Study says docs for public-private option, but specifics needed

by Kay B. Day

A qualified healthcare practitioner administers an intramuscular immunization to a woman.[Photo Credit: James Gathany, Centers for Disease Control and Prevention.]Media is touting a study published in the New England Journal of Medicine, ‘Physicians’ Views on a New Public Insurance Option and Medicare Expansion,’ with results indicating, “Overall, a majority of physicians (62.9%) supported public and private options.” One area that touched a nerve is Medicare—58.3% of respondents supported an expansion of Medicare to Americans between the ages of 55 and 64 years. Primary care physicians were the most likely to support a public option and that’s no surprise—they’re on the front lines and various proposals in Congress will address inequities in provider fees for this group. A summary of the study is available online for free at The Journal website.

Few Americans would disagree healthcare needs reform. But the term ‘healthcare reform’ means different things to different people. A late afternoon phone call yesterday reminded me the service I receive from my insurance company for the premiums we pay is where I think reform should start.

Frustration with existing system
After a recent doctor visit for a minor problem, I received a letter from the healthcare provider telling me to call my insurance company. The letter said, “Your Insurance Carrier has requested that you call them directly to update your insurance information. They need to know if you have other insurance that may be primary. They will only accept this information from you.”

I don’t know if you’ve ever had to call an insurance company, but taking care of what sounds like a simple task cut an hour out of my very busy day. The polite young woman I finally spoke to, after holding for what seemed like an eternity, had a very heavy accent that made communication difficult. When I asked her why this call was necessary, she gave me no logical answer. After the call concluded, I vented by means of some colorful language.

In the whole healthcare scenario, the only place that comes close to quality customer service is that I receive from our family doctor. I’m excluding hospitals from that assessment because I haven’t been in one overnight since having my last child.

Impact of expanding Medicare
Will broadening the age range for Medicare help the patient? At first glance it would seem so. We have to remind ourselves we would likely do what our parents do—get a supplemental policy. Medicare sounds good on paper, but a significant portion of my mother’s income goes for premiums that include her supplemental policy.

And how will Congress address the needs of the migrant community? Will employers who enjoy a cheap labor pool be asked to contribute to the healthcare costs taxpayers currently underwrite for that labor pool?

The September, 2009, issue of the AARP Bulletin said all the proposals in Congress will cut subsidies paid to Medicare Advantage private plans. [pg. 16] The same issue said, "Medicare enrollees have already seen their premiums more than double this decade, and they already spend a third of their income on out-of-pocket health costs." [pg. 8] Will legislation address that, and if so, will our children bear the financial burden?

What will the long term impact of moving more patients into a government-run plan be? What will the impact be on federal spending? Will we get a break on healthcare but lose that same break when the tax increase we know will come—maybe not now but surely in the future? Will a diluted patient pool discourage sharp young graduates from entering primary care? Will rationing increase? I say ‘increase’ because rationing is practiced now in my opinion.

The lack of ability in our existing Congress
There’s another underlying contradiction. If I save money on healthcare once legislation passes, I will lose those savings and more if the Pelosi-Reid coalition passes Cap and Tax (HR 2454).

At the heart of all my questions lies a distrust of those in charge of writing the bill. As pundits on the left and right criticize President Barack Obama, they overlook criticism due elected officials in Washington. Obama didn’t write the legislative disaster known as HR 3200—Congress did.

I am reminded that as many Americans have been negatively affected by the economic mess, either through a job loss or pay cut in their household, members of Congress voted themselves a pay raise. I believe that is one of the most singular displays of arrogance by a government entity I have witnessed.

Most of all, how will further government involvement affect personal choices for the patient? Will there be mandates for various tests even though a patient might disagree on the need? Will lifestyle changes be mandated? Will the increasingly heavy hand of government get even heavier?

Democrats have been pushing for government-run healthcare since creating Medicaid and Medicare. Both programs have been targets of scams and both programs are impacting the federal deficit—they are basically fiscal disasters.

The Journal study warrants a careful examination, with access to exactly how the questions were phrased. There are other questions I’d like the 62.9 percent who support public and private options to answer.

What are the benefits for the consumer? Specifics, please. They seem to be sorely lacking in the overall debate.