Reece, personal musings - Reform Wishes

Facts are stubborn things, and whatever may be our wishes, our inclinations, or the dictates of our passions, they cannot alter the state of facts and evidence.

John Adams, 1735-1826

This is an exercise in wishful thinking.

• I wish for a heated health care debate in Congress after the publisher releases my book Obama, Health Reform, and Primary Care Shortages. I wish the public reads the book, designed to inform people what’s involved and what’s at stake in this Great Debate. I wish the debate is long, factual, and detailed.

• The Obama administration and the Democrats wish to debate to end in comprehensive reform that requires all residents to purchase health insurance, with premium subsidies for people of modest means , and creation of a government-run insurance plan that would compete with private plans.

• Republicans and many businesses, health-related enterprises, physicians, hospitals, and private “special interests seek more market-based solutions, including high-deductible plans with health savings accounts, retail clinics, worksite clinics, concierge practices, privately run urgicenters, and third-party free clinics.

• Physicians wish for less onerous Medicare relegations, realism on electronic medical records, freedom to contract with patients outside of Medicare, educational support and debt relief for primary care physicians, help in forming medical homes, reforming antiquated physician payment, and lessening of federal “mandates.”

• American people wish for reform, lower costs and greater access, but polls indicate they wish to pay less than $50 a month for these reforms. The Massachusetts universal coverage model show costs will run at least $400 a month. Polls also reveal citizens don’t like the idea of a comparative effectiveness plan in which government officials, not doctors, decide what to pay for.

These are the facts. So much for wishful thinking.