Re: What's the big deal on Health Care Reform?
Here are my concerns, or at least questions I would like answered before I am convinced this health care reform is the correct move:
I keep hearing that one of the goals is to provide 50 million uninsured people with coverage and affordable care. How soon after passage of this plan will these people get their coverage? Is this an immediate implementation? Does it take a few months? Years?
The reason this concerns me is that if we add 50 million new people to the health care system overnight, without adding any doctors..... then what happens to the level of service for everyone? How do the doctors handle the increased load of patients if we add them to the system overnight? Does this lead to longer waits for care? Will the care I have been receiving be negatively affected? We can't train doctors overnight so I will be very concerned if the plan is to add 50 million new patients to the system without having more doctors to treat them. I have not heard what the plan is for adding doctors to the health care system, only that they want to add more insured people.
I pay for my own health care since I am self employed. United Healthcare. It costs me $300 per month. The coverage is excellent, though.... as I learned when I developed a large tumor in my left shoulder a few years ago at the age of 27. My primary care doctor referred me to a local orthopaedic surgeon who was unable to diagnose the tumor though needle biopsies. He recommended I have the whole tumor taken out for an open biopsy. However, before he would schedule me for the surgery he shoved a bunch of waivers in my face. He said that the tumor was so large that the surgical procedure posed a significant risk to my axillary nerve. (nerve that controls your deltoid muscle) Damaging that nerve could result in partial paralysis of my arm, he said.... and the waiver was covering him in the event this happened. Not very encouraging to say the least.
Since I play a lot of sports, including golf and lacrosse, I was not keen on risking possible paralysis in my arm. I decided to start researching the topic of soft-tissue tumors and doctors who specialize in them. I found an expert at Johns Hopkins University. She is an orthopaedic oncologist and specializes in tumors like mine. There are no orthopaedic oncologists in Orlando at all. I decided if I was going to have someone operate on my arm, then I wanted a real expert like her. And so I contacted my insurance company to see if they would cover my visiting Hopkins without a referral, which they did. I flew up to Baltimore and had the surgery. She never mentioned any risks to my axillary nerve. She actually laughed when I mentioned the other doctor wanting me to sign waivers. The surgery was a success and my insurance covered it.
After removing the tumor the pathologist diagnosed it as a sarcoma and I had to do 6 months of radiation treatment. No chemo, fortunately. The tumor was low-grade. But it was definitely a good thing I got it taken out. They did CT scans for my lungs to make sure the cancer did not spread there, which it had not.
Several years later and I'm doing great. No recurrence of the tumor, no evidence of it having spread. I must continue with MRIs periodically to monitor for recurrence, but we have been spreading out the scans over longer periods of time now that I'm two years post-surgery. (Recurrence is most likely in the two years after surgery)
The point I'm very slowly getting to is that I'm happy with my insurance. And I am happy that I was able to select my doctor, even though I had to fly across the country to find her. I want to know if my coverage is going to be affected by these changes, but no one can give an answer.
Toasty feels that having a government option that competes with private insurers is rather innocent and harmless:
[quote]What exactly is the downside of having a government-funded competitor in the marketplace, by the way? Serious question. Seems to me that if the government is able to offer health insurance coverage -- and note that I'm talking about coverage, not care -- at a cost that is less than what the market is offering, why should it be prohibited from jumping into the fray? This is particularly true where the government is also one of the largest consumers of health care (or at least health care [I]bills[/I], in the form of Medicare), and it can leverage its position as a market participant to drive down the costs that it pays as a third party payor.[/quote]
Let's stick with the Post Office analogy for a moment:
Generally speaking, the post office offers a low-cost delivery service. (i.e. you can send a letter almost anywhere for a few pennies.) FedEx and UPS compete with the Post Office, but do so by providing the service differently. (i.e. FedEx and UPS will guarantee overnight delivery) Of course, I realize the Post-Office has Express Mail Overnight to compete with FedEx.... but the difference is they can't guarantee overnight delivery to many places that FedEx can. For example, I live in Orlando, FL and the post office will not deliver Express Mail overnight to Charleston, SC which is only 500 miles away. So when I want to overnight my parents a package I must use FedEx or UPS, not the post office.
So the basic view of it for me is....
Post-Office, aka snail mail = cheap but slow
FedEx = expensive, but fast
There is a difference in the level of service which helps FedEx and UPS compete with the Post Office, even though they do cost more. I will pay for FedEx to ship my important package to my parents in Charleston because they can do it overnight. If the post office could provide that same service for less, I would use them.... but they can't get the package there overnight, so I pay extra for FedEx.
But how far does this analogy mirror the situation with health care?
You say the government option will compete with the private insurers, but at a cost that is below the market. So what will be the competitive advantage for the private insurers counter the government? Price is on the government's side. Does that mean the private insurers will have better service? Will I have an advantage by keeping the current insurance which I pay for? The way I see it, United Healthcare would have to offer me better coverage than the government option if I am going to continue paying for them. If they can't offer better service, then why would anyone pay more? I would just assume be on the cheaper, public option if the service is the same. And I believe most people in this country would do the same. It seems to me that it would have to be inferior coverage or else the private insurers will go out of business.
So what will be the differences between the public coverage option and my current insurance? I'm just not hearing anything about this from anyone, and I worry that my situation will be adversely affected.