7 questions to ask about health care

I was inspired by an article a friend on Facebook directed me to. It's 10 questions to ask your representatives about health care. While I disagree with the tone of the article (the author, Hugh Hewitt, gives his own answers to the questions and asserts that they are what any representative will tell you if they are honest), I agree that there are some important questions we should all be asking.

With that in mind, I present my own take on the 10 questions. I only have 7 though, as I feel that if these seven are answered the remaining three from Mr. Hewitt's list will be answered. (in particular, "have you read the bill and know it will enough to be interviewed on it". If a representative can answer these questions intelligently, then he or she has clearly read the damn thing and understood it.)

1. What will be done to ensure that my employer will not ditch my current health plan in order to go exclusively for the public option? How can I be ensured that I can keep my employer-provided plan?

This is at the root of the question. It's been very clearly stated that you will not be forced off your current plan, but the question of employer decision is a valid and important one.

2. What are the differences, if any, between the coverage provided in the general public health plan and the current federal employee health plan?

If there are no differences, then we can get a good look at what the public option will offer us. If there are, we should know those up front.

3. How will the new health plan impact Medicare funding? Will funds be pooled between the two programs (i.e. will Medicare be subsumed as a sub-program of the larger health system) or will the two be funded and administered separately?

The question isn't, "will the seniors get screwed?" The question is about the relationship between a current, functioning program and the proposed one. Is it possible that the new system break the old? If it is possible, then what is being done to prevent that possibility from happening?

4. If a doctor decides a procedure is necessary or extremely beneficial, can we be sure that the new plan will cover it? If there is not a cap on care, how does the government plan to deal with costs?

Again, let's not make this about he seniors. If Medicare has worked this long, let's assume that things aren't going to change for them or for the Veterans (unless the answer to question #3 shows a danger). The question of caps on are is important on both sides of the coin. Insurance companies just decided not to pay for things. The Public Plan shouldn't have that option, but what *is* in place to ensure that costs don't skyrocket?

5. How will the influx of new patients, waiting for medical services, impact the time it takes to receive the care that is needed?

If we are expanding the base of people who can take advantage of health care services, but not expanding the number of hospitals or medical professionals, this is a valid concern. It doesn't mean that we have the option of not providing health care to people, but we should have our eyes open to the idea that non-emergency procedures might involve greater delays than we're used to.

6. What incentives or requirements will be in place to ensure that doctors don't prioritize patients from private insurance over patients on public insurance?

I'm not entirely sure how this works currently for non HMO-Doctors. It'd be good to find out. The question of doctor compensation is important for a number of reasons, but I'm less concerned about the arguments that anesthesiologists and pathologists are suddenly going to be dropped from hospital staffs because their jobs are less essential. Again, what is the answer to question #2?

7. While socialized medicine is practiced in many countries, there are many reports of long delays and problems (especially in Canada). What systems are being put into place to avoid the pitfalls revealed by other nation's programs?

I'm sick of everyone talking about wait times in Canada, as if they were the only country in the world to have socialized health care. Many countries are doing this, some better than others. I want to know how we're learning from their successes and mistakes and how that impacts our plan.

new skins on old fears

Everyone has at least one recurring dream. I tend to find myself back in school, being informed that I have to retake a class that I never took, or failed, or else they'll revoke my diploma. In these dreams, I am having a hard time finding my classroom, trying to negotiate the requirement with my work needs, and generally trying to deal with the fact that I'm 25, 30, 35, 39 years old and stuck in a high school class.

The underlying fears are pretty clear. My forward progress in life is halted or retarded by something left undone, a failing never acknowledged or discovered. Something hidden in me threatens everything should it ever be discovered. This failing, this inadequacy will bring me not only inconvenience but shame.

Last night I had a different dream. Same theme, new twist. This dream had friends with tech connections asking me veiled questions about an old computer of mine, and then flat out telling me that due to video files on my old CSLA computer, I was under investigation by the federal government for copyright infringement. (I used to identify short clips in movies to be used to illustrate points in presentations. Everything was fair use, and our process was checked by a lawyer.) In my dream, I knew that what this ultimately meant for me was that they would come for the house.

I woke up reflecting on this. It's ultimately the school dream. But instead of something undone being revealed and threatening my forward progress, something DONE was being revealed. From the sin of omission to the sin of commission. Also, instead of simply causing embarrassment, the danger is to my home. For the first time, I have something concrete that can be threatened.

My life has undergone a major shift, and now my dreams are catching up to that shift. Social stigma is no longer the worst that can be done. I can be financially ruined now, left homeless and deep in debt. I can be a target.

This is probably part of the lassitude I've been feeling lately, the ennui that's settled over my otherwise quite content existence. I shouldn't be surprised that my standard dream is undergoing changes as well.