Reformation vs overhaul: the health care debate
Buzz word. That is what the words “universal health care” and “socialized medicine” seem to be in this year’s hotly contested presidential election. Senators John McCain, Hillary Clinton and Barack Obama all claim the people are clamoring for change in the heath care system. But the real questions seem to be what needs to change and how much.
Linda Hodges, assistant professor with the Weber State University/USU Nursing Cooperative Program, said at least 17 percent of the population doesn’t have health insurance.
“All people get sick, and they should be taken care of,” Hodges said. “It is difficult to get care if you don’t have insurance. There isn’t a system that seems to work anywhere. People from Canada go to the U.S. to get
care and people here go to Japan. It is really difficult to say what an answer would be.”
Two different answers to this question have been put out by the competing parties. The Democratic response seems to call for an overhaul of the current system while the Republican response calls for a reform.
Democratic frontrunner Obama (D-IL) summarized his plan at a speech in Iowa City in May.
“We now face an opportunity-and an obligation-to turn the page on the failed politics of yesterday’s health care debates,” he said. “My plan begins by covering every American. If you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums. That will be less. If you are one of the 45 million Americans who don’t have health insurance, you will have it after this plan becomes law. No one will be turned away because of a pre-existing condition or illness.”
Obama’s rival for the Democratic nomination, former First Lady Clinton (D-NY), states on her campaign Web site, www.hillaryclinton.com, that her plan covers all Americans and improves health care through lowering costs and improving quality.
“It speaks to American values, American families, and American jobs,” the Web site states. “It puts the consumer in the driver’s seat by offering more choices and lowering costs. If you’re one of the tens of million Americans without coverage or if you don’t like the coverage you have, you will have a choice of plans to pick from and that coverage will be affordable. Of course, if you like the plan you have, you can keep it.”
One main point, according to both candidates, is every American is entitled to insurance, even those with pre-existing medical conditions, including those associated with age. Some compensation would have to be made for this.
Dan Coster, actuarial science professor at USU, said health premiums are like auto insurance premiums. Drivers who hold greater risks, like teenagers, elderly, drivers with tickets or DUIs, typically pay higher premiums for the same amount of coverage, Coster said.
“So either the insurance companies charge higher premiums for those with pre-existing conditions, which more or less means these people are back where they started because they likely cannot afford this high-premium coverage in the first place or they would already have it, or the additional cost is spread over everyone, which raises the cost for all participants in the system,” Coster said.
He said the only way to compensate would be to have higher deductibles.
Hodges said the biggest disadvantages to these plans, however, are cost and resources.
“Some people use far more health care than they need and some people use very little,” Hodges said. “The resources are expended on a few people and the others don’t use it enough. A good portion of the health care dollar is spent on the last part of your life. We, as health care providers, need to decide whether it is appropriate. Culturally speaking, dying is taboo, and we do everything we can to avoid it.”
Hodges also said the quality and effectiveness of recent government efforts to fix health care are also under debate. In terms of Medicare and Medicaid, she said access to care improves with these for the most part. However, it doesn’t seem that people are more satisfied with what they are getting, he said.
“As a matter of fact, people seem very frustrated,” Hodges said. “The system is very convoluted to get what you need. The consumer public is very dissatisfied.”
She also said dealing with Medicare and Medicaid is very resource intensive and involves paperwork.
“Why does it take specialized people to get the bills paid?” she said. “People have to be very knowledgeable to get the bills paid. When the doctors used to say the visit was $5, you gave the doctor $5. But now it takes an insurance adjuster and a medical biller and all these people to get the bills paid.”
However, Hodges also said she wonders if the government-sponsored health care would even out the playing field a little bit.
McCain (R-AZ), the Republican candidate for president, favors an approach to reform the current system. According to his Web site, www.johnmccain.com, “Controlling health care costs will take fundamental change – nothing short of a complete reform of the culture of our health system and the way we pay for it will suffice. Reforms to federal policy and programs should focus on enhancing quality while controlling costs.”
One way to control costs, according to his plan, is to reduce frivolous malpractice lawsuits and control the rising price of malpractice insurance.
According to Hodges, lawsuits and malpractice insurance greatly contribute to rising costs.
“Everybody is practicing defensive medicine to protect themselves as a profession,” Hodges said. “People see doctors as having deep pockets that they can make money from. Doctors used to be revered as saints and respected. But now the problems are very public and people willing to think they can make money off of those problems. The insurance costs go up and so the cost of care goes up.”
Hodges also believes insurance companies should be more accountable for their actions.
“They drive the industry and it is all about profit,” Hodges said. “To me it isn’t about profit. It is about care, and because of this we lose a lot of the compassion and satisfaction.”
-michael.buhler@aggiemail.usu.edu