At Last - Health Care

If there has ever been an issue crying our for national debate it is health care. But, first we need to see that there are multiple issues involved. While they may be inter-dependant, they are not all the same issue. Lets first take up the distinct issues:

1. Cost - Is the cost of health care to high in the US? Is it affordable and is it a good value?
2. Access - Do all citizens and residents have access to health care? And, do they have access in a way to encourages a reasonable or high quality of life?
3. Who pays - Does the current financing method for health care provide for the appropriate balance between access to health care, affordability and excess use?
4. Quality - Are Americans receiving reasonable quality health care?

Over the next few weeks many will be commenting on proposed changes to our health care system. Clearly, the US system as it exists is not optimal but it is not terrible. Changes in policy are long over due. In general terms, we must consider "fixes." Answers to all of the above issues are "we an do better."

Some facts are important:

• There are 330 million Americans and everyone agrees that 280 million Americans are covered by health care insurance or plans. This includes employer provided health care 185 million, medicare and medicaid on other supported programs. The 50 million Americans without health care include illegal immigrants, citizens in transition and those that choose not to have health care.
• "Uninsured Americans" often receive essential health care due to values that say to treat everyone. Most people walking into an ER, a public health clinic or sometimes a Doctor office receive health care. It may not be the best or even robust but few are denied care.
• Rarely discussed "underinsured" Americans is a large problem. This refers to Americans covered by some health financing but who do not receive optimal care. This means their plan provides incentives to under-receive care. This results at times from co pays and cost sharing formula that financially discourage participants from seeking care.
• Too often - ineffective health care is hidden from public view. We have better control of food quality than health quality.

Reform is needed. A whole new government bureacracy is not. Reform should address the following issues:

1. Coverage should be available to everyone. Reform and incentives should provide coverage for everyone. Individuals should be required to be covered and participants.
2. Increased incentives should be embraced to encourage healthy lifestyles.
3. Financial disaster should not be the result from an unexpected health event.