Do Over !!!!

We’ve obviously been asked about our reaction to the procedural vote that took place on Saturday to allow debate and discussion to proceed for HR 3590. In a nutshell- we’re very concerned.

We’ve tried to remain bi-partisan throughout the process. We’ve been slightly biased as we’re more “in the center” than the proposals submitted by either side. We’ve always supported a more organized system (probably through a light intervention of government simply due to the make-up of the existing system) and one focused more on organized delivery and efficiciency. We’ve recognized the unfair reality of the current system that leaves a significant portion of our population with limited or no access to care but always felt that issue can be addressed as the delivery system itself becomes more efficient. The heavy involvement of government and the focus on covering everyone out of the shoot (insurance reform) as the primary goal just doesn’t make sense.

The talking points were clear as we watched the debate unfold on Saturday. Democrats were demonizing the insurance industry and were doing all of this to protect the poor consumer and Republicans were appalled with the size of the legislative monstrosity that was sitting on the table in front of them. While we certainly understand being critical of the lack of consumer focus of our health care industry, as consumers, we leaned more toward the Republican side on this one.

If you don’t want to read all 2074 pages of HR 3590 you can get a pretty good idea of the content and implications by reading CBO’s scoring of it. You can get it by going to the Resource Library on our site, or by clicking here. CBO’s letter is another “caution flag” for us considering all of the qualifications they had to use to come up with the numbers. There was certainly some creative accounting involved and we think the numbers provided are all on the low side. Remember, Medicare blew out its budget within the first two years after it was enacted in the mid-60s.

We seriously question the ability to our country to finance such a massive piece of social legislation without further adding to our national debt (despite the numbers provided by the CBO). We seriously question the feasibility of setting up co-ops or public option alternatives to be competitive in an already fragmented market (these folks have obviously never been in negotiating sessions between health plans and providers). And, we question the ability of establishing a government-based infrastructure to address the real issues of prevention, wellness, care coordination, efficiency, and patient-centered care.

In a previous posting we recommended Obama and the legislative process slow down and do this right. We can only reiterate that here but don’t think it’s going to happen. You can read a letter sent to Obama from Newt Gingerich and a host of others that reflects our views by clicking here. Unfortunately, the Democrats are now more focused on a deadline of getting this done before the end of the year as opposed to doing it right. The Republican votes are already lined up no matter what takes place in the debate over the next few weeks. Once again, it’s going to be the Blue Dog Democrats who will determine the outcome.

Our economy is still on the precipice and our unemployment rate remains high. We have two wars that need to be appropriately funded to protect the men and women who are sacrificing their lives to protect our freedoms. These should be the priorities of focus and deserve the appropriate financial resources. We will reiterate- “government-light” not “government-run”.
We wish someone would call a “do over” on this one

Health Care Reform- Continues To Focus On The Wrong Issues

It’s looking more likely that we will have some type of health care reform legislation enacted in our country. It’s also looking more likely that the legislation that will be enacted- will not address the fundamental issues facing our health care system. Politics wins.

A new poll conducted by Stanford University with the Robert Wood Johnson Foundation found that 43 percent of Americans oppose the health care plans being discussed in Congress while 41 percent are in support. 15 percent remain neutral or undecided.

These numbers have remained relatively consistent over the past month but the opponents have stronger feelings on the issue than do supporters. Seniors justifiably remain more skeptical than the younger generations.

Americans are worried about the fine print included in the health care overhaul. With the House Bill (3962) weighing-in at 1990 pages, who can blame them. You would have thought that the House would have learned from the Clinton Reform effort of the 90’s that coming out with a monstrosity of legal jargon that the average citizen is not going to comprehend is going to lead to skepticism of its content. But, the Democrats have the numbers on their side (at least in theory) that could tip the discussion their way anyway. That’s what we’re afraid of.

Unfortunately, the reform discussions continue to focus on the wrong things. The primary focus continues to be centered on “providing health care for the uninsured", when the focus should be about reorganizing care delivery, improving communication and consumer awareness, coordinating care more effectively, improving system efficiency, and developing new payment methods to assure a quality health care system is available to all citizens.

One of the frightening facts of the recent poll finds that consumers are afraid of the increases in their current costs because “people in poor health who’d been shut out of the insurance pool would now be included, and they would get the medical care they could not access before”. These individuals need to realize somebody is already paying with the system we have today- and it’s more expensive than if all individuals had access earlier in the game rather than waiting for an emergency.

Instead of focusing on “insurance reform” (public option, mandates, etc.) we need to focus on changing the current trajectory of health care costs for individuals who already have health care coverage. There is more than enough waste in our current system to provide for those not “insured” by developing a more organized and collaborative structure than we have today. There is no reason why people in poor health in our country should be shut out from access to appropriate medical care. This is inexcusable. We need to address both.

We just believe the current reform models being discussed in Congress are going about it the wrong way.

What Is Our Definition of our Health Care System?

Carl Bialik posted an interesting article in the Wall Street Journal a few weeks ago. Grab it Here If You Want. The article, “Ill- Conceived Ranking Makes for Unhealthy Debate” discussed the flaws in the data used by the World Health Organization nearly a decade ago to come up with the infamous “37th in the world” ranking we’re all familiar with. I actually think he got his title backward, it should read “Ill-Conceived Ranking Makes for Healthy Debate.”

One of the primary objectives of the World Health Organization when they released the study was to “stimulate debate and focus on health systems” as opposed to just focus on individual components. The data and methodologies weren’t perfect, but it provided a benchmark. We all knew we could do better particularly when the cost is added to the formula. No matter what the final ranking actually may be we all know we can do better than we’re doing today. And, we’re talking about it so it achieved its original purpose.

But, that wasn’t the issue that caught my attention.

When explaining the decline in the country’s ranking in child mortality and life expectancy since 2000 the article stated, “But some researchers say that factors beyond the control of the health-care system are to blame, such as dietary habits.”

And, Alan Garber, an economist and professor of medicine at Stanford University closes the article by saying, “We might get more bang for the buck by setting aside some of our health-care money to support novel approaches to improve nutrition, education, exercise, or public safety.”

Until we all get on the same in our definitions the health care system will continue to struggle. In our view, nutrition, education, and exercise (and many others) are not “novel approaches”, but fundamental participants in the health care system that is evolving. And, dietary habits should be included in any research as they are critical in evaluating the whole-person and determining the approaches or strategies to improve the health of an individual.

We obviously define “health-care” different than others.

As long the majority continues to define health care as the “diagnosis-focused insurance financed” system we have today (as indicated in this article) instead of including health, wellness, and lifestyle as critical components; we might end up even lower than 37th- no matter what flaws may be in the data.