Health Care Reform: It's Common Sense


In advance of President Obama's national speech on health care reform tonight, I thought I'd direct your attention to a cleverly-written piece in the New York Times a few weeks back, "A Common Sense American Health Reform Plan." Author and economist Uwe Reinahardt pokes a little fun at the idea that our health care reform plan should be guided by good ol' American common sense.

My favorites on his tongue-in-cheek All-American Wish List for Health Reform:

4. Cost-effectiveness analysis should never be the basis of any coverage decision by public or private third-party payers in health care, for to do so would put a price on human life — which, in America, unlike everywhere else, is priceless.

7. Government should stay out of health care. Specifically, government should not control health care prices, nor should it increase its spending on health care, which is out of control.

On the topic of health care reform, NU's medical school recently hosted Dr. Stephen L. Ondra, spinal surgeon and Senior Policy Advisor for Health Affairs in the Department of Veterans Affairs. Ondra delivered the keynote address at our medical school convocation, making several key points.

1. The United States spends more than 17% of its gross domestic product on health care, a cool $2 trillion. That's 50% more than any other developed nation on the globe. And yet the overall quality of our health care ranks somewhere in the middle of the pack or below, especially in treatable or preventable conditions. Tens of millions of Americans have no coverage at all.

By 2015, the cost of American health care is expected reach nearly $4 Trillion. This rise in cost is beyond unsustainable.

2.  The tiresome refrain from conservatives that government-run health care represents (gasp) socialized medicine is nothing new. In the 1960's, when then-US President Lyndon Johnson was developing Medicare, conservatives led by none other than Ronald Reagan used this fear-based scare tactic. He went so far as to say,

“[I]f you don’t [stop Medicare] and I don’t do it, one of these days you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free."

Given that Medicare is widely credited with helping seniors live longer, healthier lives through improved access to care, and reducing the number of seniors living below the poverty line, it is without question a successful program. Ironically, many of the "no socialized medicine" voices in the over-65 group are concerned that government-run health care might reduce their Medicare benefits.

As an aside, NPR recently featured a historian's perspective on the political maneuvering involved in the birth of Medicare.

3. Ondra shared a story about a young patient of his who, after beating a spinal tumor, lost her job and ended up in another position without health insurance. She skipped her yearly followup visits, unable to afford them. When she finally returned several years later for a checkup, this time in a job with health benefits, the tumor had returned. Instead of catching the tumor recurrence early and removing it via a minor procedure, she needed a massive, costly, and life-changing three-stage procedure.

The bottom line is that health care reform can't come a moment too soon.  This is common sense.



One of the most dangerous aspects of American society today, is the extraordinary lack of informed citizens. How/when did it begin to creep into the fabric of our culture, that so many Americans are so unable to think through a simple problem?

..and why aren't citizens able to see past (and condemn) juvenile, partisan fear tactics like drawing Hitler mustaches on our President?

As a medical biller, I see the effect Medicare has had on our older population and it is a very successful program. There is a lot of fraud and waste, but that can and should be addressed. Socialized medicine is when the government owns the doctors; we aren't talking about that in this country, we are talking about extending benefits that people over 65 now enjoy, and making them available to all.

My favorite example of uninformed citizens is the lady at a town hall meeting who stood up and said she was against a government healthcare plan, and they better not touch her Medicare! Did she not realize the irony in that statement?

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