says having a beer is bad, but we need more support for other who use it excessively and in harmful ways. Also, I’ve heard that many people smoke because it works on the brain similarly to the ways anti-depression drugs work, but will all the extra complications we all know so well.  The question becomes how to deal with things like this that do affect a person’s health and would affect a system where we are all supporting one another. I certainly can’t claim to have all the answers, but it’s going to take more than this bill to change some large structures that are contributing to health issues in this country.

Another issue I have is that we (in the U.S.) have become accustomed to thinking that money can buy anything and failing to accept that we’re all mortal and will thus get sick and die. Unfortunately, until we accept that, we will continue to clamor for more medicine and medical service to keep us going, and if we have money we’ll think that should mean we can thus use it to buy more services and stay healthier longer.  Unfortunately, all the talk of “death panels” incited fear instead of a positive discussion about death itself. Should there be people “playing god” and deciding who should live and die? Well, maybe not to that extent, but we need to find a general consensus of what a good life lived looks like so we can better make decisions about how we’re using our limited health care resources.  Should we be giving a 95-year-old a hip and knee replacement if that takes away resources from a 10-year-old in some way?  I don’t think so, but we’ve failed to have open discussions on this topic because we feel entitled to certain privileges in relation to health care, especially if we have money to pay for it.

My biggest desire is that all people have access to a certain level of health care that doesn’t burden them financially. Will that ultimately mean some kind of rationing? Probably, and I’m fine with that as long as it’s happening to everyone equally. My biggest problem is that discrimination is happening in the health care system. Sometimes it’s in the form of people not being able to purchase insurance. Sometimes it’s that, with or without insurance, people are driven to bankruptcy or huge financial burdens because of medical costs.

For all these reasons I’ve listed above, I believe we need a system that treats all and is paid for by all.  In my mind, people would contribute in proportion to their wealth for the betterment of all.  Some people call this socialized health care, others call it a collective.  No matter the name, until we unite against those who continue to profit from the current system, inequality in relation to health care will continue, with some on the outside looking in.  I hope people will recognize that the fight needs to continue until this type of system is achieved.

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