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Tuesday, March 06, 2012

Obamacare-Romneycare-Hillarycare and Health Care Reform

Debating health care reform goes back for decades in American politics.

Republicans have selective amnesia whenever it's mentioned, but two of the proponents of health care reform were Republican Presidents Theodore Roosevelt, who advocated for universal health care in 1912, and Richard Nixon's 1973, Health Maintenance Organization (HMO) Act.

Nevertheless,  since the 1990s, anti health care reform trolls funded by private insurance companies began what's become a trilogy of brand-names attached to efforts to bring about meaningful improvements to how people access quality and affordable health care.

Hillarycare became Romneycare and, now, the label has morphed to Obamacare.

I'm mystified by how people, led by the media, fall victim to labels when all our journalism training and English 101 composition classes teach us not to rely on buzz words. They're unimaginative, and, what's more, they're "plageristic".  In other words, people copycat these words without any idea what they mean.

"Health care reform", on the other hand, means people have a right to access quality and affordable health care without regard for their ability to pay -although, somebody does pay.

It seems like everybody buys into the premise of providing health care for all, because it's the right thing to do, but the concept of explaining health care reform doesn't get beyond sound bites.

In the absence of health care reform (President Obama's bill doesn't really "kick in" until 2014), the person who cannot afford to see a doctor winds up in high priced emergency rooms whenever they're too sick to function.  Sadly, some of these poor people even die before they access care because they can't get to a health care provider in time to save their lives.

Meanwhile, access to primary care is perhaps the most cost effective way of providing people with the tools needed to stay reasonable healthy.  So, when sick people, who cannot afford health care, wind up hospitalized because of an exacerbation of a treatable illness, the costs to care for the indigent patient are passed on to those who can pay - it's a health care accounting tactic called "cost shifting".

Health care reform is  needed to reduce the costs for everyone, but especially for those who access primary care, to keep them out of expensive hospitals.  With health care reform, private insurance will pay their network providers a negotiated rate to cover the costs of their beneficiaries, so they won't have to absorb the cost of charity care as a result of cost shifting.  Hospitals, and other providers, can keep their costs under control when payment for needed services is guaranteed, so they won't have to resort to cost shifting to cover indigent or charity care, which is hardly ever paid for.

However you analyze it, health care reform is needed to help keep the spiraling cost of providing care to a growing number of charity care patients under control, by providing good primary care case management and by providers receiving timely payment for services to indigent clients.

Above is a simplistic explanation about how health care reform works, but it's rendered meaningless when experts and pundits alike use buzz words to enrage the public rather than explain the alternative to change.  In fact, the alternatives to health care reform are that insurance premiums will get higher as costs for caring for an aging population spiral out of control, while the beneficiaries' coverage will reimburse for less and less services when actuarial costs include projecting for 20 plus percent profit margins.

Moreover, when government becomes a large consumer of health care, they are in the best position to negotiate the lowest rates based on the high volume of services covered.

In reality, Hillarycare, Romneycare and Obamacare are health reform initiatives with noble objectives, ie, to improve access for everyone who should receive primary rather than urgent care and, at the same time, control costs.

Health Care Reform should be labeled "affordablecare" or "American-care" or even - taaa-daaa!: "Medicare"! After all, Medicare provides primary care to beneficiaries who pay modest premiums for coverage.  In my mind, it's unfair for Medicare to be an insurance benefit exclusive for those 65 years of age and older or disabled.  I believe anyone should be able to choose to buy Medicare coverage before 65 years of age, because it's not free and it's affordable.  Repeat !! - Medicare is not free; it's an efficient health care reimbursement alternative already in place, working and providing quality programs to beneficiaries.

So, my point is, rather than belittle health care reform with irrelevant labels, why not, instead, take pride in First Lady Mrs. Hillary Clinton, for braving political turmoil to get the issue into the public domain?  Let's credit Governor Romney for daring to create a health care reform initiative in Massachusetts, because people who live there really like the coverage. And, certainly, let's applaud President Barack Obama for bringing health care reform to reality, despite the political consequences he's faced ever since the bill passed, with no Republican votes.

Moreover, let's get off this buzz word mentality, words that would get writers and reporters an "F" in English class. It's time we  educate the public about what health care reform means to them and their families.



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