Better Health: Smart Health Commentary

Featured

Average Americans Are Very Confused About Healthcare Reform

July 23rd, 2009 by Jon LaPook, M.D. in Better Health Network, Health Policy, Video
No Comments »

Doubled over in pain, you stagger into the emergency room and are diagnosed with acute appendicitis. A surgeon leans over your stretcher:

Surgeon: You need an appendectomy.

You: What are my options?

Surgeon: Either I take out your appendix or you die.

Now that’s a conversation people can understand. But what if, instead of whisking you up to the operating room, the surgeon kept talking and invited a few other people into the discussion?

Surgeon: Do you think I should take it out by an open operation or laparoscopically?

You: Huh?

Laparoscopy equipment salesman: You know, cutting you open the old-fashioned way and leaving a big scar or having a tiny incision. Laparoscopy is much better than the open procedure.

Guy who sells scar-removal cream: Wait a minute. Better for whom? Laparoscopy takes fourteen minutes longer.

Hospital administrator: But hospital stay is reduced by 0.7 days on average, patients have less pain, and you can return to work sooner.

Surgeon: Laparoscopy costs more than an open operation while you’re hospitalized but less once you’re home. What’s your co-pay?

You: Doc, my belly’s hurting a lot more now.

Guy who owns shares in a drug company: What if we just treat him with antibiotics?

Surgeon: Don’t be silly. His appendix could burst.

Funeral director: What about doing nothing?

Very smart people are zoning out of the health care reform debate because they think it’s just too complicated.
The latest poll out today from the Kaiser Family Foundation, a nonpartisan health-care-policy research organization unaffiliated with Kaiser Permanente, says only 27 percent of the public has been following the health reform debate closely. Despite this, more than half (56 percent) of Americans think health reform is more important than ever.

Simply put, there are four main goals of the legislation:

The Cost of Universal Coverage: Can We Afford It?

November 22nd, 2008 by Dr. Val Jones in Opinion
1 Comment »

I don’t subscribe to many newsletters, but the Galen Institute’s Health Policy Matters is always a provocative read. Here’s an excerpt from this week’s newsletter:

Incoming White House Chief of Staff Rahm Emanuel said this week that universal coverage will be an early, top priority of the Obama administration.

But where is the money going to come from to pay for these massive reform agendas, which were developed before the meltdown of Wall Street, the $700 billion rescue package, and a projected $1 trillion deficit?

The Obama plan is estimated to cost an additional $100 to $160 billion in the first year alone, yet the president-elect made fiscal responsibility a big part of his campaign platform. If the White House is going to extend the plan to mean universal coverage, the bill will be even more expensive.

Mr. Obama also will be facing the huge flood of red ink in Medicare, with the program starting to run out of money in 2017, about the time a second Obama term would end.

It’s impossible to make predictions in the current topsy-turvy political and economic climate, but these power political power centers, fiscal realities, and the urgency of other issues, including Detroit’s looming bankruptcy and an unstable geo-political climate, make these dreams of sweeping health reform a major challenge.

Mr. Obama will likely use the pending expiration on March 31 of the State Children’s Health Insurance Program (which will be renamed) as a vehicle to expand health coverage to all children and possibly even enact his mandate for children’s coverage. That probably means funneling more money to the states through Medicaid since they must pay part of the costs.

After SCHIP, Congress will take the lead on major health reform legislation from there.

We need to remember that 82% of the American people are happy with their own health care and only a minority is willing to pay higher taxes to get to universal coverage. Also, the employer mandate is a new tax, and it is going to be especially difficult to impose during the economic crisis. And can we really tell people who have lost their jobs that now, in addition to everything else, they are going to be forced to buy health insurance?