Health care system ailing, but bureaucracy no cure

By Donna M. Fichtner, Special to the BDN
Posted July 22, 2009, at 5:49 p.m.

The debate on health care reform has already swirled so out of proportion that many don’t even realize it’s actually a debate on insurance reform. No one argues about the quality or delivery of health care in the United States. It’s really a debate about who pays how much for which services.

While health care is not a right, it could be argued that it is a moral obligation. Reasonable people do not want to see their neighbors denied access to basic or life-saving health care simply because they cannot afford the care or the insurance premiums. Our system is far from perfect, but we do not need to create another federal bureaucracy to address the issue.

Take Maine’s Dirigo program. After five years, this public option plan provides coverage to only a small fraction of those without insurance (fewer than 10,000 people), and has cost taxpayers more than $150 million. Nearly two-thirds of the Dirigo subscribers had private insurance before, but opted to go with a less expensive government plan that today cannot accept new enrollees.

Some people think making an even bigger “public option” at the federal level will fix the problem. That would be like putting a 200-horsepower engine on a 10-speed bicycle with flat tires.

Do we really want the government (all of us) paying for our healthcare costs? If so, should the government be able to monitor our health habits, including our calorie intake, how much we drink or smoke, and whether we engage in risky behavior like riding motorcycles or having unprotected sex? If the government is paying for your health care, it could argue that it has the right to hold each of us accountable for our individual choices.

What happens to the people who just choose to go without health insurance, such as younger, relatively healthy Americans who decide to spend their money on other things? What about undocumented workers working to stay off our government lists, with dismal incomes already making them eligible for Medicaid or the ex-panded State Children’s Health Insurance Program (SCHIP) program.

How well has our government addressed other health care programs? How long have Maine hospitals and health care providers been waiting for overdue payments? How many doctors in rural areas are gladly taking on new Medicare patients? Consider also the highly touted Massachusetts healthcare experiment that is now being considered a dismal failure and costing more than anyone ever predicted.

More importantly, can our country afford another $1 trillion (or more) for expanded government programs? It appears that we can’t afford to pay the bills we already have.

Parents are responsible for their children. Parents may control what their children eat, prohibit risky behaviors and keep a watchful eye on their children’s activities. But adults are supposed to be responsible for themselves. We choose how much we sleep, exercise, and nourishment we get. Some of us make bad choices and live with bad habits. Are we prepared for our government to act as a foster parent because we simply want someone else to foot the bill for our choices and health behaviors?

The bottom line is this: Congress has a unique opportunity to pass meaningful health insurance reform that would include eliminating pre-existing condition clauses, addressing disparity in coverage and improving efficiencies to drive down costs.

We simply cannot afford to squander this opportunity by attempting to extend the reach of government more fully into our own daily lives at a price tag that will bankrupt our grandchildren and do little, if anything, to address the very real problems in the health insurance industry.

Let’s not rush this decision through just to say we did something and then regret it down the road. Let’s get it right for a change and focus on reforming insurance and being more cost efficient instead of making government bigger.

Donna M. Fichtner of Greenville is an independent consultant who specializes in tourism economic development and employee education.

http://bangordailynews.com/2009/07/22/opinion/health-care-system-ailing-but-bureaucracy-no-cure/ printed on July 24, 2014