Health Care Reform, misunderstood

Being part of the industry, it's easy to forget that most people probably have other things to worry about aside from the details of the health reform bills before the Senate and the House. Nevertheless, I'm surprised by how misinformed people are about what's actually being proposed. I really have to wonder where people are getting their information, or if they're just making stuff up based on their own superstitions about government, the poor, and insurance. I just plain don't know where some of the stuff I hear comes from.

For example:

"I don't want Medicaid for all..." ...No one's talking about anything like Medicaid for all. The most government-heavy proposals are that a public plan be formed to compete with the private ones, mostly under the same rules for coverage and financing.

"Free health care? Like they have in Canada? Please..." ...No one's talking about anything being free, or Canadian. Government, business, and individuals will all have to pitch in to get affordable coverage to everyone. What they have in Canada is radically different from anything on the table now, and for its inconveniences and occasional horror stories, it works better than our system by almost any measure.

"I don't want some government bureaucrat telling me what I can and can't have..." ...Putting aside the notion that the same people can't wait to get on Medicare, no one's talking about the government having the right to deny your claims. If anything, the government will make insurance companies have to pay your claims and have to provide coverage regardless of any health problems you showed up with. At most, the government will underwrite research on what works and what's hokey-- something that could save us money. Under the proposed rules of the game, insurance companies, public or private will actually want to pay for what works because they'll have to cover you down the road. Right now we have some private sector bureaucrat telling us what we can and can't have, and they're doing it on the basis of what's best for their shareholders, not you.

"My health insurance is fine, why would I want to change anything?" Putting aside all moral objections here, your insurance is not fine. They can deny you coverage if you sneeze, they can deny claims as they please, and even when something is covered, they can short-change you on their rates... and it costs at least twice what people pay everywhere else in the world. Why do you pay more? Because health care providers charge more to make up for everyone else who doesn't have insurance, and because they perform all kinds of unnecessary and expensive procedures either because they're profitable, or to cover their tracks to avoid a malpractice claim-- not because it's what's best for you.

We can debate what the role of the state should be in financing and organizing health care, but rules that let them select healthy, cheap beneficiaries haven't worked so well once they get a little older and sicker. Competition can be a race to the bottom just the same as it can be a race to the top... it's a question of rules. After all, if I was in business, why would I do something that took away from my profits, like paying a claim when I didn't have to? Knowing that, and knowing that the results are mediocre, expensive coverage for some, the rules of the game need to change. Who does the changing? The government. That's what we pay them for.