Health Care Choices
Health care in America is in a state of crisis. It is not a crisis of our public safety net, although we must ensure that this safety net remains firm. It is not a crisis of the uninsured, although we must do more to make insurance portable and accessible to individuals in all stages of life. It is not a crisis of quality, although we must make certain that American medical care remains the best in the world. No, the health care crisis that we have in America is one of delivery.
Gone are the days where an individual bought his or her own insurance policy for catastrophic care while paying for incidental medical bills with cash. The employer now buys the health care plan for the worker, and ironically that plan disappears at the same time that the job disappears, even though that may be when the worker needs it most.
Gone are the days in America where a doctor and a patient together decided on fees and treatments. The employer and HMO now make medical and coverage decisions, often leaving both the doctor and the patient out of the equation.
Gone are the days where doctors were able to treat their patients to the best of their abilities and did not have to anguish over being sued for outcomes over which they had no control. Judges and juries now play God, trying to compensate those who receive bad outcomes rather than those who receive bad care.
Gone are the days where doctors were not only allowed, but also expected, to treat all individuals regardless of their ability to pay. The government now outlaws some charitable care, and the legal system repays compassion with litigation.
I have long fought to return to the days when doctors and patients made decisions together. I fight this fight now not because of nostalgia, but because of freedom and control. Both doctors and patients are captives in our new health care model, and both have lost control over their futures.
Returning this control to the individual is not easy. Medical savings accounts, those high-deductible catastrophic care policies that allow tax-free payments for low-dollar medical care, are a first step. President Bush's proposed tax credit is an important step, a step toward eliminating the perverse tax policies that have brought us the current employer based system.
I do not want a Patients Bill of Rights that simply provides guarantees to those already held captive by a hostile health care system. I want a Bill of Rights that releases our health system from captivity and returns freedom to both doctors and patients. Anything short of that freedom is failure.