Sunday, January 24, 2010

Lack of Healthcare Reform Means that the American Dream is Dead.

It appears that the American Dream is dead as the Democrats have essentially no chance in passing some sort of healthcare reform package. The stunning loss of the senate seat held by the late Ted Kennedy has now given the Republicans the ability to filibuster any significant healthcare legislation.

More disappointing is that Americans seem willing to accept the fact that they can live without healthcare. In a blog at US News and World Report titled 21 Things We're Learning to Live Without, besides abstaining from cable TV, a home phone, prepared foods, and lattes, healthcare was also on the list. Millions of Americans are apparently "simply hoping they don't get seriously ill or hurt." How can this happen is supposedly the wealthiest nation in the world? Too many Americans as a result are literally one illness or accident away from financial ruin as medical costs are the leading cause of personal bankruptcy.

While President Obama and the Democrats no doubt will try to salvage what they can from their hard work over the past year, they need to be thoughtful about their future proposals. Though the public doesn't like the thought of insurance companies turning away those with pre-existing conditions, the fact is that this practice exists because we don't mandate everyone have health insurance. As George Halvorson, CEO of Kaiser Permanente, noted to make healthcare affordable a double mandate must apply - everyone must sell (that is health insurers must sell coverage to everyone who desires it) and everyone must buy (all consumers must purchase). Otherwise, those who are healthy would not participate and instead would wait until they needed it. Those who are already ill will purchase health insurance. As a result, insurance companies would only receive payments from those who need medical care, which can't possibly cover costs of chemotherapies and hospital stays which are in the tens of thousands per treatment. Since the healthy don't subsidize the sick, insurance companies would simply go bankrupt.

With the President and his Democratic party concerned about a Republican resurgence, he has already refocused his attention on large institutions like banks and redirecting the populace anger there rather than working on meaningful change. He may try the same tactic on insurers in an effort to get some healthcare reform passed.

In doing so, he may simply ignore the truth of the double mandate and make insurers not only cover everyone but also have the federal government set the rates. President Obama knows of course that it would only be a matter of time that the government would take over healthcare as insurers would have no choice but to pull out in this financially unsustainable model. If a single payer system occurs be prepared for rationing of medical care. Imagine long waiting lists to see a specialist, getting surgery done, or wondering if a treatment might be approved. Certainly some of these problems occur already with private insurers, but envision if the healthcare system was run by the DMV. Is this actually better?

It's equally as unfortunate and more disappointing that the Republican party over the past year essentially only had one mission - derail any proposals from the Obama administration. Without healthcare reform to make insurance coverage more affordable to employers, families, and individuals, America will no longer be viewed as the vibrant superpower nation it has been over the past couple of decades but a country unable to provide the basic healthcare needs to its populace because its politicians were too paralyzed to do anything but score political points for the next election. Because of their failure to lead, it is increasingly clear that in the United States healthcare coverage isn't a right but a luxury.

If Americans and employers are constantly worried about saving money for a future expensive illnesses or medical problems, then when will they ever feel secure enough or freed enough to take risks, invest, and dream?


Bob James, M.D., J.D. said...

I read with interest your post on the end of the American dream now that the democrats healthcare reform bill may not pass as written. Normally I agree with most everything that you write but not with this. Why is it that the democratic proposal is the only one that can save our country as we know it today. Can we not take some time and get the best bill and not just any bill? Have the republicans said that they do not want healthcare reform? Was the recent election in Massachusetts not a reflection of the states voters on the current healthcare reform bill? You may agree or not but I don't think that healthcare reform is dead even though the bill as it is currently written probably is. Is that necessarily a bad thing? Is it the best bill that our country could possibly get or might we do better with some more input and discussion?
Bob James

Davis Liu, MD said...

Dr. James: Thanks for your comments. It's not that I'm against the Republicans. I agree that a better bill would be having both sides reach some sort of compromise to reform healthcare. See my post - Just Say No to a Public Plan - I would also note that I was not a fan of candidate Obama because he didn't require a double mandate - everyone must buy and everyone must sell.

My concern is that Republicans don't seem to feel that significant healthcare reform is urgent. On this matter, they would be wrong. The largest federal government programs are benefits - social security and Medicare. Without any changes, our country will simply go bankrupt and this would essentially be the end of any American dream.

Anonymous said...

i agree with dr Davis Liu about : "My concern is that Republicans don't seem to feel that significant healthcare reform is urgent." i think it is very urgent! we have 46 million people without health insurance. it is not acceptable.
and look at that from Wall Street journal :
UnitedHealth Group Inc.'s fourth-quarter earnings rose 30%, helped by prior-year litigation-related charges, higher enrollment than the company expected and subsiding costs related to the H1N1 flu outbreak.

it is booming at the expense of the customer paying outrageous premiums. I do not think that they are paying a lot to you(i do not know, but i personally, do not take any insurance)

It turns out that the CEO of United Health Care makes $102,000/hour.

i'm for the Public plan. i think it does O.K in Europe and Canada, but this is my humble opinion and i may be wrong. but i feel that the change is urgent.

Doc Lib said...

Gee, I agree w/Dr James and kind of wonder at Dr. liu's implied premise that "any bill is better than no bill at all." That's what's gotten us into the situation with entitlements where we are today..bankrupt! Better to approach a highly complex 1/6 of the US economy very gingerly and start with making incremental ( but meaningful) improvements, not a meat cleaver takeover by bureaucrats. Another amusing tidbit is the other poster's number of "uninsured" at 46 mill. Where will these mythical numbers stop, before they equal the total U.S. population....hogher please,'re not scaring us enough. LOL

Mike Hensgen Houston,TX

Anonymous said...

Dear Dr. Lib, for your info:
USA Population, 2008 estimate -304,059,724 from the US Census Bureau. here

Census Bureau: Number of Americans without health insurance rises to 46.3 million
i do not try to scare you, i rely on facts!
also about bankruptcy, my dear. we are bankrupt not because we did not do small steps, but because we violated basic economic rules and lifted Glass-Steagall Act which prohibited any one institution from acting as any combination of an investment bank, a commercial bank, and/or an insurance company.

with all this said, i think we are barbarians. many third wold countries have some health coverage for everybody, but us!

Have Myelin? said...

I'm a patient on Medicaid (I hate Medicaid with a passion because doctors don't accept it) and it's now July. I have MS by the way. As soon as my doctors saw my Medicaid card they quit seeing me. Only a PA sees me right now.

I wonder if you've changed your opinion since Feb? And since it turns out that mandated health care is now a tax?

I enjoy your blog by the way.


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