Views on Health Reform.

Monday, August 31, 2009

The proposals of Health reform and the debates that are being currently discussed in America are of academic interest to me. The reform as proposed in the Bill aptly titled “America’s Affordable Health Choices Act of 2009”, are comprehensive to make health care affordable to ALL Americans and reduce their spending on Health Care in the long run.

The aim of universal coverage for all is certainly laudable. The need for the Health Reform arose because under the present status quo, there appear serious flaws in the health care industry, and many are opting out of the coverage due to high cost of insurance premiums, and escalating costs in healthcare. Just to cite an example: It is estimated that an older couple may need to save $ 300,000 to pay for health care costs not covered by Medicare alone. This Information is obtained from - www.healthreform.gov/. That is staggering!

While a very healthy debate is going on both for and against the proposals, the subtle point of the healthcare, as a social necessity and requirement is being slightly overlooked. Every family should treat this as fixed expense in their house budget. The new proposal makes coverage mandatory. People must consider it as their right rather than a privilege.

Any country trying to bring about reforms in any segment of its economy should be country specific. This should be based on its own culture, its own philosophy of life, and its affordability. I am rather shocked at the American media bashing Britain’s NHS (National Health Service) infuriating that Country. The right-wing critics of President Obama’s proposals on healthcare reforms are spreading canards and misinforming the American Public about NHS, and if that system were to be introduced, Americans would be worse off. This is purely exaggeration.

What Americans need is to look at the proposals with a COOL mind and study it comprehensively what the Nation needs as a whole rather than on individual specific.

This reform aims at making it mandatory for all to be covered. This requires rules to be framed and regulated so that no body (Insurance Companies or any related organization) could prevent from denying coverage, whatever may be the medical history of the insured. Currently certain pre-existing conditions are NOT covered by the insurance companies. This is plain cruelty and stupid thinking. Do the insurance companies expect Healthy persons to visit and get admitted in the hospitals? It is a premise and fundamental that insurance companies use the money they get from the healthy to expend on the sick and make a profit from the difference. Like the Banks receiving deposits and lending to the needy, as the latter group in both cases is always less in monetary value.

Sometimes, the reforms also warrant provision of subsidies, which could be in the form of tax rebates or assistance to such of those small companies to cover their lower-income employees, whose families could also be brought under insurance coverage. By this, they can afford healthcare.

To keep the escalating cost of insurance premia under check and induce competition, the reform proposes that a government run insurance plan is made available to public through public auction. In other words, a choice is offered to the public as another option to take care of their health needs.

This Public auction is being vehemently opposed out of fear that the healthcare in future would become inefficient due to government involvement; would not care the elderly; would further weaken the system due to bureaucratic wrangles; would consider the lives of disabled persons as worthless; would drive some to opt for euthanasia. So on and so forth.

All this talk and fears are baseless, and needs to be condemned. A media report went to the extent of saying that Britain’s NHS considers the life of its citizen Stephen Hawking, an eminent globally known Astro-physicist and an advanced ALS (Amyotrophic Lateral Sclerosis) patient as worthless, and not fit for coverage. This is purely absurd. He refuted the statement saying he is surviving because he is covered by NHS.

Now, the reform proposals do require funds. This can only be raised through additional taxes and cost savings elsewhere in the budget. An exercise is needed and would be done in such a way to keep the federal deficit under check from further bulging.

And that is Government’s responsibility, which has to bear the risk, and is willing to take it.

It’s a balancing act, and government alone has the wherewithal to set things right. The globe has already seen the type of players in the private sector plunging American economy, and that of the world close to abyss, through financial sector. Would the American public ready for a similar scenario to emerge through its present status quo on healthcare sans reform?

It is wise to save, invest and spend on Healthcare, than on Defense to fight an endless war in other countries. A healthy nation would always become a wealthy nation in letter and in spirit.

These are thoughts to ponder.

Comparatively speaking, India does not have a uniform Health policy for all its citizens. The government is not even thinking about it, nor is it in its priority right now. That is a pity.

That does not mean there are no schemes at all. There are; covering different classes of people by different organizations. Each scheme has its own rules and regulations. Some are effective, some are evasive, and finally we end up paying from our personal savings to meet the medical expenses that often drive many into bankruptcy. Coverage is not mandatory.

So long I was in employment; my employer covered the medical expenses of my family. After retirement, I took a health insurance policy, paying the premium annually through my interest income I get from my bank deposits. The insurance company meets my hospitalization expenses (Should I get admitted) only partly. I am disabled with ALS; do not require hospitalization as yet, but engaged a full time care giver at home to assist my basic needs. I am totally dependent on him. I pay the expenses from my pocket, which is a huge burden on my family budget. Only god knows how long this would be. There is no provision in any scheme to come to my aid. I have to live with this burden which could increase along with progression in my disability till my death.

I digress a bit from my views. My friend Baikal at the Blogosphere of Austin American Statesman sent a public message, requesting my views on healthcare debate, and how care and treatment in USA for me would be different than in my country. His message prompted me to write this blog.

It is a hypothetical case, but let me imagine the care and treatment that may be available. Under the reforms, I would be covered; provided with palliative care; provided with quality accessories, like wheel chair, whose cost may be subsidized or fully met by the government. Mine is an incurable disease and as long as I live I may be taken care of. Just like Stephen Hawking being cared under NHS. Such assistance is NOT available to me in India.

Every reform is beset with flaws like human being born with imperfections. He/she continues to be imperfect even today.

A broader vision and understanding is the need of the hour to the proposed healthcare reform. And that is my considered view.