Putting You in Charge of Your Own Health Care

Americans are ready for change in the way they receive and pay for health care. Surprisingly, it may not be the changes that most politicians, big businesses, insurance companies and special interests are pushing. Americans are ready to take back control of their health care. They are ready for a change from unaffordable insurance that comes only from an employer they may prefer to leave – insurance that seems to provide more of a hassle than convenient protection from unexpected expenses. They are sick of sitting for an hour to see a doctor, then seeing a nurse for 10 minutes and the doctor for three and often left to wonder about what happened. They are burdened by high taxes for government programs that seem to provide health benefits for everyone but them while the same government clamors to cover even more in financially unsustainable programs. They have heard enough of empty promises from politicians who care only about getting re-elected and having more power. Yet even with all these and other problems, many Americans have given up and figure that it is up to the government to solve the problem. They wonder if the government solution will still allow them rapid access to high quality health care they deserve.

The current proposals for reform are cloaked as big changes, but as it turns out, they are actually more of the same. They can be summed up in this way: turn more control over to the government and insurance companies while politicians and special interests jockey for credit and work behind the scenes to benefit – at the expense of individual Americans. Albert Einstein once defined insanity as doing the same thing over and over and expecting different results – but that is what is being proposed today. While most American want more individual control over their own lives, the health reform proposals will expand the control over health care held by third-party payers (insurance companies and government). This would make matters worse for Americans.

The story of how we got to where we are today is long but has its roots in the World War II–era policy that stated that a tax deduction could only be applied to health insurance provided through a job. That lead to employers’ control of health insurance purchase and removed the consumer from the decision – decisions they make every day for auto, homeowners and life insurance (products that are affordable). Insurance companies then sold to employers – not to consumers. Insurance products then began to expand from "accident and sickness" policies, to "health" insurance. Thus they cover every minor expense except for a token deductible from patients. While this seems desirable on the surface, in the end it leads to little control over demand for medical tests and treatments and drives up the cost of health care and insurance for all. Instead of asking your doctor, "Do I really need another pill" or an MRI, or a surgery, consumers take the "free" benefit. Unfortunately, doctors often do more tests and treatments to survive government-fixed prices through high-volume services and to protect themselves from lawsuits. This leads to what the government and insurance companies call "over-utilization," the boogeyman they seek to kill by having more control over what kind of care every patient can be authorized to receive. Authorized by someone else besides the patient through cookbook medicine and rationing of care. That is the same thing that happens in socialized medicine in other countries.

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April 8, 2009

Dr. David McKalip is a Solo Practice Neurosurgeon in St. Petersburg Florida and President of the Florida Neurosurgical Society.