In listening to the President the other evening, I can see a person who believes in the American dream. To do everything possible to build a bridge between party lines, and fundamentally reach out to all sides to change this healthcare dilemma which has lasted for over 63 years. He clearly stated “he is not the first president to attempt to change healthcare, but he is determined to be the last”.
As I watched Congress unfold, the divide between the parties was clear, as it has been for the past 8 years. With America’s war over seas, the economic challenges at home, and the millions of unemployed, uninsured, hardworking Americans struggling to stay above water, one would think that a feeling of solidarity might exist. Before I continue with my comments on President Obama’s speech, I would like to invite every American to wake up and see the politicians that they are electing as party-less individuals and thoroughly evaluate what they stand for. We cannot afford to elect politicians who are unwilling to participate in the movement for healthcare reform.
Now concerning Obama speech, his ideas in fixing what is wrong with our current healthcare system is based on the accumulations of all the concerns and cries of the American people. So it is clear he is responding to the needs of those cries. So to ask to balance the playing field and have the insurance industry take responsibility and include everyone, without dropping coverage, applying caps, he gets 5 stars. This is needed and the industry should be held to those high standards, isn’t this why we buy insurance?
The idea of having the healthcare reform not increase the budget deficit, and having a provision in the law to prevent this from ever happening, again he gets 5 stars, if he could do it.
So with all this positive energy there should not be any more objections, you would think? Well, this reform plan still needs adjusting. Here are my concerns over what was stated,
Everyone will have to buy insurance; this is a mandate which was compared to car insurance. The reason given is many American simply refuses to buy health insurance, specifically the young invincible. I understand the reasoning, but would it not be better to offer a community healthcare center option, where those individual can join the center and contribute directly and/or purchase catastrophic insurance. This idea offers those individual a choice of gaining access and/or purchasing insurance at an affordable cost. Otherwise, the consumer will always opt to purchase the most inexpensive insurance plan and will have gained no guaranteed to get healthcare access. Which bring me to the other points?
Having insurance does not guarantee you will have access to see a medical provider. Many providers are opting out of dealing with any insurance carriers all together. Mainly because of the low reimbursement payments offered by insurance, as well as the over burden administration associated with the carriers, and the full time staff needed to handle the collections and billing. Top that off with shortage in primary care physicians, and no incentive given to become a PCP. What good is insurance with no access to doctors?
Now looking at the plan design to include prevention and wellness as the standard in every policy, although it is vital, has this not been added to the policies back in the 80s & 90s?. The results have been low and the carrier simply increased the premium accordingly to cover the cost of the preventive exam and wellness. So by having the carriers include this in the design, we are enhancing the problem of administration and increasing cost. Why do we need a middleman? A community option/ direct care facility can solve this situation, without administration. It can also eliminate many standard treatments that are associated with standard care. So by having community options centers work with carriers in providing most of the primary care functions, we can eliminate most of the administration cost associated with the small claims, which in some instances represents 80% of expenses in healthcare administration.
These centers operate independent of insurance carriers, and can be private, non-profit, and co-operative in the community. It services the need of its citizens and is based on the population of the community. The fact is we do not have to wait four years; these facilities can exist immediately servicing the uninsured by following the 47MR model.
Not only are these centers an options to affordable care, but it also upgrades the quality of care given to the citizen in their community where doctors can be doctors free of protocol treatment. Quality of care is also a serious problem not address in the speech. The “stabilize and release” tactics practice in private hospitals, the waiting weeks for an appointment base on who is your insurance carrier, the “protocol medicine” doctors are force to practice, all are the result of the insurance carrier “controlling the payment” to providers, or the concern of proper coverage and payment.
Again, the system of distribution on how we handle the claims, how we pay the providers, and how the consumer understand the EOB, while administrating the employers enrollments and eligibility is all encumber some and administratively overburden. So if we are to lower cost we must find alternatives which streamlines, optimizes these function. Not just accept the status quo and continue the same pattern.
And finally, the infamous public option of which seems to be the controversy in getting healthcare reformed passed. Well now that we understand the ideology of creating an government insurance carrier to compete with the private carriers, to break the monopoly of the industry by listing them in the exchange, with no subsidy and only for those small business and individual who are looking for affordable care is great, if the community option is whom they insure, which will offer a different and unique plan apart from the status quo of the insurance companies. This way there is no conflict with free enterprise.
So I accept the President invitation to come forward with new and innovative ideas and let’s get this healthcare reform passed this year. The biggest concern is how do you get to the President to discuss these issues.
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