What do you need to hear from the president’s health care speech tonight?

Absolutely the only reason to keep a public option out of health care is to preserve the obscene profits in the upper management of some of the health insurance companies – I believe that United Health Care is the worst. These big money interests are spreading so many scary stories to preserve their ability to maintain those huge profits. I’d like to hear a comparison of the salary of the top director of Medicare to the salary of the top executive of United Health Care. That should make it clear that a government option is a good idea. I’d much rather have a government official, who’s required to allow me to receive the accepted standard of care, be in charge of my options than an insurance company bureaucrat whose salary and bonuses depend upon how much care is denied to policy holders.

1. Eliminate the ‘prior condition’ clause in all contracts. As we continue to dissect the gene pool, they will find that all of us have a ‘prior condition’ and will stop paying for anything.

2. Stop the insurance companies from ‘dropping’ you after you have had knee or other surgery.

I believe the premise for insurance companies to exist is for them to calculate the ‘odds’ on groups of people contracting conditions. If they drop a person who’s paid in for years because of a knee surgery, all the odds are on their side. We don’t allow that in our gambling casinos – why does it continue to happen here?

I need to hear President Obama is dropping the whole ill-conceived effort to overhaul a system based on making money from sickness and injury, and coming back with universal single-payer health care. Sadly, I’m not holding my breath.

I want to hear a concrete, declarative statement about what he will sign.

I don’t want general policy statements. I want concrete activities which need to occur in order for him to sign a bill.

Of course, I want to see a single-payer system and a major overhaul of the insurance system. Other facets of health care need to be changed (eliminate direct marketing of pharmaceuticals to the public, for example) – god, I just want to hear what he *specifically* wants to see.

His political capital is wavering on this – Go Big or Go Home. I don’t want a President who wants to get re-elected. I want one with big brass you-know-what who won’t care about election, just about doing the right thing. (That, of course, will improve probabilities of my voting for him – as will implementation of a single-payer or at least public option system.)

President Obama should acknowledge that this initiative with the letter and spirit of a limited federal government as defined in the “U.S. Constitution” That the President, Senate and House will influence, not legislatively mandate, solutions brought forward through the Several States, private sectors and U. S. citizens.

I want to know when I can quit working my soul-sucking job that I keep just because I’m afraid what will happen when I get sick.

Look, it doesn’t matter whether there is a public option or not. What matters is the following, and the current proposals address only some of this.

1. Every barrier to obtaining quality primary care should be removed. This means more GPs and fewer specialists. It means no paperwork and no up front costs to patients. It does not mean more PAs or clinics in supermarkets following the Rapid Oil Change business model. Free, unfettered primary care is the best way to lower overall health care costs and improve overall outcomes. But it is probably the most difficult aspect of our health care system to reform. I suggest a loan forgiveness program for anyone going into general medicine, pediatrics, or internal medicine. Also, a requirement for all insurers (private or public) to pay primary care costs in full without deductible or copay. This is the most likely area where a public option would help. BTW: we would be money ahead if we provided free primay healthcare to illegal immigrants. Sure, they are not supposed to be here, but if they end up in the emergency room they will cost 5 times as much.

2. Tort reform. Bad doctors must be weeded out, but not by a system that is little more than a get-rich-quick scheme for attorneys. Those who are badly served by the health care system should be compensated, but not in any way that there is the incentive of a windfall profit.

3. Eliminate the concept of pre-existing conditions. Everyone is covered by whatever insurance plan they pay into no matter what. Duh.

4. Eliminate employer provided medical insurance. Employer provided medical insurance is an historical accident and puts our corporations at a significant competitive disadvantage in the global marketplace. Also, the future of American prosperity lies in small business and self employment. To free our citizens of the need for a big business job just to provide health care would be a huge shot in the arm to our economy. It is the right way to counter the negative impacts of globalization.

5. Eliminate provider networks and pharmaceutical formularies. Our healthcare system as it is today places many limits on our access to health care. Foremost among these are provider networks and pharmaceutical formularies. True health care reform would enable anyone to see any doctor and be prescribed whatever medicine that doctor believes is appropriate.

6. Separate pharmaceutical research and development from pharmaceutical manufacturing. We currently have many drugs that are unnecessary and companies inventing maladies that require their patented drugs. By breaking the link between R&D and manufacturing, the incentives to invent diseases to match new drugs, and the incentives to abuse the patent system are removed. Yet the incentive to drive efficiencies and lower costs are retained.

Finally, we must reject any attempt to turn the health care system over to Free Market Principles. The Free Market relies on consumers deciding whether to spend their money on goods and services. When applied to health care, this means some people deciding between poverty and illness or death. Make no mistake: this is what the ultra-conservatives want. They believe the poor, disadvantaged, or unlucky should choose death rather than burden the wealthy and healthy with the cost of their care. This is why health care reform is a moral choice. Either we consider health care as a right, or we declare that the poor are guilty and should die for their sins. I for one see no middle ground on this point. And as a Christian, I cannot support any point of view that prices the poor out of life and health.

The sad thing is that most of the 45 million uninsured are not poor: they are self-employed business people who want nothing more than to make their way in this world through their own ingenuity and hard work. But the system we have today denies them care because they do not fall into a defined, protected group.

Come on, folks, let’s get this done. Let’s unlock the creative spirit of the American economy by removing worries about health care from the equation. Every other major economic power did this decades ago and are at a competitive advantage because they have done so.

So let’s do it.

TM

PS: All of the hysteria about death panels is horse hockey. Think about it: there aren’t enough government employees around to form up enough panels to look at individual cases, even if someone wanted them to. And nobody does. The propoponents of health care reform do not want that. The only villians on this issue are the people who falsely claim that these death panels will exist. Those people are truly evil.