The Doctor Is In: Why We Should Be Glad Health Reform Passed

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President Barack Obama signs into law health reform legislation that will extend health insurance coverage to millions of uninsured Americans.The richest guy I know sent me an email with an attachment titled Health Care Mythology, a rambling thesis loaded with fears and fallacies about health-care reform. I started reading the piece but had to stop after finding so much misinformation in the first several paragraphs.

Even though President Barack Obama signed the reform bill into law on Tuesday, critics will continue to make more or less the same arguments against it for a while to come. These criticisms include everything from claims the reform oversteps congressional authority to ones that the lawmakers conjured up in secret a bill that "the American people don't want."

Among the more persuasive concerns, critics say that our leaders should be focusing on creating jobs and restoring our ailing economy. And clearly, the opponents have all gotten the talking-points memo that says "keep mentioning big government" to stir up opposition to reform.

I'll admit there are some valid concerns with the legislation, starting with the fact that there aren't enough preventive or cost-cutting measures -- or curbs on the insurance industry. But to those of us on the front lines delivering health care, it's clear that unless you're exceptionally wealthy like my buddy, or have a great employer-sponsored coverage, the system isn't working. This law is the best bet to save both lives and money.

America, a Communist Country?

The most vocal, yet not necessarily most informed, detractors make comical claims that America has become a socialist or communist country. Others are calling this a fight over our inalienable rights because the government shouldn't mandate that citizens purchase health insurance. Some 14 states are now disputing this requirement.

Republicans have vowed to use any and all maneuvers to derail the new law. The GOP had tried to hold the legislation up in the Senate, but senators completed their work on the bill on Thursday, sending it back to the House for "reconciliation." Throughout the reform process, when Republicans had a chance to offer a credible alternative, the GOP suggested Band-Aid approaches that didn't cover the uninsured or offer much of anything substantial aside from malpractice reform.

There is clearly a schism in the way people think about the health reform issue, and it's mostly a divide between Democrats and Republicans. Why is this issue so polarizing? Do critics not want higher taxes? Do they think the bill is going to create too much debt? Or do they simply want Obama and his agenda to fail?

The Current System Is Failing

They can't possibly think our current system is working. Maybe the system is working for them -- or maybe they just think it is. As I said in my most recent column, sooner or later, if we kept the status quo, all of us will be hurt by higher premiums and out-of-pocket expenses. Even worse, we could be precluded from buying insurance altogether.

I have to admit, the current system isn't even working for my own family anymore, and as a physician for 20 years, I have access to good medical care. Since I started my own medical practice five years ago, I have searched for an affordable plan for my employees and family. Since I accept most carriers, I have a good idea of which ones to steer clear of, and we've been able to find a quality carrier. But we still have to haggle with them over coverage, as I mentioned in a previous post when my wife was sent for a breast MRI. In addition, my premiums have risen steadily every year and I pay a $5,000 deductible (my employees pay less but it is a larger proportion of their salary).

The system is also not working for senior citizens who pay a small fortune for prescription drugs. Every time you go to a pharmacy, you see older people with anguished looks on their face haggling with the pharmacist or clerk because they can't believe to have to pay so much. I had to pay out of pocket for my son's allergy medication last spring. A one month's supply set me back nearly $100!

People Are Putting Off Care


It's not working for my patients who switch jobs, get laid off, are self-employed, work for small businesses or have preexisting conditions. I see people struggling every day, putting off needed care because they have no -- or inadequate -- health care coverage.

Keep in mind that I practice medicine in Greenwich, Conn., a wealthy suburb of New York. I see patients all the time nowadays who live in million-dollar homes yet don't have health insurance. Some have been out of work and some are behind on mortgage payments. Some of these people are insured though HUSKY, the state-run Medicaid program.

One of the things I like about my practice is that I have a wildly diverse patient base -- my patients run the gamut from successful financiers and entrepreneurs to hotel maids and waitresses. Regardless of their profession, prior income or level of education, those who no longer have insurance share the same worries nowadays that an accident or illness will cause financial ruin.

I realize that there's a subset of Americans who may never change their mind about the passage of this bill. However, this is the beginning of a long journey. I am optimistic that some critics may warm to the idea of reform when they realize that they don't have to worry about going bankrupt to pay for medical care if they lose their job or want to start a small business.
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