Neil Crosby
CAHU Vice President of Public Affairs
As I am reading about the most recent casualty of a Health Care Reform gathering Wednesday night in the LA area where a portion of a person's finger was bitten off by a demonstrator from MoveOn.org, which is a group focused on pushing for the type of reform that President Obama is calling for and who would really like to see more government involvement, I am more convinced than ever that we need to push harder than ever for the type of reform that will indeed help the health care system, not destroy it. However I also feel stronger than ever that it is all about how it is done.
The people pushing hardest for the type of health care reform that has been written in the House bill, and/or those who want even deeper reform such as a single payor system, use very emotional issues and dialogue to push their side of the discussion. For example, how can a country as rich as ours allow 47 million people to be uninsured. A very emotional point, until you calmly point out that nearly 1/3 of the uninsured qualify for an already existing public program, or that another 1/3 make enough money, according to studies, to purchase insurance coverage but have not, or that some people make a conscious decision not to purchase the financing mechanism that would help them pay for their health care when they need it, health insurance.
They also bring up how this country spends more on health care than many other countries and has less to show for it when it comes to outcome studies, lifespan, etc. Well those may be true statistics, but again we can calmly point out that many of those other countries don't have a fast food restaurant on nearly every major corner, and that most households in other countries may not be able to afford X-Box or have that big plasma TV that can be so alluring, to me as well. That many of our outcome statistics could be improved by lifestyle changes, diet, exercise, smoking and other improvements, and that tearing down what works about our current system and replacing it with more government bureaucracy is not the sensible answer.
As we have also heard, proponents of more government involvement of health care reform have been dismissing the public's more recent reluctance to support the administrations efforts as being created by the far right talk show hosts, etc. Therefore it is more essential than ever that people calmly correct them by pointing out that I believe what I am saying to be true, that no one put words in my mouth or made me say them, I am speaking out as an American that I want to keep what works about our system.
We have heard so much about how the Public Option could be the answer. If I recall correctly, in California we have already been there done that with the Health Insurance Plan of California, the HIPC. Created in 1993 the HIPC was a public option where employers could go directly to the HIPC to purchase coverage for their employees. The HIPC did not allow brokers to represent employers in the beginning of it's existence. After only gaining low to moderate enrollment the HIPC decided to allow brokers to represent their employers, however broker commissions needed to be listed separately on the billing statement. In spite of the commission being listed seperately on the billing statement so many of the enrolling employers still choose to have a broker representing them that the HIPC did away with the separate listing of commission. As many of you may remember, the public option HIPC performed so poorly that eventually the decision was made by the state of California to morph the public option HIPC into the 'Co-Op' PacAdvantage, which was run by a not for profit co-op of very large employers called the Pacific Business Group on Health, PBGH. As even more of you will remember PacAdvantage struggled until it closed it's doors in December 2006. Are all of the perimeters of this previous public option and co-op plan exactly the same as what is being proposed, who knows. But one could calmly stand their ground and show the facts that we have already tried that idea, and it did not work, at least at the time.
There is another concept that is being pushed that just doesn't work when it comes to health care. As you have no doubt heard many a time, "we can combine our collective buying power to negotiate lower health care costs". This is another area where we can calmly discuss the fact that health care itself is not a bulk product. It is not a product or parcel that Costco can buy huge amounts of and mass market it under the Kirkland label. Health care is a very splintered service, it's a prescription over here, it's an office visit over there, it's a test over here, it's a counsel over there, it's a hospital visit over here, it's a hospice process over there, you get the idea. It's a potential of millions of different providers all giving service that they expect and deserve payment for. Other than a government system saying we are only going to pay you .15 - .35 cents on the dollar of what you would receive as a provider for an insured or cash patient how could you possibly combine buying power. Oh but wait, we do have that already don't we? Ask any hospital or medical group administrator about whether they could survive financially if it were only that level of government reimbursement that they were to receive. The ones I talk to now openly talk about the fact that they much cost shift to insured or cash patients to make up for the government reimbursement short comings already.
But again, these are emotional issues to those that want to see more government involvement in health care. So let me ask you, when you get into a discussion, argument or what ever you call it with a person that is all wound up over an issue is there anyway to win? It just escalates, names are called, fights break out, digits are bitten off, and no one wins. No one is actually listening anymore, in fact we have just lost all credibility by arguing, they have forgotten our valid facts. I'm not saying not to be involved and speak with passion, it's just going to get the point across, stay in their minds, be more credible if we speak the facts that we all know are true. It is more important than ever to speak those facts to your associates, your clients, your service club, your church group and your family and friends.
Do get involved, share what you know to be true, just do it in a way you will be proud of when it is all said and done, and let me know if I can help you in any way.
