The health care reform law’ s most controversial provision is the mandate that all American adults buy health insurance starting in 2014. Critics have labeled this as “individual mandate” implying that it takes away the individual’s right. Twenty-one State Attorneys General have filed lawsuits against this mandate.
A week ago, I was invited to an afternoon cook out and hike by the local professional Toastmaster club, held at a regional park in Southern California. I was greeted by another physician from the local Kaiser hospital. In a few minutes we were surrounded by a large number of Toastmasters, questioning both of us the implications of the health care law. The main issue stated loudly was “Why should I be forced to buy insurance?” “Why should I pay a penalty if I do not provide health insurance to my employees?” “How are we going to pay for it?” They all looked at me for a response.
Our response. Can each one of you assure us that you will never get sick? Can each one of you assure us that if you do get sick and do not have health insurance, you will pay all the health care costs from your pocket? There was pin drop silence in the park.
The other Kaiser MD joined me and pointed out that realistically speaking health care is a fundamental right. We pointed out that as citizens we expect to have law and order, well maintained roads, and national security. We pay for all of these public services from our taxes. Should we have universal health care as it exists in many parts of the world and should the government pay for it? They all shook their heads and said no. What the health reform brings is that each of us takes personal responsibility for our health by preventive actions such as annual medical checkups and early detection of diseases like diabetes, hypertension, colonoscopies etc. This health care bill will enable each one of us to do this with no deductibles. We pay for this by buying health insurance when we are well before we get sick.
Costs. We tried to educate these learned toastmasters that health care has become a profit-making business. For instance, a recent publication of Fortune 500 the top health insurance companies annual revenues in 2009 were $87 billion for United Health Group, $65 billion Wellpoint, and $34 billion for Aetna. Many saw a huge increase in profits, such as CIGNA that showed a 345% increase in profits from last year. On the other hand, American Medical Association (AMA) reports that physicians practice costs will go up by 20% while payments to physicians by Medicare is planned to decrease by 40% in the next 8 years, at which time the number of seniors will increase from 43 million to 49 million. What the new law is attempting to achieve is improving the delivery of health care, end the spiraling cost of insurance and slow the growth in costs.
This group of Toastmasters seems to agree that we do need a mandate and regulations in the delivery of health care. At this point the Zoology Professor intervened stating “let us start the hike and enjoy nature.”