RSSQuality of Life and Healthcare Reform
Dennis AuBuchon | July 13, 2009
There is no doubt that healthcare reform is needed but the question to be asked is what will
be changed. Many individuals have little or no healthcare and this is a problem which needs to be properly addressed. Those who have healthcare do not want to see changes that will affect their quality of life. It is not known what will emerge in the final version of any healthcare reform legislation but one thing that must not change is the quality of life for all Americans.
There has been some talk about limiting medication to individuals who may be terminally ill or when there is no positive impact on the patient. The critical point in this scenario is who is going to make that decision. It should not be a government program who has no concept or knowledge of what circumstances are involved in making decisions for medical care. The healthcare profession is an honorable one and I feel that proper decisions as to the need for medical treatment in most cases is being properly made. These decisions are typically made by doctors and patient’s families. Sometimes there are procedures in place within certain insurance companies to have proper authorization but even this is questionable in some cases.
Decisions have been made by insurance companies in the past related to medical decisions which have caused them to be reversed in some instances but for some the decision came too late. Control of healthcare decisions related to the quality of life should not be taken away from doctors and patient’s families through any healthcare reform legislation. Some of the changes being discussed with which I agree involve insurance companies covering pre-existing conditions and having health insurance even when you change jobs. These are great ideas and are badly needed today with the current economic environment. The question involving this change is how it will be implemented.
There are many discussions as to what should be in reform legislation for the healthcare industry but the current size of the legislation is 615 pages as it now stands. While there are many issues surrounding the reduction of healthcare cost the language of current legislation as with many of this size is hard to understand. There are constant references to other sections leaving out details related to the section being created. Legislation of this nature needs to be clearly presented so the public understands the requirements and the options available. Regardless of what the finished product contains it should concentrate on the reduction of cost through greater efficiency and not impose additional expenses on businesses who cannot afford to offer health insurance for their employees.
Regulations for health insurance coverage are and have been primarily the responsibility of the states but one place where the federal government can improve healthcare is to create a common standard for insurance coverage. Differences in regulating the same insurance companies should not exist. Requirements which vary by state increase the cost to insurance companies and creating common regulations would make it more efficient. Each state already has processes in place to monitor the activities of insurance companies. Creating a complex new regulation, which presently appears to be the case, with a 615 page bill will cause increased expenditures by state agencies just to understand and enforce the detailed requirements. Complex legislation will also cause increased costs to businesses to assure they comply with the new/revised requirements. Given the present economic environment we need to reduce the cost of government not increase it. This applies at both the federal and state governments. Changes are always taking place to improve healthcare individuals receive. I understand the need for some type of standardization through the federal government but many of the ones being discussed will forever change the way healthcare is administered and monitored.
Granted changes need to be made in healthcare and some proposed changes will cause government expenditures to increase. One of the keys in healthcare reform is to create a bill which the public can readily understand by reading it without the need for a lawyer. There also appears to be provisions to impose fines of more than $1,000 for Americans who refuse to buy affordable healthcare insurance. The term affordable may depend upon the level of healthcare required by individuals and/or families in conjunction with their medical history. There appears to be exceptions in the present proposed legislation for those on low income.
While I feel the current existence of Medicare and Medicaid is a good thing adding another bureaucracy to the healthcare industry in an attempt to reduce cost may in effect cause costs to rise. To explain this scenario changes in regulations for healthcare will cause healthcare organizations and professionals to be under additional scrutiny. This in effect in my opinion may cause deterioration in the quality of healthcare and the decisions being made. While regulation is a good thing in some respects we must be careful to not impact the quality of healthcare now being provided by doctors and hospitals.
Questioning medical decisions by doctors who are there with their patients and are in the best position to determine the care needed is wrong. Insurance fraud may be a subject involved in some legislative proposals but those that commit this act should be addressed on an individual basis. Creating situations where doctors may question their decisions as someone will be second guessing their actions is wrong. Another aspect which is involved in healthcare reform is the costs of malpractice insurance for doctors and all healthcare professionals. Avenues to address these situations and bring the cost of malpractice insurance down could greatly reduce the cost of healthcare, a key goal in healthcare reform. The key target of any healthcare reform is to provide health insurance for the uninsured or underinsured. This is a viable and necessary action that needs to take place.
Another aspect is the cost of medications that are dispensed. It takes money to perform research in developing new drugs to meet current and future needs. Restricting what drug companies can charge for drugs decreases the incentive to do the research. We have come to expect a certain quality of life existence and changes being discussed in current legislation as covered in news reports seem to be cause for concern.
Today some insurance companies have requirements for pre-certification for certain medical procedures while others are not so restricted. The insurance industry is a viable organization and provides a service with a risk. That risk must be rewarded. While the cost may be a concern, cost is not everything. Everyone deserves to have quality of life and government should not interfere with that right. I understand the cost of healthcare is rising and many individuals are having a hard time financially when unexpected illnesses or major illnesses occur. We all want quality of life for our families and want to have all the options on the table. If an individual cannot be saved the option to at least make them comfortable so they do not suffer should not be restricted. If this condition is in place in the final legislation it would be a good thing but I fear the chances of this occurring appear slim.
There are reports that some agreements have been generated between the pharmaceutical industry, hospitals and the government. I welcome this type of cooperation but the details have not been provided as to what the agreement entails. We the public have a right to know what promises have been made and if they represent a decrease in the quality of healthcare currently being provided to the public.
One last point to make is I am not against healthcare reform for those underinsured or uninsured but not at the expense of the quality of care now being provided. As previously stated we as individuals have come to expect the best possible care for ourselves and our families at affordable prices. The methods now being discussed for making changes in the healthcare industry will cause a shift in the way healthcare professionals operate. While this may not be entirely a bad thing establishing requirements that will cause healthcare professionals to second guess their decisions is wrong. This situation if it exist in the final legislation enacted will or at least have the potential to reduce the quality of life and healthcare that doctors have routinely given their patients. Also reducing the income of doctors may cause others considering entering the medical profession whether it is what they want to do.
It is no secret that more doctors and nurses are needed. Any action to decrease the amount doctors and/or hospitals can charge reduces the prospect of increasing the quantity of individuals choosing this profession. Let us not create these situations. Healthcare organizations and all the professions associated with them are great and they provide a valuable service to their patients. I have seen and experienced great service through healthcare professionals and they should be rewarded for the quality of care they provide. As I previously stated any healthcare reform legislation whether it is at the state or national level should not affect the quality of life for individuals. The issue that should be addressed at the federal level is some commonality in healthcare procedures/requirements so insurance companies do not have varying requirements from state to state. This would help to decrease administrative cost and thereby reduce healthcare costs.
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