Wednesday, October 7, 2009

my response to the White House on Healthcare reform inquiry

I received an email today (via LinkedIn) soliciting opinion on Healthcare reform proposals, directly back to Office of Health Reform Director and Counselor to the President Nancy-Ann DeParle. I guess I got this email, since my LinkedIn profile lists me as working in the healthcare industry, which I do, in my employment with a medical device innovator/manufacturer. It may have been intended to seek input from medical professionals only, but I gave my input anyway.

The context of the question was basically this. Watch this video, and tell us if you agree with these doctors who support Obamacare. They also asked "What is the biggest health care problem in your state?" Here was my response:

my experience is quite different from the doctors on the video, and I do not think the proposals currently being discussed by the White House and Congress will solve the problems faced by our healthcare system.

We first should differentiate between the healthcare payor system and MEDICINE. Medicine today in the United States is the best in the world, and in history. Our healthcare PAYOR system is what needs reform, to improve access, choice and competition. Adding new layers of government and bureaucracy will make things worse, not better.

I am happy with my health insurance coverage (Anthem Blue Cross-California), but it is very expensive, and my premiums have gone up. I have employer based coverage, through my company which is based in California, but I live in Texas. I was certain I could get a better deal buying coverage on my own, and began shopping for a plan, including taking a look at high-deductible/catastrophic coverage, combined with an HSA. Unfortunately, even though I found much lower prices for adequate coverage, they were made unaffordable by the federal tax system, which makes health insurance premiums tax deductible only if purchased through my employer. This is a scenario where the federal government is currently LIMITING choice and competition through taxation. I would like to see this fixed in any proposed healthcare reform.

Additionally, it became obvious that my options were limited to what was available in my state. Current regulations prohibit a NATIONAL market for health insurance. This is another example of government currently LIMITING choice and competition. I would like to see this fixed in any proposed healthcare reform.

Professionally, I am very concerned about the federal government having increased involvement in setting fees for services. We already see this with Medicare, which causes a shifting of cost-burden to private insurance companies, driving up premiums for private insurance. As more Americans shift to a public "option", more services/procedures will fall under government fixed fee schedules, which will continue to drive up cost of private insurance, eventually eliminating private health insurance as a viable business model. Government setting prices/fees will quickly affect our medical technology/pharmaceutical innovators, as they will not have a true marketplace in which to market medical innovations. Medical breakthoughs will come to a grinding halt in this country, as the potential reward will be too small to take the risk of investing the necessary capital. This will be a disaster for the continued advancement of MEDICINE in the United States.

Many physicians I work with are already contemplating early retirement, if the plans by the White House are enacted. We need patient, consumer, and physician friendly reform, which should also include tort reform. There is no need to "test" this in certain areas, as the President has suggested. Tort reform has already been successfully implemented in Texas and other states, and should be adopted immediately on a national level. There is no reasonable position that be taken in support of the current medical/legal environment in this country.

I am all for reform, but I am against the proposals being made by the White House and Congress. I am for the right kind of reform, as I have outlined above, and still waiting for it to show up in proposed legislation.

Joseph D. Terry


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