Many Unanswered Questions

On Health Care

To the Editor:

The health care commentary by Michael Keegan and speeches by President Obama leave many questions unanswered. True, health care reform has not been getting an honest debate but castigating the more vocal opponents adds little positive to the debate.

Where are the proponents and Mr Keegan’s specific, factual responses to the issues and concerns with the proposed health care reforms?

* Why hasn’t Congress held public hearings? Isn’t this issue important enough to get it right? With hearings, the “extremists” might have less to be upset about.

* Where is the in-depth analysis of why health care costs continue to grow or why US health care is more costly than in other countries? How much is spent because of drug addiction? Alcoholism? Misuse of prescription drugs? Being overweight ($117 billion a year per the overweight Surgeon General)? Smoking (President Obama smokes)? Service to illegal aliens? Lack of tort reform? Unchecked theft in government programs; e.g., Medicare? Why isn’t this its own issue rather than a potential saving to support reform?

* The Congressional Budget Office states that health care reform would add significantly to the deficit. How do proponents, as promised, propose to enact reform without cost?

* Why a penalty (tax?) on persons deciding not to purchase health insurance? Shouldn’t this be a personal decision?

* Why should voters trust their representatives who admit to not having read the proposed bills?

* Medicare does dictate medical decisions. Some tests have frequency limitations. Other requirements exist that limit doctors’ decisions. Shouldn’t the public expect similar, restrictive regulations (especially to save money), under health care reform?

* Should reform permit optional procedures?

* Are there sufficient medical practitioners and facilities to meet the increase in demand for services?

* Shouldn’t tort reform be in the proposals? Malpractice costs may be about two percent of health care costs. However, the cost of related defensive medicine is probably much, much more. What, is the cost of extra tests, visits and treatments to limit exposure in the event of lawsuits?

* The President and others state that bureaucrats will not make decisions. Why then does the proposal give the Secretary of Health, Education and Welfare discretion to set rules and regulations? Shouldn’t a 1,000-page proposal cover this?

Of particular concern, the Secretary is to develop “quality measures” on end-of-life care. Couldn’t this allow this bureaucrat to set measures making what could be defined as poor advance planning a medical error (malpractice) adversely impacting doctors and, therefore, patients? This “death panel” concern could easily be eliminated by expressly stating in the reform that no regulation may be enacted that would make lack of or “inadequate” end-of-life planning in any way be considered inadequate care by the doctor or a patient error.

Whatever the ultimate proposal is, members of Congress, in particular, and government employees should be directly covered. With skin in the game Congress may actually design a bill that gives consideration to reality.

Hank Kessler

48 Elizabeth Circle, Sandy Hook                        September 15, 2009