Ask the Doctor: Health care reform

CHICOPEE, Mass. (WWLP) - Polls are suggesting that the nation is sharply divided on support for and against the health care legislation that passed in the House of Representatives on November 7.

22News spoke with 22News spoke with Pediatrician Dr. Michael Posner about what is ahead in the health care reform debate.

1.) Where is health reform heading?

Response: That is undeniable, with numbers ranging around 45% pro and con, and 10% undecided. But polls have been shifting all year. Last week the American Medical Association and the AARP, which no longer requires members to be retired, both came out in support of the bill. Most health policy experts are rallying to it, stating that it is better than anything that has come this far in years, and certainly better than what we have been doing. No one wants to be uninsured, but that has been the other side of the coin for millions of Americans.

2.) But isn’t the possibility of increased costs built in to any solution that improves coverage?

Response: Certainly some people think so, but I don’t think we have ever been forced to tackle the problem. It has been easier to protect the turf of individual parts of the system by limiting services to some, overcharging others, and congratulating ourselves that we have the best medical care in the world. But, not for everyone. All parts of the system are going to have to prove their mettle, and trim their sails like we all do when we can’t afford our lifestyle. [ Graphic1] This bill includes provisions such as cost reductions in Medicare by negotiating pharmaceutical costs, the taxation of overly generous insurance coverage, exploring ways of paying groups of doctors a fixed total yearly amount for a covered person’s medical care, and studying ways to compare cost and efficacy of treatments. The current discussion of breast cancer screening is part of that.

3.) S till, critics say that subsidies to low and middle income folks to provide coverage will add to the total bill, and may increase our debt load.

Response: We cannot fix the system by depriving people of needed health care. If we look seriously at inefficiencies as we go, we will more motivated to improve our system than if we turn our backs on those who can’t afford care. The only fair approach is to make the changes simultaneously, so that everyone ends up getting what they need, not what they can afford to get. Most other developed nations have done this already. We can afford good care, but only by trying something other than tinkering with what we have had before. I think this bill is a good start, one that we can improve over time as we learn. Without any change we will continue to stagnate.

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