Health Care

We spend twice as much on health care as the average industrialized nation, and get poorer results for our population and our companies.  I have trouble accepting that every other industrialized country has figured out how to solve this problem, while we continue to struggle with it.  President Obama and Congress had, and to some extent, continue to have a heavy task ahead of them, both in reconciling the House and Senate bills, and in selling this proposal to the American people. The final outcome remains to be seen, but my goals–some of which will be implemented  in this reform package, some of which will not–are clear and committed. Our goals should be to lower costs, improve quality, and expand coverage.

Lowering Costs

Three of the biggest factors in lowering costs are the lack of preventive care, the high cost of caring for the chronically ill, and the lack of competition.  One way to increase preventative care is through a public option.  It would allow people to stop using the emergency room as their primary care provider and start seeing a doctor before their conditions become expensive.  Estimates are that this lowers the costs of people with health care by about $1000.  More coordinated care for the chronically ill—as they do at the Mayo Clinic—has the benefit of both lowering costs and improving quality.  That’s because a coordinated team makes fewer mistakes than the traditional model without incurring significant costs.  Third, one of the best ways to bring in competition is via a public plan.  Many would prefer that we allow more competition across state lines.  I support that as well, but it assumes that there is a state with high quality, low cost health care.  There is not yet a public plan that offers robust competition, which requires less overhead and has less inefficiency than a typical private sector plan.

Improve Quality

The best practices in medicine are not broadly practiced.  Studies have shown wide disparities in treatment without commensurate results.  We have the opportunity with health care reform to establish national data-driven standards for delivering health care.   This has the benefit of reducing adverse outcomes for patients, lawsuits for doctors, and costs for the entire system.

Expanding Coverage

Reducing costs is directly linked to expanding coverage. The less health care costs, the more people who will be able to afford it, so, the policies above, should by themselves, expand coverage.  But I am one of those that feels that health care, like education, should be available to all Americans.  It’s not just economically smart, it is the right thing to do.  A healthier nation is a more productive, more competitive nation.  So here again I reiterate my support for the public option.  Some Americans simply aren’t profitable for private sector insurers and won’t be covered.  Only an insurance plan without a profit motive can cover these Americans.

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