Friday, September 4, 2009

My health care questions

Let me just say up front, it is not my intent to blog about politics in general, nor about health care reform in particular. I have not read a single one of the 1,000 pages of the proposed House bill. I know little about the current system beyond my personal experience -- mostly positive, as one of the "haves" in this "haves" vs. "have nots" debate -- and what I've read and heard anecdotally about others' experience -- mostly negative.

I share concerns about how any of it gets paid for; I figure Medicare will be bankrupt by the time I get there. I worry that my personal experience will become negative if my employment is threatened (and whose isn't these days?) and I'm just hoping that I'll have enough savings to pay for pain medication if I can't get anything else next time some serious medical condition befalls me.

I think there are things that seriously need to be fixed, but I do not presume to know enough to have an informed opinion about how to fix it, and I'm not as prescient as all the talking heads and people with loaded pistols at town hall meetings who seem to be certain about what problems will arise as a result of the fix, whatever it is.

But, I have questions about two of the points that have been put forth on the topic. I pose them not to make a political statement, but to seek understanding.

Please, help me understand.

First is the argument that there aren't enough physicians to care for the 47 million people who are now uninsured. If everyone has access to health care, this reasoning goes, there won't be enough doctors to go around, and those of us who now have access to health care will have to stand in line with the newcomers.

Whether there are or aren't enough physicians isn't my question. Rather, it's this: how is it okay for me to deny your opportunity to see a doctor, regardless of how sick you may be, because I might have to wait longer?

When my kids were young there were mothers who refused to share the names of their babysitters, for fear other moms would "steal" them. This argument feels a little like that, with far darker consequences.

Is this really what we're saying?

Then, there's the argument about rationing. Pass health care reform (in whatever form, I gather) and rationing of care will follow. I actually don't doubt that. Too much demand chasing too few resources -- whether doctors or dollars or anything else -- means choices much be made, even if only on the basis of who showed up first.

My question is: don't we have rationing now? People with jobs and insurance get care. People without jobs and insurance, or people who have pre-existing conditions, or whose doctors recommend treatments that aren't covered in the policy, or people whose insurers find a reason to cancel their coverage once they get sick, do not get care or go bankrupt trying.

How is that not rationing, just with a different set of criteria, and a different person making the rationing decision than might be the case with some other process? What's the difference?

Help me understand.

Just don't tell me that it's okay for me to shrug and say "I've got mine. Too bad for you."

Help me continue to believe we're better than that.

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