Tuesday, August 4, 2009

Getting out your message

Home from China, and of course awake at 4:30am due to jet lag....

The next month will be key for the health reform discussion as members of Congress are home and both trying to listen to their constituents as well as trying to get out their message. There is lots of confusion among the public as the Democrats and Republicans hone their message. The President and the Administration increasingly talk about 'health insurance reform' as opposed to health reform. I think this is an attempt to respond to the tried and true lingo of a 'government takeover of the health care system' that opponents are fond of. And insurance companies aren't as popular as doctors, so there is more focus on changing the ills of insurance, though Karen Ignani, President of American Health Insurance Plans notes in the last link above that insurers are in favor of many of the discussed reforms, including eliminating pre-existing conditions.

Several thoughts. One, 1 of every 2 dollars spent today in the U.S. health care system is paid by the federal government, and this doesn't include the impact of the tax exclusion of employer paid insurance premiums. So, we don't exactly have a system that is now devoid of government payers. Second, I get the need to have a message that people can understand, and they can get being harmed by an insurance company. But, there will have to be reform of how care is delivered if costs are to be changed/reduced. Finally, it is interesting how effective an argument about a government takeover is, and how people fear 'government bureaucrats making decisions.' Most of the horror stories about paperwork, care being denied, doctors having to jump through hoops to get approvals are about private health insurance, not Medicare, for example. In fact, one of the problems with Medicare costs is that almost nothing is done to determine whether care paid for is reasonable--it is left up to doctors and patients.

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