Opinion Extra

Degenhart: Rx for productive health care reform

The U.S. Senate is feverishly debating health care reform, and there are more than 2,000 pages of proposed legislation that could dramatically and permanently change the delivery of health care in this country. Most Americans can agree that changes are needed in our health care system, that costs are high and access to care is limited. We all want a healthier America, but the right reform does not lie within the legislation that stands before Congress.

America still has the best health care in the world. We live in a country with the best survival rates for almost all types of cancer, a country with a health care industry that continually offers the latest advances in technology and research and a country with minimal waits to receive optimum care. This is sharply contrasted by countries with socialized medicine such as Canada and England, where it is common to wait long periods of time before receiving necessary, critical care.

The original goals for health care reform were to reduce costs and improve access to care. Those are lofty goals, but they have been poorly addressed thus far.

It can't be done through legislation with a price tag of more than $1 trillion. It will cost every American more; insurance premiums paid by employers will be taxed, income taxes will be raised to counterbalance the cost, physicians will be charged user fees for programs such as Medicare, and state budgets will be burdened with expanding Medicaid programs.

It is estimated that there are 45 million uninsured Americans. Let's examine the numbers. Approximately one third, 15 million, are citizens who qualify for Medicare, Medicaid, VA or state benefits but are either unable or incapable of accessing the system. The government could ultimately rescue these citizens merely by ushering them through these programs. Another third are Americans aged 21-35 who choose not to purchase health insurance, yet have the means to do so, and approximately 8 million to 10 million are illegal aliens.

Finally, there are approximately 8 million to 10 million who truly do not have access to health insurance, do not qualify for Medicaid, Medicare, other government or private health benefits. It is these 8 million to 10 million who need to be identified and cared for, which can be done for less than a trillion dollars.

It's not too late to get health care reform right. Currently, this debate is completely partisan. In spite of repeated efforts for bipartisan input, House and Senate leadership have accepted no input from the minority (Republicans). Our very own senator, Jim DeMint, has introduced several bills and amendments, yet they have not seen the light of day. Even Dr. Don Palmisano, past president of the American Medical Association and an accomplished surgeon, attorney and professor of law and medicine in New Orleans, believes we can and should start over.

What should be included in legislation?

-Tort reform. It is estimated that $200 billion to $300 billion per year is wasted on defensive medicine and litigation. The present system is too expensive and does little to improve care; some victims receive no compensation, and some are overcompensated. Health courts could be an alternative.

-Portability. Americans should be able to buy health insurance across state lines like car or homeowners insurance, which would increase competition and help bring down costs.

-Market-based solutions. Not everyone needs the costliest coverage. A healthy 25-year-old, single man does not need obstetrical coverage. A woman does not need prostate screenings. People should be able to shop for health insurance that tailors to their specific needs, not what the company or government mandates.

-Health savings accounts. These accounts allow Americans to have some say and control over health care costs - and ultimately lead to wiser spending.

-Wellness promotion. The long-term effects of self-inflicted unhealthy lifestyles are devastating. There should be financial incentives for wellness, for maintaining an ideal body weight, for not smoking, for regular exercise. These habits need to be promoted in our schools, long before physicians start seeing the patient and the ravages of obesity, hypertension, diabetes and cancer have already taken a toll.

America, we can do better. We need to improve the delivery of our health care. Let's start over, look at all facets of this incredibly complex issue, and do it right. It may take years. That may seem too long to some. But we've spent the past 100 years building the best health care system in the world. Don't destroy it overnight.

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