Health Care Debate (Part I) What is 'Health care?'

Of late, I have remained fairly dormant when it comes to posts which pertain to politics.  I know myself and many friends are still suffering from TRump whine/gloat fatigue and I certainly try to NOT contribute to its continued presence in my friends FB feeds.  But as the GOP failed in their first attempt to repeal Obamacare, delaying a vote on a terrible piece of legislation, I wanted to demonstrate how complex this debate will (well maybe 'needs to') be as we move forward.

We do have a health care coverage crisis in our country.  I think that is an area where we can mostly all agree.  I don't believe Obamacare is the answer, I wholeheartedly believe socialized medicine is even worse of an idea, and I will state here that I also don't agree with the recently proposed GOP legislation.  It is so easy to simply say "I support Obamacare", or "I support repealing Obamacare."  The problem is those statements honestly have no substance.  If I may, this issue goes FAR beyond a hashtag, a tweet, a protest sign or a simple Facebook post. 

We need a sustainable high quality of care system, where customers have freedom of choice in providers and insurers, and where insurers and providers have a right to charge rates which will allow them to remain viable and encourage growth and investment in better care and options for consumers.

That said, before we all get into our respective camps and begin saddling up our high moral horses and demonstrating our superior intellect and greater compassion via social media emotional justice protocols, I am going to explain where my head is at right now on the issue and why I get so frustrated with the standard Democrat & Republican sound bytes and talking points today.  I don't think I am alone in my line of thinking, but maybe I am.  One sure way to find out is to lay it all out. 

I hope others will vastly improve upon my humble thoughts and maybe share their ideas and views, either here or on their own Facebook feed or public blog and further the meaningful public discussion.  This is only my first post on the issue, and as you will see, I think it will take a lot more depth to really derive a solution, or to even honestly express an encompassing view on the health care debate.  So, let me take the plunge.

"Health care is not a right."- Grant Jacobs

When I said that recently on a post, someone called me on it.  I cannot tell you how grateful I was, it allowed for more dialogue with someone who’s opinion on the topic I respect.  A statement such as the one above requires context.  My literal view: there is no guarantee in our constitution, no proposed amendment, no stipulation in any of our founding documents declaring health care as a right.  It is not found as such in the Bible, nor am I aware of it appearing in any religion’s commandments or tenets of their faith.  

But, far beyond that, here is what I clearly think everyone needs to be more diplomatic and engaging in dialogue on this issue: please define, in very specific language, exactly what “health care” is. 

Are you referring to basic services such as the ability to see a general practitioner or qualified nurse practitioner?   What about Emergency Care to stabilize someone in serious jeopardy of dying?  Specialists in every single area of medicine including mental health?  What about prescription drug coverage?  If so, which drugs?  Those for basic illnesses or do you include even the experimental treatments?  How about transplant services?  If including transplants and other very extensive surgeries, do they apply to people of every age or just those under 70 as in some European nations?  What about transportation and lodging for family when hospitalized somewhere other than your immediate area (have to seek treatment in another city say)?  What about elective, non-life saving services/surgeries such as plastic surgery?  Gender reassignment surgery?  Vasectomies?  What about mental health coverage?  Can you be permitted to see any doctor in the entire US, or just those in your immediate geographical area?  Does “health care” cover ‘medical’ marijuana too?  What about “ending life” care/assistance? 

See?  This is just me tossing examples, and it is already very complicated.  What are the limits, because there have to be some very hard limits. 

Me? I would say basic health care services should be made available to everyone and then those more advanced services should come from an optional expanded coverage/advanced care policy which gives consumers more choices of the scope of their coverage.

As of this moment, I would say my line of thought would be along the lines of either looking at the community (state or local run) clinics approach or perhaps consider some version of the job corps for medical students where the government can help pay off student loans in return for residents/qualified students/etc to work and staff a primary care facility at or near every hospital?  Perhaps some friends in the medical field might have some thoughts?  I know I would certainly value their opinion.  Then allow consumers to purchase coverage which would go beyond the ‘basic’ coverage for all citizens, and tailor the programs to be available in all states.  Don’t tie the plans to employers, rather require insurers to simply charge rates by a scale based on patient risk factors.  Easy for me to say I know, how do you set that up?  I know a healthy 25-year old should pay a fair amount less than an overweight nearly 50-year-old with a prior history of joint surgeries.  But, as to how the principal of premium calculation is scaled, again we will need the best agents, accountants, actuaries, and providers to design the various levels and scales of coverage. 

I think we need a national register of doctors and they need to be graded and reviewed to ensure bad doctors are removed from the pool of providers, and we also need to protect them from absurd judgments in malpractice cases.  Ironically, this is an area where I can see technology coming into play in a big way.  Get a program like IBM’s Watson to track the performance of patients in the months and years after procedures and see if further treatment is required or the provider managed to ‘cure’ the patient of the specific problem they were seen for.  Watson can also track all patients as we can have each patient issued an ID number just like a social security number and track prescriptions.  This raises some privacy concerns though.  (Good God this is getting complicated…)

I am going to pause here, and end this post with the question (again): what is health care that we talk about so often?  Do you see how we can’t just hashtag and tweet a simple answer to that question and be taken seriously in the discussion?  My hope is simply to move the conversation along to the actual substance of the debates, not the simplified superficial labeling of a view on the matter in 140 characters or less.  I have not said one meaningful word yet on the funding and controlling agent yet.  Those are complex issues in their own right.  I just want to convey my reason for saying this issue, much like immigration has a TON of layers to it, and we must deal with them all if we want to actually solve the problem and not just give lip service to our favorite side at the dinner table.  Did anyone get this far? 

I will try to put some more thoughts down in part 2 and maybe a part 3.  How to pay for it and who 'controls' it?