Health Care

Costs, policy and management of health care in the United States have for too long been poorly contained, coordinated or guided. I give credit to the Obama administration and Congress for tackling a very complex issue that has too often been driven by non-transparent activity of organizations and individuals. I give the administration and the Democratic controlled Congress a low grade, however, for rushing to promote poorly designed bill components that are unrealistically costly and for not effectively involving Republicans in the debate and word crafting. I don't approve of the Republican tactic of voting as a 100% block, and deplore some of the rhetoric of their elected and other political leaders. The process through which the 2010 legislation was created was very poor in many respects. It was too partisan, and the information given by politicians was too often presented as fact when the information was opinion, inaccurate, or misrepresented. I accept the work of the Congressional Budget Office as a non-partisan 'best estimate' of how the new health care law will, over time, affect health care costs to individuals and the taxpayer's government budget. I realize that there will be new costs and long term savings. The law should not be repealed but it needs a lot more work.

Americans are justifiably proud to point out the many achievements of medical professionals in saving lives and improving the quality of life for millions. For decades, there has been common agreement that some aspects of health care in the United States need fixing. Congress needs to acknowledge that 1) health care is a complex issue that requires thoughtful discussion, thoughtful fact gathering, and civil/respectful debate that honestly seeks input from all affected groups and 2) complex legislation logically require fine tuning and partial overhaul. This bill in particular needs major work to reduce health care costs and improve its effectiveness and efficiency. The following are important issues that need to move forward through fact finding, debate, and amendments.

• Individuals, health care professionals, insurers and public policy must promote habits and practices that emphasize wellness.

• Electronic record keeping needs to be updated to 21st Century capability. To the extent private enterprise creates or expands on developing and marketing such technology, the health care industry or Congress must make sure that it is designed to transmit patient information into the record keeping systems of others in need of the information (clinics, hospitals, insurers, patients, etc.). Proprietary systems can not diminish the free flow of patient information except to the extent they infringe on individual privacy rights since digitized data can more easily be obtained and distributed than the predominantly hard copy system that still dominates.

• Individuals must be expected to do their part, to a realistic degree, in taking care of themselves by managing personal wellness behaviors and responsibly using health care providers.

• Our nation must thoughtfully grapple with the areas of health care that are the most costly (procedures and treatments, Medicare and Medicaid) and then take action based on good information and healthy debate - even if politically unpopular.

• The health care industry needs to assume greater - and coordinated - responsibility for balancing the need for profitability and the general wellbeing of the nation.

• Organizations that advocate for employers and for individuals who do not have the physical/mental/emotional ability and/or the financial resources to fully take care of themselves - including health care insurance or other out-of-pocket costs - need to assume greater responsibility for maximizing personal responsibility expectations of those for whom they advocate.