Monday, March 29, 2010

Health Care Reform Won't Affect Me

Health Care Rally for a Public Option in front...Image by leoncillo sabino via Flickr

I am not making this up. I actually went to the Washington Post website, entered in a bit of information about my current health coverage and was told that health care reform will not affect me. I admit I feel a bit disappointed.

After all, this is the legislation that inspired Vice President Biden's on-microphone gaffe, "This is a big f***ing deal."

To be fair, when Congress writes a bill purported to be as big as the novel War and Peace (which, by the way, had 1225 pages in the original edition and 1475 pages in the most recent reprint), it obviously is going to take some time to read all the provisions and even longer to figure out how to implement them. One sound bite I heard was that most of the provisions won't take effect until 2014. I know from experience that a lot can happen in four years.

Still, if health care reform is going to cost the US $1 trillion dollars (that's 12 zeros), I'd like to think that I am going to get some benefit from it. Then I realized that, as long as I am disable and receiving Medicare, I won't get any direct benefits from this legislation. More than that, I realized that anyone on Medicare, Medicaid or covered by employer-sponsored medical insurance won't get anything tangible. That includes the disabled, elderly, welfare recipients and those working adults and families receiving medical benefit from an employer.

This legislation supposedly helps people get medical insurance. It is supposed to provide subsidies to those who can not afford insurance. Has anyone mentioned yet how they are going to determine who gets subsidized and who doesn't? How much new paperwork and bureaucracy will be created to help make this determination? If it is anything like the process for qualifying for other public benefits, like disability or welfare, this is going to be a nightmare.

What does making health insurance mandatory mean for those who now must purchase insurance? I wonder if it just opens the door to medical care only to have it slammed shut again when the newly insured are overwhelmed by out-of-pocket expenses (co-pays, deductibles, co-insurance and out-of-network reduced coverage) they can not afford. So will the newly insured use their plan if they can not afford the associated out-of-pocket expenses?

Which brings me to the question, does medical insurance = health care?

Plus how many people are going to actively avoid getting insurance. After all, car insurance is mandatory for all drivers here in California and yet there are still uninsured drivers. Will there by a self-pay option that allows people to opt out of getting medical insurance?

For me, the biggest unanswered question is whether making for-profit health insurance coverage mandatory really the way to go here. I still think that health care needs to be non-profit, patient-centered and evidence-based. I believe that the money generated in health care system needs to be reinvested into things like medical research, practitioner continuing education, patient supportive services like social work and upgrades to medical equipment.

I fear that this heath care reform doesn't get to the heart of the matter. After all, having health insurance doesn't insure that people will be healthy. Personally, I'd rather see Congress invest $1 trillion dollars into improvements in agriculture and food production to make fresh, minimally-processed, healthy and nutritious foodstuffs affordable and available to everyone. With so many health care costs tied to what gets put onto the American dinner plate, it seems to me ensuring that everyone eats more healthfully would be a better way to spend my tax dollars than supporting the for-profit health insurance industry.

Which makes me wonder, did we just do this ass-backwards?

Yes, I am disappointed that health care reform won't affect me and seems to do nothing to make the health care system more accessible, effective, affordable, patient-friendly or efficient.

O.K., I've share my two cents, now it is time to tell me what you think. How can you let me know your opinion? By leaving me a comment of course!

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