Inside the Capitol

Thursday, August 20, 2009

8-26 More Thoughts on Health Care

Syndicated Columnist
SANTA FE – My layman's explanation of health care two weeks ago elicited numerous replies, as expected. Some of them had additional information I thought I'd pass on.
I mentioned Medicare and Medicaid as two instances of the government already being involved in heath care. I was reminded that the Veterans Administration and the Indian Health Service also provide health care.
The point was made that the government already takes care of old folks and poor people. The rich can take care of themselves and the young have their health.
So that leaves the middle-aged middle class to worry about whether they can find insurance at a price they can afford. To that, we now need to add that vets and Native Americans also have the assurance of government healthcare.
Most of the middle-aged middle class have insurance through their employers. But that's not guaranteed. Much can happen to that relationship. Premiums, deductibles and co-pays can increase dramatically. The employer's contribution can be decreased. Costs can become unaffordable to the employer or employee.
Employees also can lose their insurance through layoffs, dismissals, resignations, transfers to a location not covered by the employer's insurance or by divorce from the spouse who has insurance coverage. In that case, the only choice is an individual policy subject to all the underwriting restrictions of the insurance industry.
One reader responded to my point about the middle-aged middle class being the most disadvantaged in the current health care system. He said since he is in that category, he figures any time any segment of the health care industry complains about something being proposed, it must be good for him.
Last week I visited my family doctor for a back surgery follow up. He had a new notice on the bulletin board in the registration area. It encouraged patients to ask for a living will form, complete it and leave a copy for their medical records. I did so and discussed it with my doctor. I left feeling better about life -- and death -- than I ever have.
Several years ago, my wife and I prepared a living will with our attorney. But he's not likely to be at my bedside. My doctor is the person who needs to have it. And his medical consultation was invaluable.
There's no telling how much more the national hysteria about killing grandma will increase. But now might be a good time to talk with your doctor just in case the pressure on medical personnel increases to the point they become reluctant to discuss end-of-life planning..
If congressional Democrats are to get a health care bill passed, it appears to me they must greatly simplify what the House has passed. Starting over would be a good idea. It seems they have tried to tack on every idea they've had over the past 60 years of failed attempts.
Hammering away at a few major, but simple, concepts might sell a bill to the public. Don't worry about the current congressional opposition. They're not going to come around.
But with a simple bill, there will be less to attack and it will be easier for those of us in the general public to wrap our minds around the concepts and not fear any surprises hidden in those thousand pages that may come out and bite us.
I'm guessing something will pass. Democrats need to fulfill that campaign promise. They have the votes, so if they don't pass anything, watch out for the 2010 election.
The bill that is passed will have to please the health care industry, which is spending $1.4 million a day to assure it gets something it can live with. There are some possibilities.
Universal coverage, for instance, would cover the 46 million who currently have no health insurance. That's 46 million new customers, for goodness sake. Some company has to be smart enough to figure out how to benefit from that.
WED, 8-26-09

JAY MILLER, 3 La Tusa, Santa Fe, NM 87505
(ph) 982-2723, (fax) 984-0982, (e-mail)



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