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Wednesday, June 10, 2009
Michael Reagan :: Townhall.com Columnist
Efficient Nationalized Healthcare? Not So Fast
by Michael Reagan
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President Barack Obama has undertaken the expansion of health care to the roughly 45 million Americans who do not currently have health insurance. Having about one American in seven with no health insurance is undeniably an undesirable situation which deserves our attention and concern.

This is not just a matter of compassion either, but also of practicality. About the most expensive way imaginable to deal with routine illness is to provide it in hospital emergency rooms, yet this is the only alternative for millions of people. In addition, the uninsured commonly defer getting needed treatment, and with the looming threat of infectious diseases to all our families, we are all at risk when millions go without needed treatment.

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Our problem, however, lies in the dwindling supply of health care providers. Most doctors are overworked, many are underpaid. The number of doctors is increasing at a woeful 1 percent a year, and the number of available nurses has been flat for years. With an increasing population -- and one that is aging as baby boomers move into their 60s -- who is going to provide health care to 45 million more Americans, even if we make the wildly optimistic assumption that we could afford to pay for it?

Well, if you are not scared yet, you should be. Let me tell you how the so-called experts would solve this conundrum. It is not pretty. In fact it is so ugly that no one wants to discuss it publicly. Certainly not the Obama administration, or the Democratic-controlled Congress, but also not the private insurance companies -- the ones that once opposed the Clinton health care plan but now apparently see government as the almighty solution.

Apparently the agreed-upon approach is to give health care to 47 million new beneficiaries without massive new costs by being "more efficient" in allocating the currently available health care assets. Well, efficiency is good, right? Not necessarily.

Here is what this "efficiency" would mean in stark terms: severely restricting health care services to our elderly, and the severely and terminally ill. "Efficiency" here means providing services to millions of young and healthy, who do not need much of it, and cutting health care to seniors and the severely ill who "statistically do not have as much to lose by not getting good health care."

In other words, the administration believes that those of above 60 will not live nearly as long, no matter what health care we receive, as a healthy 25-year-old, so why "waste" doctors, nurses, drugs, hospitals and surgeries on us? Health care resources, in cold, hard, inhumane computer calculations, are more "efficiently" used letting the elderly die years earlier after a less-healthy retirement.

My father was a supporter of Medicare. He worked tirelessly to insure that the insolvency which we were facing in Medicare funding when he became president was resolved in favor of continued quality Medicare services for our senior citizens. He cared. He knew that we owe a debt to our seniors that cannot and should not be denied in the name of so-called "efficiency."

We all want a health care plan that is best for all citizens, but we must do better than the current proposals being floated by Democrats in Congress and the White House. Go to Reagan.com and stand with me in opposing any health care plan that increases taxes, buries us in debt, or which reallocates health care away from the elderly and ill.

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About The Author
Michael Reagan, the eldest son of Ronald Reagan, is heard daily by over 5 million listeners via his nationally syndicated talk radio program, “The Michael Reagan Show.”
A good suggestion
One of our State legislators suggested (just by way of musing, nothing actually came of it) that insurance companies should start covering preventive care and giving premium-payers a "kickback" on their premiums if they do sensible things like actually use their health club membership, losing excess weight, etc. He was taking this idea from an insurance industry white-paper that suggested that health care use could be reduced substantially, which would reduce health care premiums.

Example, a coworker of mine wanted a gastric bypass (to-date three coworkers have gotten them, paid for by my ever-increasing health insurance premiums) but she was denied unless she first lost 50 pounds. She lost 70 and then decided to forego the gastric bypass and just keep eating less and doing the treadmill. She has since lost 150 pounds and is at her correct weight for her height. Cost to our insurance of a gastric bypass surgery -- $25,000. Cost of her health club membership -- about $1000 a year, less the cost of the food she's no longer gorging herself on. That means she can go at least a quarter century living a healthy lifestyle on what she saved all of us on that surgery.

VA as a model for good health care?
Really? Gene, you may be the only veteran I've ever heard not complain about VA health coverage. I live in a big military town -- lots of military retirees here and many of them would rather tap their current employer-health insurance plan or pay out of pocket rather than go anywhere near the VA. Most often they complain about long waits for appointments, long waits AT appointments, poorly trained doctors and nurses, limited and ineffective preferred medications and a general attitude of treating the symptom rather than the actual illness. We accept TriCare where I work and basically it doesn't seem to cover much. My favorite is the example of the bipolar woman who needed mood-stabilization drugs, but Tricare would only authorize an anti-depressant that threw her into a manic phase, at which time TC authorized a tranquilizer, but still refused any sort of effective treatment for bipolar. Another is the insistence that TC clients see only licensed social workers, but then reimbursing at a rate where the licensed social worker is getting paid less than a file clerk.

If that's how they do mental health, I seriously doubt they're a model for primary care.
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