MEDIA RELEASE

Former U.S. Rep. Ed Case is asking for opinions in an anonymous online survey about health care.

His latest newsletter:

Dear Friend,

In this enewsletter I sum up the reform debate fully underway in D.C. I also ask for your thoughts in this quick (anonymous) clickthrough survey after you’ve read this summary.

Terms. 

These are some common terms in the debate:

– Universal coverage. Available health care for all, whether provided publicly or privately.

– Public insurance. Health insurance available from government, like Medicare for seniors.

– Private insurance. Health insurance available from the private sector, like HMSA and Kaiser.

– Single payer. Health care paid centrally by government, whether provided publicly or privately.

– National health care. Government owned and operated health care, like the Veterans Administration.

– Public option. Government insurance available to those who don’t want or can’t get private coverage.

– Trigger. A public option kicking in if and when private coverage doesn’t do the job.

– Mandated coverage. Government-required insurance, like employer coverage of employees in Hawaii.

Other Countries. 

The debate also includes the pros and cons of different health care systems in other countries. For example, Great Britain has single payer tax-funded national health care. Japan has mandated universal coverage and active government cost containment of mainly private delivery. Canada has a hybrid of both. 

In general, these systems have mixed results on access (although everyone’s technically covered, actual access is a problem for many) and quality (as witnessed by many who seek treatment in our country), but have controlled costs better (although partly by limiting care). 

A great public broadcasting show, Sick Around The World, evaluates five systems and offers great lessons on what does and doesn’t work and why.

Debate. 

Like every difficult debate in Washington, this one’s framed by directly opposing views. 

One is that nothing’s really wrong with health care in our country and that, if any reform is needed, it should be only to improve private delivery. 

The other is that everything’s wrong with our system and that only national health care to the exclusion of private insurance and delivery will fix it.

The real discussion is taking place, as it always does, between those poles. 

One key issue is whether to mandate universal coverage and, if so, through government or private delivery. The pros include that it would certainly increase access and might spread out overall health care costs; the cons that it might overburden our struggling businesses and not improve cost and quality. 

Another is whether to implement a single payer system; the pros include that it might reduce crushing administrative burdens, and the cons that it would create a new government bureaucracy.

The eye of the debate storm is over a public option, meaning government health insurance existing side-by-side with private insurance and available to all, such as through an expansion of Medicare or the federal employees health insurance program, with or without a trigger. Its supporters, President Obama foremost, believe that the only real way to increase access, reduce costs and increase quality is to create a government-run alternative to private carriers. Its opponents fear that, besides the additional bureaucracy, it will end private insurance and lead to national health care.

As much as some want to ignore it, an unavoidable core of the debate is the cost of any reform and its impact on our rapidly deteriorating federal budget. Any of the reforms substantially expanding government’s role are priced at huge figures, some well in excess of $1 trillion over the next decade, and the question is how to pay for that. 

Supporters believe that can be made up through cost containment, preventative medicine and health technology savings and through tax increases, and that the current costs of a broken health care system are far greater. 

Opponents doubt cost containment and practice savings alone will finance reform and believe that additional costs should not worsen the budget. 

Here’s a realistic summary of the hard choices being considered to pay the bill: Health Care Reform Payment Options. (http://crfb.org/documents/HealthOffsetoptions.pdf)

The debate is further complicated by a whole range of difficult, polarizing and interrelated issues, ranging from reforming tort laws to saving Medicare to increasing medical professionals and reducing prescription drug costs. 

But for most, the central question remains how best to increase access to affordable quality health care by all Americans without breaking our national bank and harming our economic recovery.

In my next enewsletter I’ll report on your survey responses, update the Washington debate and share my further views on our best way forward. 

As always, I deeply appreciate your consideration and welcome your comments. 

Again, here’s the survey: Health Care Survey

Mahalo and aloha,

Ed Case

U.S. Congressman (2002-2007)