Health care in America must be an incredibly fascinating topic to the rest of the world. We are a distant outlier — no other developed nation has the problems that we have. I have certain opinions about it that may or may not sit well with some in South Hillsborough, and I am aware that my opinions also contain a certain hypocrisy.
I was working for the U.S. House of Representatives when the Affordable Care Act was being debated and ultimately passed. During that time I was struck by just how much something as basic as human health could be so politicized. It was not productive; in fact, in my eyes what happened was counterproductive to the extreme — and both parties were to blame.
All legislators on both sides of the aisle received the same reports and numbers showing that future health-care costs would almost certainly seriously damage, if not consume, the U.S economy within a decade or so. All but the most myopic lawmakers knew that something needed to be done. Whether what was actually done was the right thing is highly debatable (I realize that is stating the obvious), but both sides knew that something had to change or this nation would have a problem of horrific proportions on its hands.
The Democrats passed the legislation with no votes from the Republicans. I suspect if things had been reversed, that if the Republicans had been in power, they may have passed similar legislation with no votes from the Democrats. It was all a huge political game with enormous stakes. My guess is that, for some moderate Republicans, their greatest fear was that some Democrats would bolt, leaving absolutely nothing for a solution and at least a decade of waiting before someone developed the courage to try again. Many legislators knew that could be a Very Bad Thing for this nation.
Keep in mind that, with the exception of one president, all other presidents since Theodore Roosevelt have attempted to pass some form of health-care reform. That is a century of trying to make something happen, to make something different and more workable. An entire century.
The late Massachusetts senator, Ted Kennedy, reportedly once said that among his greatest regrets was not accepting a health-care reform offer from President Nixon because he didn’t feel at the time that it was enough. But it would have been a start, at least; and that is how big, social legislation works in this country. It is imperfect and it is messy. But over time, it is supposed to get better. And now, 40 years later, we’re still fighting about the very beginnings of it.
Dr. Satya Gullapalli at Prime Care of Tampa Bay is my doctor, and, to me, she exemplifies the very best of American health care. She is patient and thorough and listens to me whine about this or that, things that are suddenly beginning to ache with age. I’ve had some great doctors in my time, but she is the best. I’ve never had to wait more than a few minutes for an appointment, and yet she allows all of the time I want. She is an outstanding doctor and a shining example of why so many people believe that American health care is the best in the world.
I do not want the government to tell me that I may or may not see her as my doctor. Also, I want her to make boatloads of money for what she does. She deserves it. She took on the massive undertaking of becoming a doctor, and she excels at it. She has earned what should be a significant financial reward in my book, although I know with certainty that financial reward had little to do with her choice to become a doctor.
All that said, I do not believe that human health care should be entirely a free-market commodity. I do not believe that health care should be a luxury reserved merely for those who can afford it.
I also do not believe (and this required a new paragraph) that the burden of providing health care should be placed upon the shoulders of businesses, such as it is today. Small- and medium-sized businesses — which make up a huge portion of the U.S. economy — have enough to worry about without having to deal with providing health insurance to their employees. To business, that is purely a cost, and it has no revenue potential. Providing health insurance is not the business of American business. At least it shouldn’t be. It is a burden that they simply do not need and should not have (in my opinion).
There are some people in this country who brutally and casually abuse U.S. taxpayers. I know one such young woman who is a poster child for all that is wrong with the safety net provided by our tax dollars. Yet I have to believe that she is an exception. And I believe that such abusive exceptions are the lesser evil to not providing health care to the far greater majority who need it but cannot afford it. We are supposed to be an advanced nation, and, again, to me, health care should not be purely a free-market commodity. It should not be lumped into the same category as buying a Ford or a Chevy.
I don’t understand why a basic level of health care cannot be provided via a simple (and, one would hope, relatively painless) tax on income (which, of course, would go hand in hand with reform legislation that would rein-in malpractice insanity). That would remove the burden from business and help to ensure that emergency rooms are not jammed with people who allow the taxpayers to foot the bill. If you lose your job, you would still have your basic health care. And yes, if you make more income, you’ll pay more for your health care, but that wouldn’t remove an incentive to make more income — because, in making more, you can buy more comprehensive health care (along with a nicer home, a nicer car and a bigger TV).
It is the same concept that if you lose your job and don’t pay income taxes, you don’t lose your citizenship and status as an American. Why is that so complicated? How could that be evil? My wife and I pay a boatload of money for health insurance, but, if it came right down to it, I would pay more still if it meant that I could keep Dr. Gullapalli. Yes, it would mean yet another tax, but it would almost certainly be less than what we’re already paying via hidden taxes. I’m no more a fan of hidden taxes than I am of placing a needless burden on U.S. businesses.
I am not even remotely suggesting the end of private health care or private health insurance. But no one’s primary physician should be an emergency-room doctor. That is just insanity.
At this point in my life, I gain no real, immediate advantage from the Affordable Care Act. I don’t have children to keep on my health-insurance policy, I have no pre-existing conditions, and I am extremely happy with the service I have now, despite that the cost of it has risen dramatically over the past decade. But I also know that could change.
And for this nation, things are going to change whether we like it or not, for better or for worse. My fear is that unless we can come together as a nation, with an honest, open-minded debate and without the political games and brinkmanship, we may well be facing “for the worse.” And that would be a Very Bad Thing for all of us.