Competing Models for Universal Healthcare have More in Common than You Think

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ALPERN AT LARGE--The issue of healthcare, sadly enough, has become highly contentious and viciously partisan, but the need to compartmentalize politics and healthcare policy is critical.   

My previous article was kindly responded to by fellow CityWatch writer Bob Gelfand, who set the right tone:  we've got to TALK and COMPROMISE. 

Particularly if we're not so much on different sides of a given issue.  Part of the reason why health care appears so troubling politically is that we're not always "hearing" what the other side is saying. 

But there ARE differences, and they must be addressed...yet in a manner we've not seen to date.

Example #1: President Obama made it clear that doing nothing is NOT an option, and President Trump, interestingly enough, agrees. 

Example #2: Too many individuals, and families, and businesses were hurting because of the rising cost of health care, so President Obama took action.  Again, interestingly enough, President Trump agrees ... yet uses the "Obamacare" model as the unsustainable and unaffordable option that was hurting the same individuals and families and businesses that President Obama was trying to help. 

So once you/me/we get past the "Obama's coming to getcha!" or "Trump is Hitler!" and focus on fixing the problems, we'll disagree on a few things...but, like Mr. Gelfand and myself, we'll probably agree more than we disagree.   

It's all about the quality, affordability, and access to health care, right? 

1) What we can do, and MUST do, is emphasize transparency and flexibility for negotiations and improvements.   

House Minority Leader Nancy Pelosi (who's as responsible as anyone for no longer being the Speaker of the House and for Democrats losing the House) wants transparency now

Well, ain't THAT rich?  OK, I agree, but perhaps the Democrats would do well with different leadership, because it was Ms. Pelosi who rammed the ACA down our throats, and the results have been less than stellar. 

Costs are UP, Enrollment is DOWN and one need not be a right-wing partisan to suggest that the "Affordable Care Act" hasn't been so appropriately named. 

President Trump has made it clear that the ACA repeal/replace is a work in progress, and will speak to ANYONE willing to talk to him. Some Republicans are fighting Trump's and House Speaker Paul Ryan's plan, and many Democrats are vigorously concerned about it (as they should be). So, let's talk.  And no one party should be relegated to "the back of the bus". 

2) There's the inevitable, and potentially beneficial, divide of universal health COVERAGE vs. ACCESS. 

The ACA or "Obamacare" did NOT get to its goal of universal coverage, and even ended a host of health plans that were used and cherished by tens of millions of Americans. 

Paul Ryan is NOT trying to achieve universal health insurance and without getting too reflexively angry at that, let's catch our breath and remind ourselves of competing realities: 

a) A 43 year-old woman with sudden-onset breast cancer should not lose her insurance, and her family should not be destroyed financially because of her terrible misfortune.  Period. 

b) A 43 year-old man in good health who has not worked in 5-10 years and who wants ongoing health insurance is someone who should be offered the ability to work for his healthcare benefits, or should be relegated to the free public health care system that counties are legally obligated to provided.

The first situation requires much attention and fiscal support from all parts of government, and the second situation shouldn't get us too concerned about "how will he be covered?" 

Paul Ryan and Donald Trump are emphasizing opportunity over mandate and affordability over forced full-coverage for all Americans. 

(And even though it's tough for some of us to talk about, the issue of how much we're spending on those not here in the country legally isn't a trivial one, or an issue that's going to go away.) 

The rest of the issues relate to the need to balance capitalism and socialism, between the benefits of the free market and the need to have government protect us all from predatory behavior, and Gelfand, in his CityWatch column, addresses many of them: 

1) Drug costs are three or more times more expensive in the U.S. than the rest of the world, and we're indirectly subsidizing Europe and Canada.  That must end. 

2) We need more residencies, and government-subsidized health educational costs of physicians and nurses to pay for health care in underserved areas.  Lots of health care professionals would give up a few years of their lives to avoid hundreds of thousands of dollars in debt. 

3) Opportunities for individuals and their families to work for their health care should be promoted so long as they are able-bodied, and a host of public works projects can be addressed by those opportunities...you know, that "win-win" situation Trump has always talked about? 

4) There will be arguments over the federal and state roles in funding and overseeing health care, but the first step is always the hardest step...particularly since this will be a neverending argument. Just pass something, and so long as it’s financially sustainable we can deal with fine-tuning the inevitable glitches in ANY system that is passed in Washington, D.C. 

On a final note, it should be emphasized that Republicans and Democrats both have major problems with Mr. Trump and Mr. Ryan ... which can and should be used to the advantage of all of us. 

Because debate and compromise is a form of arguments and policymaking that is ... well ... healthy.

And healthy is what our nation needs to become, more than ever.

 

(Kenneth S. Alpern, M.D. is a dermatologist who has served in clinics in Los Angeles, Orange, and Riverside Counties. He is also a Westside Village Zone Director and Board member of the Mar Vista Community Council (MVCC), previously co-chaired its Planning and Outreach Committees, and currently is Co-Chair of its MVCC Transportation/Infrastructure Committee. He is co-chair of the CD11 Transportation Advisory Committee and chairs the nonprofit Transit Coalition, and can be reached at alpern@marvista.org. He also co-chairs the grassroots Friends of the Green Line at www.fogl.us. The views expressed in this article are solely those of Dr. Alpern.)

-cw 

 

 

 

 

 

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