 Meet halfway on (Healthcare)
reforms
Parties must
find common ground to improve health care system
By Dr. Robert L Chacona.• August
31, 2009
Our national health care struggle is well under way. Improving
access, maintaining quality, limiting costs and reducing the deficit
are again hot issues. Democrats and Republicans affirm that
America's health care system needs help. Both parties profess a
commitment to extend care to America's uninsured and underinsured.
Both insist that tendencies toward "rationed" and "tiered" health
care should be avoided. They agree that it is unacceptable for
health insurance premiums to increase four times faster than wages
as health insurance company profits soar. And they agree that
exclusions for preexisting conditions, wanton claims denials and
conflicts of interest of claims reviewers must be stopped.
Everyone agrees that the solutions to the problems are founded on
keeping what is good and even great about our health care system and
discarding what is broken and dysfunctional. They mostly also agree
that more health insurance regulation and oversight has become
essential. But the actual ways to best reach all those
well-intentioned goals
is where the trouble starts.
Contentious issues include the actual costs and how the additional
health care, with its nonprofit federal "insurance exchanges" and/or
state "insurance cooperatives," will best be afforded.
There is dispute over participation requirements in a national
public-plan intended to encourage competition and favor consumers,
and disputes over coverage mandates that would boost both
insurance/provider usage and profit. While Congress will likely
succeed in rolling back many of the Bush administration's tax cuts
to the wealthy, ideology heats up in confronting what are to be
acceptable methods of cost containment. These important questions
concern whether it is possible for more affordable health care to
promote quality care and encourage more patient choice with more
candid, doctor-patient input than our current system.
There is compelling argument that "patient-targeted" cost
containment will be a must.
A serious campaign to better educate America's population beyond the
basics of prevention - how diet, exercise and routine health care
specifically help control specific diseases - seems indispensable to
any cost containment. Incentivizing wellness rather than merely
paying for more disease treatment has gained solid support from both
sides of the aisle. Currently, most insurance companies do not pay
for patient education or for many accepted preventive
procedures. Initiating more regulation of corporate food
conglomerates and their advertising practices would also prove
beneficial. Supplying extensive statistical information on
procedures and providers and making that information readily
accessible would further encourage patients to play a more
intelligent role in their health care delivery decisions.
There still remains serious discord, even among Democrats, involving
the establishment
of a Washington-based bureaucracy to command and control systemic
federal standards. Supporters point to such an agency's inherent
promise for efficient, beneficial regulatory oversight. Detractors
focus on inherent dangers of any centralized agency for ineffective,
hazardous autonomy. While both sides have justifiable concerns,
there could be consensus on implementing ways to prudently ensure
that any such agencies provide full disclosure of policies,
decision-making processes and procedures instituted to improve
them.
Access to affordable, quality medical care has again taken
well-deserved center stage.
Having been both a practicing dentist and a health care consumer, I
wonder if dental care
will play any role in this current reform. Dental care costs have
not risen at the same rate
as medical ones, but dental premiums and deductibles continue to
increase, even as benefits decrease. Given the many correlations
between general health and oral health, oral health instruction also
needs to venture well beyond the basics. It seems evident to me that
universal health care will incorporate oral care at some point to be
truly effective.
Whether health care reform succeeds or fails will be determined over
the coming months.
But inaction should not be an option. Through forthright, insightful
exchange, the legislative reform-process must prevail over
tendencies toward partisanship and self-interest. Though complete
accord on the present proposal is not possible, the many areas of
general agreement must be enacted. Our nation needs and demands it.
Dr. Robert L. Chacona was raised in Ithaca, maintained a dental
practice in Manhattan and is the author of a book, "Longevity Logic
- Empowered Health Defense," about oral health, longevity and health
care delivery.
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