Health Care Reform – Why Are People So Worked Up?


Why are Americans so worked up about health care reform? Statements such as “don’t touch my Medicare” or “everyone should have access to state of the art health care irrespective of cost” are in my opinion uninformed and visceral responses that indicate a poor understanding of our health care system’s history, its current and future resources and the funding challenges which America faces going forward. While we all wonder how the medical care system has reached what some refer to as a crisis stage. Let’s try to take some of the emotion out of the debate by briefly examining how health care in this country emerged and how that has formed our thinking as well as culture about health care. With that as a foundation let’s look at the pros and cons of the Obama administration healthcare reform proposals and let’s look at the concepts put forth by the Republicans?

Access to state of the art medical services is something we can all agree would be a good thing for this country. Experiencing a serious illness is one of life’s major challenges and to face it without the means to pay for it is positively frightening. But as we shall see, once we know the facts, we will find that achieving this goal will not be easy without our own individual contribution.

These are the themes I will touch on to try to make some sense out of what is happening to American health-related and the steps we can personally take to make things better.

A recent history of American health – exactly what has driven the costs so high?
Key elements from the Obama health care plan
The Republican view of health care — free market competition
Universal access to high tech health care : a worthy goal but not easy to achieve
what can we do?
First, let’s get a little historical perspective on American health problem. This is not intended to be an exhausted look into that will history but it will give us an appreciation of how the health care system and the expectations for it developed. What drove costs higher and higher?

To begin, let’s turn to the American civil war. In that battle, dated tactics and the carnage inflicted by modern weapons of the era combined in order to cause ghastly results. Not generally known is that most of the deaths on both sides of that war were not the result of actual combat but to what happened after a battlefield wound was inflicted. To begin with, evacuation in the wounded moved at a snail’s pace and this caused severe delays in treating the wounded. Secondly, many wounds were subjected to wound care, related surgeries and/or amputations on the affected limbs and this often resulted in the actual onset of massive infection. So you might survive a battle injury only to die at the hands of medical care providers who although well-intentioned, their interventions were frequently quite lethal. High death tolls can also be ascribed to be able to everyday sicknesses and diseases in a time when no antibiotics existed. In total something like 600, 000 deaths occurred from all causes, over 2% of the U. S. population at the time!

A few skip to the first half of the 20th century for some additional perspective and to bring us up to more modern times. After the civil war there were steady improvements in United states medicine in both the understanding and treatment of certain illnesses, new surgical techniques and in physician education and training. But for the most part the best that doctors could offer their patients was a “wait and also see” approach. Medicine could handle bone fractures along with increasingly attempt risky surgeries (now largely performed in sterile medical environments) but medicines are not yet available to handle serious illnesses. The majority of deaths remained the result of untreatable conditions such as tuberculosis, pneumonia, scarlet fever and measles and/or associated complications. Doctors were increasingly aware of heart and vascular conditions, in addition to cancer but they had almost nothing with which to treat these conditions.

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