Is It Really That Complicated?

I grew up in Detroit where the automobile was everything.  We made the best cars in the world and everybody else made junk.  There were decisions to be made obviously, but that just meant deciding between Chrysler, Ford and GM.  Nobody dared drive a “foreign” car as that would just be insane because in Detroit we made the best cars in the world.  Nobody bothered to look at the facts, the rust, the breakdowns, the lousy mileage, etc. because we just knew we were right.  It wasn’t until the industry was forced to face reality that programs were put in place to actually build world class cars again and now we are all proud of what is happening.

What really concerns me is that I see the same thing happening in healthcare today.  Everyone knows we have the best healthcare in the world and there really is no reason to mess with it.  The fact that we spend twice as much on a per person basis as most developed countries and get results that are average at best statistically doesn’t seem to matter in the debate because we are the best.  On MSNBC Monday morning I even heard a physician/congressman say we are the best at treating five different types of cancer.  Has it really come down to that type of hairsplitting?

As we have waited for the healthcare ruling from the Supreme Court, it has become painfully obvious to me that the reason we are so messed up is that we are so politically divided and don’t really bother with facts.  Look at all the blogs and notice the ugly tones underneath what is being said.  People on the right say “Obamacare” as if is a curse word.  Those on the left are still holding out for a single payer system and think all that Obama gave up to our industry and the right was inexcusable.  Many people are against it and think it is the worst piece of legislation to ever be passed.  Of course very few people can actually tell you what the law says or provides.

The funny part is when we tear the bill apart and ask about all the pieces everyone wants to keep all the pieces, but not the law itself.  I don’t get it.  Is is good that young adults can stay on their parent’s insurance until they are 26?  Good idea and even the insurance companies want to keep that one.  Should the insurance companies be able to cap lifetime benefits?  Should they be able to take you off the plan if you get sick?  Should they be able to exclude people who have pre-existing conditions like kids with asthma or adults with hypertension or diabetes?  Take a look at this blog that reports the 2011 insurance company CEO compensation and see if they are hurting.  Is accountable care wrong?  How about coordinated care?  Rewarding providers for results rather than activity?  Is it evidenced based medicine we disagree with or what?  Should everyone be able to buy insurance at a price they can afford, like auto or home insurance, or should they have to hope they are working and their employer will buy it.

Oh, I get it and have listened very closely to those against the bill on both sides.  Lots of folks don’t want the government involved in healthcare.  Everyone heard the cry, “Keep the government away from my Medicare” despite the fact that it is a government program.  The facts are clear.  The government runs Medicaid, the VA, the DOD plans, Medicare, all the special programs for children and through its tax subsidies pays for a third of all employer provided plans.  The government is totally the foundation for healthcare today.  How many employers would even provide healthcare if they couldn’t deduct it?  Without government support our pharmaceutical industry would be in very serious trouble.  Just look at sales of drugs without Medicare coverage for a sneak peak at how we would do without the government.

Thursday morning should be the day the Supreme Court rules.  Who knows what they will say, but my prediction is much of the country will be disappointed.  I am hoping for a Solomon type ruling where they push politics aside and really determine what is and is not constitutional and then challenge us to patch up any gaps that might exist after the ruling.  I don’t want to see so many of the positive gains thrown out, but even for me the ACA is a compromise.  My personal view is that everyone should be allowed to buy into Medicare if they want.  Companies and individuals should be able to choose that coverage, regardless of age, but those under 65 would have to pay what it costs.  If the court rules against ACA this thinking may have new life.

This Supreme Court watch is one of the most important events in our lifetime.  There is so much at stake.  This is not a sporting event where one side wins and one loses.  This is much more than a political win for the left, right or center.  Take a look at this report out last week that shows over 26,000 adults die each year because of lack of insurance coverage in our country.  This is not about whether we make better cars than others around the world, but whether we can do a better job dealing with the healthcare of all our citizens.  Even for somebody from Detroit this seems a lot more important.

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