Finally, healthcare reform in plain English

Nine months after taking office, President Obama outlined his plan for overhauling the nation's health care system in a speech before Congress on Wednesday. It was long overdue.

Sixty-seven percent of respondents to a CBS News poll released last week said they didn't have a clear understanding of health care reform ideas because they found them too confusing. One of the reasons Americans are so puzzled is that President Obama hasn't done a good job explaining why we need reform or how his strategy will help fix the problem. His message got lost in translation.

Meanwhile, opponents have spelled out succinctly and effectively the failings of the Democrats' proposed plan -- and they've thrown in a few fabrications to boot. By using misleading words and phrases like "rationing," "government takeover" and "socialized medicine," and some truly ludicrous ones like "death panels" and "killing grandma," opponents of the president's plan have convinced many Americans that the health care reforms under consideration are indefensible. As New York Times columnist Charles Blow put it, "Conservatives speak in bumper stickers. Obama speaks in thesis statements."

That changed on Wednesday night when the president finally addressed critics head on, countering fallacies with facts. He spoke clearly, plainly and with authority about what's wrong with our nation's health care system and what needs to be done to fix it, and he defined the broad goals of his plan. "It will provide more security to those who have health insurance," he said. "It will provide insurance to those who don't, and it will slow the growth of health care costs for our families, our businesses and our government."

Some of this is quite complicated, and the president put it in the simplest terms possible. He probably didn't change many Republican congressmen's minds, but he may have gotten the attention of some citizens on the fence and those who were not sure what to think, in part by acknowledging valid ideas put forth by Republican lawmakers.

As a physician, I am particularly encouraged by the possibility that medical malpractice reform might be included in the legislation, since this has been sorely missing from the debate.

At the same time, the president stuck to his core message that we need to provide quality health care to all Americans. He said that one in three Americans have gone without health insurance at some time in the past two years. That seems about right based on anecdotal evidence in my practice. But the president pointed out that reforms are also necessary for the people with insurance. "Those who do have insurance have never had less security than they do today," he said.

It's now incredibly common to see patients who have either lost their jobs or are about to -- and they risk losing their health insurance as well. All President Obama or any politician needs to do is spend one week in my office or that of any doctor in America to see first hand how inefficient and unfair the health insurance industry is, and how frustrated both doctors and patients are as a result.

I saw a patient this week who was about to pay $1,500 out of pocket for a battery of lab tests (a Pap test, HPV test, STD screening and a cholesterol test) because her insurance company denied coverage. The first few tests are routine screenings for cervical cancer and the cholesterol test is obviously a preventive screening tool. The patient said she couldn't afford to have a colposcopy, a diagnostic test for cervical cancer even though the procedure was clearly necessary in her case. Fortunately, after the patient and my office staff spent two hours on the phone, the insurance company reprocessed the first panel of tests and covered them. Let me point out that the patient was a bright, educated woman; those without her persistence might not know to push back and challenge a denial of care.

I witness manipulative tactics like this by insurance companies every day that make it difficult for patients to navigate the system and get the quality care they're entitled to. The question is: Have enough Americans had similar experiences that the president's speech will serve as a wake up call to take action? Maybe Obama's simple yet stirring speech will inspire people to support the efforts to fix this problem, rather than let politics derail it.

Did he leave out details? Yes, there are still a lot of specifics to be worked out, which is why laughter erupted in the chamber when President Obama said, "There remain some significant details to be ironed out." But that's where Congress steps in to consider the various options and ideas, and to find compromise in order to close the deal.

So much of what has and will be written about the president's speech is partisan: The focus is on whether Obama will regain popularity in the polls and reinvigorate a faltering presidency or if Republicans will succeed in killing health care reform once again. From my perspective, this is not a chance to win a political victory. This is about finally being within reach of a health care system that works -- for everyone.

Russell Turk, M.D., is an obstetrician and gynecologist in Fairfield County, Connecticut.

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