Health care reform is essential even if confusing

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September 23, 2009


            Health care reform has been on the National agenda ever since World War II in various formats. This year seemed to be the year of change until the opponents raised the ugly heads of distortion, fear and outright lies.

Two issues are seldom ever clarified. There is the concern for adequate health care and there is concern about who pays for it. The latter is generally the role of health insurance. Access to good health care is dependent on having health insurance or a lot of wealth.

            Despite the claim by Rush Limbaugh that “there's no health-care crisis in this country” (1), the facts speak otherwise. Most importantly of all, we spend more on health care than any other industrialized nation on earth. This is not an insignificant amount but rather twice and three times as much as other countries. Most countries are spending less than one tenth of their income for health care. We spend one of every six dollars on health care, soon to be one of every five. (3)

            A second failure of our health system relates to life expectancy and infant mortality. Why is our life expectancy lower than 17 other countries? Why is infant mortality greater than countries like Cuba and Russia? (3)

Opponents of health care reform say that their health care will be rationed under reform. Health care is rationed all the time under our present system. Those without insurance or the ability to pay for health care are limited in their access. Those with health insurance are limited by the choice of doctors and clinics, exclusion of coverage under the policy for various reasons including pre-existing conditions. One of the most critical areas of rationing is the lack of portability of one’s insurance coverage. It is too often connected with a place of employment. If someone becomes unemployed, there goes the health insurance coverage. COBRA is an attempt to solve this problem but premiums under this plan are very expensive. In light of current economic conditions there has been some assistance provided.

            Waiting for service is also a form of rationing. We have heard horror stories about the Canadian and British systems but they have been exceptions rather than the rule for their health care. Under our current system we have long waits for service too. I personally was referred to a clinic in Ann Arbor and the earliest appointment I could get was two months away.

            There are excellent examples of health care that we would do well to adopt. The Mayo Clinic and the Cleveland Clinic both operate efficiently and are recognized as superior providers of health care. These operate right here in our country. France is also said to have an excellent health care system.

            Critics would do well to avoid comparisons to the Canadian or British systems since the proposals in Congress do not even suggest that type of plan. The critics only add confusion to an already confusing issue.

            In contrast Dr. Arthur M. Feldman listed “10 Things I Hate About Health-Care Reform” in the Washington Post (2). Among other comments he wrote that we need to have more doctors, reform tort law, and reduce the administration of claims. None of these are addressed in the current reform proposals, he wrote.

            In the 1980’s Congress allowed non-profit health insurance companies to become profit based with the argument that costs would be lower. The reality is that the insurance premiums under these new companies skyrocketed. Greed coupled with blatant refusal to honor claims made these companies look good in the financial world. They joined the ranks of other corporations with highly compensated executives. In some cases fraud was rampant.  (3)

Dr. William Frist, the former Tennessee senator and onetime presidential hopeful, and Richard L. Scott were two people who participated in such private companies. Both are very vocal opponents of current health care reform. Scott’s company was convicted of fraud and paid nearly one billion dollars in damages. Scott was ousted from the company and three employees sent to prison. (3)  Oversight of Medicare payments would help to stop this kind of fraud and the money saved through oversight will more than offset its cost.

            We also have the problem of millions of uninsured people who nevertheless seek health care in emergency situations. These cost the rest of us more than it would cost to have these people insured. Insurance would also help the otherwise uninsured people to seek health care before their situation becomes an emergency.

            Finally my urgent plea is for people to think rationally about health care reform and not let the opponents and selfish interests of insurance companies decide the format of our discussion.  This requires effort and responsibility.


Norbert Bufka is a Midland resident and monthly contributor to the Midland  Daily News. He can be reached by email at You can visit his website at There are footnotes and references for this article.

(1) "There really isn't a crisis in health care in this country ... In fact, the odds of you being wiped out by a catastrophe or accident once the government gets started running this stuff is greater than if the private sector does -- but day-today, there's no health-care crisis in this country." --The Rush Limbaugh Show, 6/18/09

 (2) 10 Things I Hate About Health-Care Reform

One Doctor's Orders for How To Really Fix Our System

By Arthur M. Feldman

Sunday, September 6, 2009


Arthur M. Feldman is a cardiologist and chair of the department of medicine at Jefferson Medical College. He is the author of "Pursuing Excellence in Healthcare: Preserving America's Academic Medical Centers." He will be online to chat with readers Tuesday at 2 p.m. Submit your questions and

He says we need more doctors, tort reform, better access to care, payment by insurance companies, ability to use new treatments, and more.


(3) Johnston, David Cay. Free Lunch: How the Wealthiest Americans Enrich Themselves at Government Expense (and Stick You with the Bill), New York: Penguin Group, 2007.

See also Johnston, David Cay. Perfectly Legal: The Covert Campaign to Rig Our Tax System to Benefit the Super-Rich -- and Cheat Everyone Else, New York: Penguin Books, 2003.