Thursday, September 10, 2009

Pulling the Plug on Grandma

By now, if you're tuned into the debate in the U.S. about health care reform, you've heard the scary predictions about how the proposed changes will affect folks who already have insurance. Conservatives and Republicans believe that offering a "public option" will lead to the following undesirable consequences:

  • no private insurance company will be able to compete with the public system because the government will keep raising taxes to subsidize it. The private companies will go out of business.
  • corporations who now offer health insurance to their employees will stop offering that coverage, forcing people to move to the public system.
  • the public system will be, by definition because it is public, poorly run and will provide worse care.
  • the public system will not adequately reimburse doctors for their services. Doctors who earn a lot of money now will not be able to do so once a large number of people are covered by the public plan.
  • the best doctors will not be doctors anymore. the doctors who remain in the field, and the people who train in the future to become doctors, will not be "the best" doctors.
  • the new plan will not be adequately funded (or something?), so there will be rationing of health care. In other words, someone else--not your doctor, and not you--will be deciding whether you receive treatment for your condition. Most likely, I'm told, it will be a government bureaucrat who knows only spreadsheets and not you. And certainly not health care.
  • we will pass on an unmanageable financial burden to future generations with no benefit.
  • providing health care to all Americans will cause us to lose our national character in terms of excellence and global competitiveness.
I have so much to say about all of these assumptions. First of all, because it's just how I am, I wonder how we know these things are going to happen. Second, I enjoy pondering what these assumptions say about us and our beliefs about human motivation. What do we believe and trust when we imagine about why people become doctors or politicians or bean-counting bureaucrats? And third, why do we act like this is the end of the world? Like we can't go back and adjust and amend things later as all of these "catastrophes" materialize?

Have you ever kept track of your predictions about the future? I'm amazed at how consistently I'm wrong! If I'm reluctant about going on a trip, I end up having fun anyway. If I'm in a bad mood, something good happens that turns my mood around. All of my fears (especially the worst ones) are based on the past. Usually the reality of life turns out to be a little bit of what I was afraid of, plus good things, plus some stuff I never imagined. If I reflect too much on how little I know about what a choice will bring, I might never get out of bed. The good news is that I trust myself, my ability to deal, and the support I have around me. And I trust that I can always re-group and keep evolving.

My bottom line? Health care reform has to start somewhere. Honestly, I don't care where, as long as 1) it does start, 2) it does continue, and 3) it always puts the needs and health of consumers above those of the shareholders of publicly-traded companies.

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