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Last updateThu, 19 Nov 2015 8pm

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The health care debate needs to be about principles

If there is one word that describes the debate over health care in the United States it’s “confusion.”
There are intense passions, all sorts of disinformation, and, sadly, an inability on the part of the advocates for a national health care initiative to define their key principles. Perhaps, if the latter were more strongly emphasized, and some of the misinformation explained and pushed aside, then maybe the debate would be more civil and informed.

The reaction to the now infamous House Bill 3200 has been intense. But what’s been most distressing has been the amount of misinformation that’s been promulgated about the bill and what it means. Some of it’s downright shameful. For instance, Medicare, the system that covers health care costs for the elderly, has paid for consultations about end-of-life care for years. There is nothing particularly new about this. However, because this same kind of consultation is also mentioned in H.R. 3200, the bill’s critics are claiming this is some sort of organized effort to “promote” limiting care for the elderly. While the claim isn’t remotely true, it makes a great sound bite. And true or not, it’s been touted on the Internet, in endless e-mails and on the talk shows.
However, perhaps the most telling bit of misinformation, and one that frankly doesn’t make a lot of sense, is the notion that the new health care proposal will put a “bureaucrat” between you and your doctor. This is interesting, because under the provisions of the bill, if you have insurance, nothing is going to change. You keep that insurance. And what’s more, if you’re in an insurance program, or moving into a new one, you’re going to have a few more rights.
For instance, if you have a preexisting condition, it will be covered. That’s a big deal and, needless to say, insurance companies don’t like this. But, also consider this. If you have ever tried to get a non-standard treatment paid for by a private plan then you know there is already someone between you and your doctor, and that’s the account manager at your insurance company. The House Bill, at least, offers us a little extra protection when it comes to seeking coverage, which currently is often denied by private plans.
What the bill does is provide a public option, not that dissimilar to Medicare, for the nation’s 45 million uninsured citizens. People, I might add, who for the most part, contrary to popular disinformation, have jobs, work hard, but who aren’t covered by private insurance. It’s a staggering number and it comes with a significant economic and social cost. To many in the rest of the world, and not just Europe, the idea that so many of their citizens would be denied health care is unfathomable.
However, what makes this debate so confusing is  the bill that’s being discussed isn’t likely to be the one that is finally approved. That is, assuming a health care bill actually makes it all the way through the legislative process. While the House is likely to pass its bill fairly soon, the Senate, through its various committees, is looking at as many as six different core proposals. There is the national plan, variations on this, and even the idea of a co-op approach. That’s still an undeveloped notion, but who knows, maybe it’s a good idea. But these multiple proposals are causing confusion. How can the American people debate a proposal that’s a moving target?
There are also some legitimate concerns. For one, many worry that if there is a national insurance plan, employers, anxious to avoid what is a very expensive benefit, will cancel their plans and force their employees to move to the national plan. Then there is the concern that insurance companies will want to drop high cost patients. These worries, which are addressed in the bill, need to be a part of the public debate.
Then there is the cost. It’s expensive, and a modest estimate is that a national plan will cost $100 billion a year. That’s a lot, but here is another footnote — our current system, which doesn’t cover everyone, is one of the most expensive in the world. This is primarily because it’s inefficient in its approach to delivering services and because it also relies on a highly bureaucratic and paper-intensive system.
At the moment, the health care debate isn’t focused, and a lot of people, because they can’t tell what is and what isn’t the truth, are confused and upset. That’s why the advocates for a national health care plan need to raise the level of the debate. They should stop picking on their opponents, stop worrying about a few hot heads at their town meetings, and start talking about their key principles. The American people deserve that.

You may reach David Kerr at This email address is being protected from spambots. You need JavaScript enabled to view it.

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