Thursday, October 15, 2009

Side Notes: Obamacare

I would like to comment on the health care debate that is currently raging in Congress and America in general. Not only does this affect all of us, but it will also have implications for music therapy treatment options and reimbursement issues. With this in mind, our music therapy seminar class has considered the subject over the last several weeks in order to try and grasp the main ideas of the current plans being bandied around the legislature.

This propaganda poster is actually right on the mark. Our class did a survey of health care systems in 10 countries around the world. I was assigned Japan, which has a very tightly regulated government run health care program. Every country we looked at also had some type of government run health care. In each case, our investigation found that longer wait times were one of the major complaints in these other systems. Interestingly, the longer wait times only resulted in shorter times with the physician. Since the government controls how much the doctors can charge for patient visits, the only way to make up the lost revenue is to see more patients per hour/day.

Our class actually had a very civil and productive discussion about the plan President Obama has put forth. There were arguments for and against, but we did not have a shouting match or anything so heated like the demonstrations shown on TV. It seemed that as a group of regular folks just trying to solve some problems with our health care system, we were able to rationally discuss the situation. Of course, we did not have to worry about being elected or pleasing certain interest groups.

I found it interesting that we could not find the details about the current situation of the health care legislation. We found the plan that Obama outlined, but the plan being considered in the finance committee does not look very much like the original Obama plan anymore. Senator Baucus has changed so much, including taking out the public option and not promising to cover all people, that no one really knows exactly what they are trying to accomplish. All of this information was found through third hand sources since the senators have been conducting all the discussions in secret. They have not even promised to post the final legislation for all to see on the internet before a vote.

Our class acknowledged that there are problems with the system in the U.S. Obviously the increase in cost every year is out of control and the U. S. government spends much more on health care than most other modern countries and provides less in services overall. We agreed that America excels in critical and acute care as well as having top of the line doctors and equipment. Other countries seem to have problems with quality control and customer service since the government control is not responsive to consumer driven sentiment. Some of the countries have successfully contained dramatic cost increases by regulating drug prices and drug companies and providing more coverage for preventative care. Unfortunately for the U. S., our population is much more diverse with many poor dietary and cultural habits that increase the health costs across the board. We do not have the benefit of a very homogeneous society like Japan. As the rest of the world becomes more metropolitan, many of America's health care problems are seeping into the systems of the socialist democracies and causing them to limit benefits or increase taxes.

After much discussion, our class decided to pretend like we were the Senate Finance Committee and hold a vote to see if the current Baucus bill should be voted out of committee to the full senate. I was surprised that the bill did not even receive one vote! The most liberal thinking class members were too upset that there was not a public option in the bill and the more conservative people were very concerned that there was so much deception about costs and increased taxes. Of course, since our class met, the bill has been passed out of the Finance committee in the real senate.

In my opinion, the entire Baucus bill seems to be a horrible injustice to taxpayers. The bill was only passed out of the committee by plain bribery on the part of Senator Baucus. People may call it bargaining, but when certain key states like Nevada, Oregon, Rhode Island, and Michigan are exempted from paying for some of the costs listed in the bill because they have Democrat senators, it is obvious what is going on. Seventeen other mostly Democrat controlled states also received special deals to limit the state's costs in the health care plan. Either every state should have an equal burden or the bill should not be passed. I think that the current plan is just a money grab from some people like the drug companies and medical device makers and reapportionment of the money to interest groups lucky enough to have their names mentioned. The last time I looked, music therapy was not on the list of the blessed! (Not that it should be.)

If you are going to change the health care system, then change it. The bills before congress right now mostly tinker around the edges and just play favoritism to one group or another. Since Democrats are in power, they should be honest and admit that it is probably over 90% of their interest groups that are getting the benefits. The options for health care will not increase as a result of congress passing any of the bills in the pipeline. There is not a bill offering a single-payer government run program and there is also next to zero proposal for any kind of market driven reform of health care since the conservative viewpoint has been locked out of any negotiations. Americans should not just throw their hands up in the air and say any reform is good. A vote for change does not abrogate our responsibility for due diligence in developing good ideas that make a difference!

To be honest, our class was very disheartened. In our examination of the details of the health plans and the process it is going through we found that the entire mess in Washington is so far removed from how regular people seem to think and act that we were at a loss for suggestions to improve the health care plan. We are even more concerned because we spent weeks looking at the issue to the best of our ability by looking for unbiased information and could not see how the current health plans will be successful in fixing anything. This Halloween, the scary thing is that most people will spend only a few minutes thinking about this subject while at the same time being informed by extremely partisan voices. Is this really in the best interest of our wonderful society and country? At the moment it does not look like anyone will be able to stop the legislators in Washington from messing things up once again although I am convinced that a much larger percentage than is reflected in the polls would oppose any legislation in its current state.

Washington D. C. - Where nothing makes sense and the keys to knowledge have been lost forever!

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