I pride myself at trying to be fair and listening to all opinions and not judging why one may favor one side of an argument over another. I presume most actually believe and feel justified in the argument they make. And with most things in life there usually is more than one correct answer, or more accurate, no perfect answer.

But the health care reform debate has to be broken down and truth told before real reform can take place. I am not biased in my opinion in either direction and I do not propose to have all the answers to all the problems but I do understand many of the dynamics causing the pain and the outrage coming from both sides of the argument.

Intelligent debate and meaningful reform must attach the true causes of either side of the argument. With this in mind and a goal of only to educate I hope to share some of these truths for either side, left or right, republican or democrat to address and determine a solution.

Some common arguments made by each side for and against and the facts that can be discussed.

1. We have the best health care in the world. Well how can any one know this to be fact? Has any one actually been treated in every country in the world for every potential need? Of course not! Are other countries healthier, thinner, and more active than ours statistically, are others less? This is just an opinion. I personally have spoken to Medical Professionals in India who have told me that in many cases they feel they have better care for some treatment needs than the USA. What I can tell you is that the cost of medical treatment in India is about one fifth of the cost for the same treatment in the USA.
2. Costs are Skyrocketing for health care. This is true but the reasons are not what everyone is being told. There are many factors contributing to this and may share responsibility. The only way to control this is to address all of these factors in reform.
a. Patient Non Payment is at 49%. That is right for every dollar patients are asked to pay nearly fifty cents get written off as bad debt. The fact that patient direct billing is now 40% of the gross revenue of a typical health care providers business means that this cost is spread to all who pay, (insurance companies, patients who actually pay and government agencies), eliminate this problem and you help control costs
b. Medicare and Medicaid do not pay a fair amount. The fact is these agencies today pay as little as 50% of the actual cost of the services provided by the health care provider. This causes the provider to charge all other payers more, inflate the billing to government agencies and increases over all costs. Have government at least pay the actual costs and you slow the rising prices. Adding more people to a government plan that does not cover the actual costs of services provided can not sustain a long-term solution. The patient out of pocket will go up, or provider charges will rise and if half those people do not pay the cycle will continue.
c. Insurance has become maintenance. The purpose of all insurance is to get the consumer or buyer of the policy through unforeseen or catastrophic events. Homeowners, theft, life all pay when an event has the potential to create a situation where the policy holder has the potential for large financial or personal loss. Health Care Insurance has migrated to something different that can not be maintained at a fair price to all. Whatever the reasons, the fact that now insurance is expected to cover your cold medicine, your regular checkup, your visit just because you are bored, has put real strain on the industry. Insurance companies are for profit businesses. Getting back to the consumer paying for the regular maintenance will control rising costs, of course not if only half pay the bill.
d. Unseen costs and charges are a result of the system and methods that use technology from 30 years ago. Little things like having your records from a hospital copied in a paper format cost $50.00 or more per event. I spoke with a health care management consultant the other day and he told me getting medical records online for each patient in itself was an expense the industry can not absorb. Each provider has to pay someone to actually take the record, scan it, post it and then worry about protecting the confidentiality of the patient as well. This fundamentally adds costs that are in the billions of dollars each year in the USA alone. Every provider would have to buy software, pay some one to copy and scan and buy protection against a lawsuit if the data got into some ones hands as a result of them posting it. On the other hand, not having access to the records in a digital format that can be shared (using today’s technology) causes each provider on each visit to duplicate tests, duplicate diagnosis, and duplicate already completed work. Writing laws limiting the liability and relaxing the confidentiality makes sense to control the costs. In addition, if you want to get this done, government grants and initiatives to get these medical records into the technology available makes more sense than trying to spend the tax payers money to duplicate all the work. This is reform all parties could agree on. It would be a one time fixed cost, not a deep dark hole no one can project. Manage the data in a secure manner with severe penalties to hackers or non-medical uses and you could trim trillions off the cost and improve the care overnight. Give the patient the right to share this data with whom they need to.
e. Lifestyle and aging are real concerns in the final stages of life and the health care costs associated with them. It is a fact that many seniors go through life savings because of illnesses associated aging. A twenty something healthy person does not need to see a doctor every month, and in many cases may not need to for years at a time. I have never had a broken bone, a heart attack, cancer or any illness that required tens of thousands of dollars of care. I am certain I am not alone at 51 years of age in this category. Yet over the years I have either paid myself or had insurance through an employment contract that has cost either me or someone hundreds of thousands of dollars over the last 35 years. Yet I have never needed more than a couple of hundred dollars of treatment per year for that same time. If you are a smoker, obese, live high risk lifestyles you will pay for it with your health later in life, or someone else will, it is fact and reality and reform must address this somehow. If you buy auto insurance and you get tickets you pay more, if you have multiple accidents you pay more. If you own a home and live in a flood plane you have to buy additional flood insurance. All to avoid catastrophic events. Why not find a way to reward those living well and charge those now for the costs they will create later.
f. Malpractice and legal costs for doctors are at rates no one can justify or afford. I understand that just like in all businesses there are bad doctors or health care providers. But the cost to protect oneself from malicious and potentially needless lawsuits is ridiculous for health care providers. This is reform that is truly needed, enough of the lobbyists trying to justify not getting this done. Perhaps a panel could be set up to determine if a lawsuit has merit before it can go forward could be implemented. Make doctors and citizens serve on this much like jurors. Review the facts and determine if indeed something malicious or negligent occurred before burdening the system with a trial to determine fact. Doctors for the most part are trying to do what is right, if by no fault of there own something goes wrong they should not be forced into bankruptcy. The fact is every one of these law suits and the money paid for them causes the cost of health care to increase. Assuming most health care providers truly want and try to do the right thing we are penalizing ourselves by this need to sue for even the most innocent of events.

Now fundamentally I do not claim to have all the answers to the above realities but I am sure people smarter than I could come up with solutions. If you attack the fundamental reasons for skyrocketing costs and stop making political arguments about the issue real progress can be made. I am neither a doctor nor a scholar in the industry. I do work with health care providers on a daily basis and these conditions are real.

Anthony Wunsh
alwunsh@msn.com
Homer Glwn, Il 60491