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(HealthNewsDigest.com) – The debate over health care reform has drifted off course and become political blood sport. I have been professionally involved in health care for over 20 years as a former health plan administrator and currently I am the CEO of a patient advocacy organization. I have had the opportunity to read the House and Senate versions of the bill and the Baucus plan abstract thus far. It is very clear that there are some heavy hitters lobbying hard for their points but those who need change the most have limited funds and limited access to those with the power to make change. I am speaking of the millions of Americans with pre-existing health conditions who may or may not realize they are a layoff away from the loss of health coverage and may not belong to an organization that will lobby on their behalf.
In all of the banter and debate over health care reform one critical issue I hear argued about in the media is that health care reform will take away individuals rights to have a choice in their health care. This is a nothing more then fear mongering – approximately 70% of Americans have NO choice in their individual plans – their employers make the choice for them, which by the way is often determined on premium not quality. Employer based coverage will be maintained as the most common access point for coverage under any of the reform bill, however should you change jobs, become unemployed or choose to become self-employed you will have access to coverage at a reasonable rate, without fear of having pre-existing conditions held against you.
I have heard people comment that those with pre-existing conditions should not be afforded protection under legislation to have access to coverage. The reason we have problems in our health care delivery system is that those in the most need of care are disenfranchised by being locked out of coverage by failure to reinstate policies, cancellation of policies or exorbitant pricing of coverage. This leaves the care of the most ill to emergency rooms and clinics – the most inefficient and expensive care possible. If more people were covered by some form of health care illnesses could be better detected and chronic illnesses more affordably managed.
The population served by the organization I represent are those with a genetic heart condition, hypertrophic cardiomyopathy. As we are learning more about the role of genetics in our own health it is clear that many of us have genetic predispositions to a number of conditions. Rather than be afraid of this fact we should embrace our understanding of this important tool and use it to help identify those at risk, treat diseases before those with genetic conditions become disabled and ensure all Americans have access to genetic testing options. Thankfully we are protected under the Genetic Information Nondiscrimination Act to obtain the knowledge of our genetic information and not have this data used against us. However, when this genetic condition turns from a genetic marker into a disease we are left unprotected by current laws and we are open to discrimination by means of having these genetic illnesses held against us as pre-existing conditions.
This is not a partisan issue; it is irrelevant who you voted for in the last election, this is a crisis that impacts all Americans. Our children’s future’s are at stake – if you have a child with ANY medical condition you have to worry what will happen when your child is no longer covered by your group policy. What happens when they graduate and are on their own – currently if they lapse coverage for more than 63 days all pre-existing conditions can be held against them in terms of payment of claims and if they have a chronic condition such as heart disease, asthma, diabetes or autism they may simply be denied coverage as adults. Then where do they get coverage? If they are sick enough from social security, if not they simply do without or head to the emergency room for care that will sustain life, not treat complex diseases. That is what we currently have in effect and one reason health care reform is not something to be used as a political weapon as is currently happening across the USA.
As Americans we have the ability to make health care available to all in a fair and affordable manner. This concept is not incompatible with free market business and it is not socialist. We regulate many services in the USA including banking, education and security – health care is no different than these services. We must also help to educate our children on how to be good consumers of health care, to understand their own bodies and help them care for themselves as best as possible. This includes good diet, exercise and preventative care training in school and knowing how to interact with the healthcare system.
I have been on all sides of health care over the past 20+ years – I built health care plans, I purchased group policies, I have been a consumer of health care and I have lobbied for changes in health care legislation on several fronts. The sad reality is we have no “health care system” in the USA – we have a fragmented concept that is urgently in need of repair and the time is now.
Some politicians are asking for us to start over again with the legislation that will bring reform, in my opinion that is simply stalling already unacceptably delayed change. We have been waiting for nearly 80 years for reform and this delay has killed many Americans and bankrupted others. Further delay will cause physical and financial hardship to more – the time for change is NOW.
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