MANAGED CARE July 2009. ©MediMedia USA
I have been watching the national health care reform debate with interest and amusement — as we all have, no doubt. Not working for an insurer, a TPA, or a PBM, I can look at the process with a little more detachment than someone worried that his company might be made redundant, as the Brits like to say, by something in a national health care reform bill.
But my interest is turning into irritation. In any public policy debate, it ill serves the nation to endure lies, half-truths, misrepresentation, misinterpretation, and disingenuousness. Arguments should be won or lost on their merits. So when Senate Minority Leader Mitch McConnell trotted out the objection to a government-sponsored health plan as “making people stand in line and denying treatment like they do in other countries with national healthcare,” it got my back up. Just as when Sen. Lindsay Graham, also a Republican, said that in national health systems, “The first thing that happens — you have to wait for your care....”
Now turn to page 6, where Contributing Editor John Carroll, in discussing a California law requiring timely appointments with physicians [1], presents stats that show that we don’t do well on that score at all. Our rate of same-day appointments for chronic illness complaints was about the same as Canada’s and far worse than other countries.
Then we have the backers of the so-called public option. No, they say, this is not a stealth plan to move the country to a national health system. It’s just that a lot of folks can’t get insurance under the existing system.
Gimme a break. Of course it’s a tryout for a national system. The real question is whether the nation wants that system, or whether such a system can preserve large parts of the existing market system. But we are not ready for that discussion. As economics professor Tom Getzen tells us on page 43 [2], reform as currently discussed in Washington is not going to do the trick. So we’ll be having this discussion again in a few years, no matter what Congress does this year. I hope that will be an honest discussion.