Here they go again

                                          - Heather Thomas, OB-GYN Nurse Practitioner

The problem with the current debate on health care is that it is not about health care at all; it is about yet another transfer of power from the citizen to the state. From the perspective of the citizens, that reality is reaching the boiling point. The “tea parties” were, and are, misperceived as being about taxes. They aren’t. They are about the frustration citizens feel about an over-reaching, abusive, intrusive and tyrannical government. Taxation is only a part of the equation. In the same manner, explosive town hall meetings are revealing the same frustration; this time, on the heels of the health care debate. It’s about health care - but it is more.

Two things are certain regarding health care in the U.S. One, the system is far from broken. Two, a take-over by the federal government is not the way to fix it even if it were.

History has shown us that the solution to any societal problem, real or imagined, is not to be found in a single, grand piece of “reform” legislation. It should be clear that answers should come from health and medical professionals, not politicians and bureaucrats. It should also be clear from common sense that needs and abilities are different for different people. And it should be very clear that 1,100 pages of legalese and 500 amendments promoted by special interests are only going to compound a complex situation and add to the problem. The solutions will not, and should not, come quickly, contrary to the demands of the Obama administration and the Democrats controlling Congress.

Why Americans aren’t buying “health care reform.”

The American people don’t want another vast, federal bureaucracy guided by thousands of pages of regulations, driven by partisan politics and special interests, and run by mindless bureaucrats. They don’t want another excuse for excessive taxation, government mandates on behavior, and control over personal decisions.

Americans don’t want yet another national program catering to trial attorneys or special interests, and supporting the needs of illegal immigrants. They don’t really care what the AMA, AARP and ACORN think; they are tired of big, and often corrupt, lobbying interests pushing their own self-serving agendas.

Americans don’t want another government program so wonderful that Congress exempts itself and public employees from it. They want government to clean up the messes it has already made, and pursue the waste, fraud and corruption that currently plague its former creations. Americans don’t want health care becoming the next “General Motors.”

What Americans do want in health care.

The following are among the possible improvements that do not require a massive, national government intervention or take-over. Neither do they require a trillion dollars of new spending. Many, in fact, will reduce spending. Here they are:

Education Reforms

• Require P.E., health and hygiene classes in all K-12 educational programs. Create a federal guide as a model for states, not a federal program.

• Require proof of citizenship, immunization and health status for enrollment in schools at all levels.

• Increase availability of medical education facilities and encourage the entry into health related fields. Restore the prestige, honor and rewards accorded to those serving in health and medical fields. Promote scholarships, public and private, based on service in military, VA, free/rural clinics, and other public service facilities assisting seniors, veterans and the poor.

Patient Reforms

• Require personal responsibility for basic and reasonably anticipated costs, including office visits and co-pays. If patients want more, they can buy more via insurance. Accept that treatment will not be equal; if someone pays more, they will get more.

• Promote development of individual and small business co-ops for pooled negotiations, insurance, pre-paid medical and other cost savings systems.

Legal Reforms

• Cap medical malpractice awards based on “pain and suffering.” Nothing in life is perfect, nor should it be expected to be.

• Establish state malpractice panels to review all malpractice claims and promote arbitration as an alternative to litigation. Permit panel and arbitration data and conclusions to be included in any subsequent litigation.

• Permit discounts by health providers for waiver of legal liability by patients. Allow patients who trust their doctors more than their lawyers the benefit of removing litigation from the health cost equation.

Doctor-Patient Reforms

• Encourage computerization of records and integration with hospital, pharmacy and related medical products and services. This can be a private system. Citizens must have the option to exclude themselves from any public/government database. Assign a unique medical ID and disallow the use of social security numbers for further privacy protection.

• Restore dignity and professionalism to doctor-patient relationships by excluding government, not allowing it greater intrusion.

• Stop trying to control the incomes of doctors and other medical professionals. We don’t control that of lawyers, rap singers or baseball players - why doctors and nurses, of all people?

Hospital Reforms

• Provide incentives for community and regional hospitals to be run as non-profit organizations, and require patient and insurance billing to be based on the same costs. The cost of patient care should be the same whether paid for by the patient, an insurance company, or a government agency - there is no equitable justification for volume discounting!

• Deal with the poor by encouraging the development of privately or publicly subsidized facilities such as the Shriner’s and St. Jude’s, VA, county hospitals and free/low cost clinics. Prevent high-cost emergency rooms from being used as medical clinics.

Insurance Reforms

• Increase competition by allowing purchase of insurance across state lines.

• Prohibit rejection based on existing claims or pre-existing conditions. Allow rating differential to a maximum of plus or minus 20% to reflect health, lifestyle, or medical conditions.

• Do not set coverage requirements, but encourage a variety of plain-language coverage options to meet the needs of different age and health level groups. Let the marketplace respond to what consumers want, not government dictates.

Pharmaceutical Reforms

• Prohibit the sale of pharmaceuticals for more than 20% higher than the lowest price charged worldwide. Stop subsidizing Canada and other Socialist medical systems.

• Streamline the FDA approval process and intellectual property protection; place caps on liability for approved products.

• Allow generic products upon recovery of drug development expenses.

Tax Reforms

• Stop using the tax system to punish and reward.  Make all insurance, medical costs, and medical savings accounts exempt from all taxes. The cost of preserving the health of oneself or one’s family should not be bonus to government.

Government Reforms

• Set up state commissions to analyze methods for improved operation of Medicare/Medicaid and VA systems. Commissions should be comprised of medical professionals, health educators, hospital management, pharmaceutical and medical equipment manufacturers, and citizens. Establish national non-profit clearinghouses to annually review and discuss state experiences for possible adoption by other states and federal government. Let the private sector compete, innovate, imagine, and invent.

Don’t tread on us

Americans are getting fed up with a government that seeks to manage and control every aspect of their lives. They have had it with vast expansion of the domain of the national government to areas in which it has no expertise, no Constitutional authority, and no business. The incremental approach to tyrannical control used for decades has been accelerated under this President and this Congress to allow a take-over of the auto industry, the banking and finance industry, the securities industry, and the economy as a whole.

An attempt to effect “Marshall Law” over health care will not be tolerated. Together with a Machiavellian desire to take over the Internet and free speech in radio and cable news, this power grab may well be the fuel necessary to spark the next American Revolution. The egoists in Washington D.C. don’t seem to get it. The American people do.