I have just finished reading yet another article about healthcare and President Obama's efforts to implement change. As I read the article, which mentioned nothing about Obama's legislative efforts, it occurred to me that I didn't know what exactly people were referring to when they talk (or write) about healthcare reform. The reason I often don't know what they are referring to is a result of the speaker (or writer) not knowing what they are talking about. Seriously. I just read an article by a columnist on the Yahoo finance page about why the public is not supporting the proposed legislation for reform. The author made some good points and added a few huge misunderstandings as well. Truly, he doesn't know.
The debate usually breaks down into two sides, Republican and Democrat, rather than focus on providing healthcare. The Republican political position is that while we would like to improve the current healthcare system to be more efficient, cost less and cover more of the population, ....this is not the time to make those changes due to the current economic environment. They also feel that any change to the existing system may threaten their personal doctor-patient relationship, which they feel would be a disaster. The Democrats feel that now is the time for change, since they have control of both the White House and Congress. They also feel that coverage needs to be extended, by either offer or mandate, to everyone living in the country, citizen or not. I confess, I don't have the details of the proposal at this time. Cost be damned. President Obama has said that the additional costs for covering the additional people will be covered by raising taxes on the wealthy. We will discuss that later.
Who am I?
I spent about 15 years working in the healthcare industry, starting out as a Group Life and Health Underwriter for the largest insurance company in the U.S. and ending up as a Vice President of Underwriting for the largest HMO in the country. I am not a doctor, nor a politician. My job was to analyse risk, price the risk, price the products and manage the risk/pricing to earn a specific profit for the insurance company/HMO. I have since moved on and have not been involved in the business for almost 18 years, a lot of my knowledge is old. But I am still an underwriter at heart, I still analyse and think about issues before I decide. I wish politicians did that.
So what are the issues in the debate about healthcare?
Clearly, cost is one of them. Change always involve cost, and in this case, that cost is tax money. So taxes and reform are joined together. Coverage is another. It is universally agreed that there are millions of people wandering around the country with no coverage at all. What isn't agreed is how many, exactly, are we talking about, and how much it will cost to cover them. Then there is the age old issue of "quality of care". This is my favorite issue, because it means whatever anyone wants it to mean. To some people it means we can't change because we already have the best care possible, to others it means we must change because this country is falling behind others in quality of care and is no longer the best in the world.
Cost.
Coverage/access.
Quality.
Those appear to be the issues at the heart of the debate in Congress. They are big issues and anyone that attempts to answer or inform you of all the nuances of the issues in a single column or two is unlikely to succeed. I will try to write about them in a series of articles over the next few days. Perhaps I can at least help inform some people.
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