The Health Care Debate – Perfect v. Good

Ever since the health care debate started this past summer, I have been trying to figure out how to express my thoughts on this controversial topic. Part of my hesitancy to post was due to my own uncertainty concerning the proposals and part was due to the fact that I was struggling on how to express my thoughts in a concise cohesive fashion. As I have researched it; listened to the talking heads; listened to the common man and even listened to health professionals, I have come to the conclusion that the topic is too confusing to even be summed up in one post, let alone in the 15 second sound bites that you hear on the evening news.

That made me think of something I heard recently from some of the democrats who were calling for compromise regarding the health care bill. They said that you can’t let the perfect be the enemy of the good. In other words, just because something is not perfect does not mean it shouldn’t be pursued. Rather if it is still good and better than the alternative of doing nothing, then indeed, it is worth pursuing even if it may not be the ideal. I am sort of viewing my post along those lines. This is not going to be a perfectly thought out position, nor is it going to be some treatise on the bill. Rather, here are some general thoughts about health care in general and how they relate to the proposed bills.

First of all, something needs to be done. Nothing makes me more frustrated in the health care debate than to hear conservatives say things such as “If it’s not broke, don’t fix it.” This insinuates that the current system works. For the average American who has a good health care plan through their employer, yes it does work and the people who make that comment are generally (if not always) in that category. Unfortunately, the number of people in that category continues to shrink.

As an attorney in practice for myself, I am thankful that my wife’s work provides coverage for us (at a cost), but frankly, there are many times my wife Jen and I look at each other and say to one another, “what are we paying this for?” Everything health related that we do use seems to either not be covered (like chiropractic care or medical massage both of which Jen requires for her bad shoulder) or if it is covered, they come with such large co-pays that we wonder if we would actually save money by not paying for the insurance and just paying the service as we need it. The only thing that prevents us from doing so is the chance at some major medical need arising where we would need the coverage. I hear other people saying similar things regarding coverage and co-pays. All this means to me that he current cost of health care has gotten too far out of control. Along those lines something clearly needs to be done.

Second, just because the Senate passed a bill on Christmas Eve does not mean that passage of the bill is a certainty. They are MANY differences between the House and Senate versions and for those of you who need some brushing up on your Government 101, the bill will now go into conference between the two chambers to try and hash out a deal. If a compromise is reached (and I emphasize IF), the bill then goes back to both chambers for a simple up or down vote. No more amendments are allowed once it comes out of conference.

You will now be hearing a lot in the news about the conference that will be meeting between the House and Senate to try and work out the differences. For instance, one of the major hurdles is abortion and the so-called Stupak amendment. Congressman Stupak (D-MI) offered an amendment to the House version of the bill that would prohibit federal dollars from being spent to cover abortions. The amendment passed in the House and therefore was added to the bill. It was largely believed that many moderate house democrats, like Congressman Stupak, were unwilling to vote for the bill as a whole if the amendment was not added. A similar amendment was introduced in the Senate by Senator Ben Nelson (D-NE) but it was never added and therefore is not part of the Senate bill.

Another major difference between the bills is the existence of a public option. The House bill provides for a government insurance option that people would be able to purchase based on income level. At certain income levels, it would become an entitlement. The Senate bill does not provide for such an option. Instead it mandates everyone carry insurance and provides some tax credits and some public funding to make it affordable for people to buy policies from private insurers. Whether the conference can come to some resolution on these and many other differences will decide the ultimate fate of the health care bill.

Thirdly, like I said above something needs to be done and I think that the bills that have been proposed are a step in the right direction. First of all, both bills require insurance companies to accept applicants with pre-existing conditions and not disqualify them from coverage. Additionally, they require coverage for certain preventative screenings which will actually cut long term health care costs if problems are detected earlier. These are things that have been sorely needed for some time now.

Along these lines, I hope that it will make health insurance companies think more about their customers than their shareholders as has been the case in the last several decades. Another line that conservatives spout that makes me cringe is when they decry “government run health care” as meaning the decision about someone’s health will not be made by the patient and the doctor but by some government bureaucrat. The problem with this argument is that it assumes the current system allows for medical decisions to be made by the doctor and patient when in fact it is made by some insurance company bureaucrat. So what’s really the difference? At least the government bureaucrat won’t be answering to next quarter’s profit and loss statement and what that will do to stock prices.

So those are some of my thoughts for now. I’ll try and be better about posting as the bills go through conference. As for my next post, since I still consider myself a Republican, I’ll post where I think they went wrong in the long term on this health care debate – so keep checking in.