What is in it for me?
Washington Post reporters Rob Stein and Alexi Mostrous point out that insured Americans hold the pivotal opinions in health system reform, but feel they have more to lose than gain. (read it here) Here are some of the comments by insured people highlighted in the article:
Sharon Williams, for example, voted for President Obama,
believes millions of uninsured Americans deserve health care and is convinced
that the system needs fixing. But the reform proposals being debated in
Washington make her nervous. "Something needs to be done, especially to help
the kids and the elderly," said Williams, 48, who works for the Forsyth County,
Ga., school district. "The current system needs changing. But if the reforms
affect the insurance I have now, I would have a deep issue with it." Williams,
who participated in the Post-ABC poll, said she would not support plans that
increase her insurance premiums substantially or limit her health-care choices.
"Obama says we will not be affected, but I'm not entirely sure I believe him,"
she said during a telephone interview last week after an Obama news conference
dominated by health-care reform. "What the average person gets out of this plan
needs to be clarified a lot more." Williams is concerned that her employer could
replace her current insurance with a public plan, offering fewer choices. "It's
something I wouldn't like. I like what I've got now," she said. "Under my plan
at the moment, I can choose my doctor. I don't have to be referred [to] one. I
like the fact I can pick the ones I like." The price tag of the plan also sets
off alarm bells for Williams. "The entire cost -- trillions of dollars -- is
eventually going to fall on all of us. It has to," she said. "And although the
president says it won't, I'm worried we're not hearing the whole story." For her
part, Williams remains hopeful that a plan she finds palatable will emerge. "I
don't want to be selfish," she said, "but I would not want to give up the
quality of health care."
Jonathan Smith, 29, of Buchanan, Va., a poll respondent
who works as a health inspector for the mining company Consol Energy, fears the
plans will limit his choices and increase his premiums. "I have coverage through
my employer myself, and my health insurance is really good. I don't have to pay
anything. I can choose what kind of coverage I want," he said.
But many experts say people remain open to change if they see clear
benefits for themselves. That's the case for Tim Bigelow,
48, a retired Marine and registered Republican from Shiawasee, Mich., who
supports health-care reform. "As it stands right now, with the economy the
premiums may go up. I would assume that they probably would, and that's
significant. I'm very concerned about it," Bigelow said. Bigelow worries that
reform will increase the cost of his health care, which he gets through the
Veterans Administration and his employer. "Costs are a real concern to me,"
he said. "We just don't have the nitty-gritty information, I guess. But the
final cost to me would be a pretty important factor in whether I supported it or
It is a long standing American political adage that people vote their pocketbooks, thus the finding of recent polls that less than half of Americans believe that covering the uninsured is the principle reason for health reform, while the majority believe that controlling costs should be the main objective. Unfortunately, Obama and Congress have this exactly reversed in their proposal: coverage is the principle aim of the legislation under discussion with cost control an afterthought receiving lip service only.
Americans who have health insurance and are satisfied are chasing a mirage. The kind of health insurance that guarantees financing for needed health care was the case decades ago but now is the exception, not the rule. Satisfaction with our health care system falls dramatically once illness and injury happen in the family.
What can a policy wonk do to assist these people to understand the reality of the American health system nightmare? I have found that the most useful information to this end details the lack of quality in US health care delivery. Read the final comment attributed to Ms. Williams above, she does not want to give up health care quality. If I were to make a presentation to her, I would help her see that what she should fear is not what health system reform might do to her health care, but what being a hospitalized patient may do to her health. Preventable injury of hospitalized patients is the 5th leading cause of death in the US, killing more people than AIDS, auto accidents, or breast cancer. And poor quality care drives up costs in the US by $500 to $750 billion each year. That's a TARP payment each year because we have poor quality. I take it as a personal responsibility to disabuse people of the notion that they should be satisfied with the status quo in American health care. Do not fear socialized medicine, fear being a patient in an American hospital.
What is in health system reform for every American? Better quality care meaning care at a lower price which doesn't kill hospitalized patients.
Let's make it happen in Utah.
Dr. Joe Jarvis