Precept Employee Benefits Blog

Health care reform proposals are making headline news.  Again.   The insurance industry came out with a proposal a month ago, and the Democrats have announced that it is a national priority.  Sen. Wyden (D, Oregon) jumped the gun and came out with his own reform proposal, which received wide attention.  Here in California the Governator announced that he would propose reforms, and one of the Democrats (State Sen. Perata) one-upped the Schwarzenegger announcement by coming out with one of his own plan.

What’s up?  Why all this activity, when our health care system has been in serious trouble for at least a decade?   And is there really hope for accomplishing anything?

First, it is clear that proposing reform is a no-loss situation.  No one disagrees that our system is broken.  So you propose a solution, show you care, get favorable press, and usually that’s the end of it.  That sounds like perfect politics and is probably behind a lot of the current activity. 

Actually accomplishing something is another story.  Unfortunately, there is not a simple problem accounting for what’s wrong with our health care system, and most proposals focus on solving only one problem.  These include:

1. The uninsured – it is indeed a national disgrace that we leave 45 million Americans without reasonable access to medical care. 
2. The cost – it bankrupts employers, creates unbelievably huge federal and state deficits, and drives individuals to insolvency.
3. The danger – our health system kills at least 100,000 Americans every year, causes millions of deadly, preventable infections, and misses countless opportunities to get better outcomes.
4. The waste – we keep critical information buried on pieces of paper inaccessible to patients, physicians, and researchers, waste up to 30% of what we spend on administrative and malpractice boondoggles, and discourage preventive care which would save billions in long-term costs.

Give me a few minutes and I can propose a reform to fix any one of those problems, and so can you.  It’s not difficult, as the number of reform proposals suggest.  What I can’t do, is come up with a simple plan to solve them all.  In fact, any proposal to fix one is likely to make the others worse, often much worse.  What happens to cost and waste if we suddenly cover 45 million additional lives?  What happens to waste and medical outcomes if we suddenly lower costs by paying less for health care? 

Discouraging?  It’s actually even worse.  Realize that health care has powerful vested interests which will oppose meaningful change.  Think of the AMA, the insurance lobby, the business groups, consumer organizations, the AARP, hospital associations, nursing unions and all the competing demands for scarce public dollars – education, the military, and Social Security.  These have tremendous political clout and will use it to oppose any change which threatens their turf.  They have done it before and will do so again.

Fixing what’s wrong with our health care system is going to take more than political sound bites and made-for-TV quick fixes.  There’s nothing wrong with generating momentum for change, but meaningful improvement will only follow from sustained, thoughtful, compassionate, and very long-term dedication to understanding and improving our health care systems.