Philadelphia Inquirer January 26, 2010
Meaningful reform will require courage
By Valerie Arkoosh
Doctors can empathize with the president and Congress right now. Treating a relentless disease can be enormously frustrating, and sometimes we may feel tempted to give up and walk away. But just as doctors stay with their patients, Congress and the president must stay with their patient, the American public, by keeping their commitment to strong health-care reform.
Although the political world went topsy-turvy last week, the Massachusetts vote did not change a single thing for American patients. Close to 50 million remain uninsured, those with preexisting conditions still go uncovered, and many face delays and denials of care.
Over the past week, a number of prescriptions have been offered for the reform effort. Besides abandoning it entirely - which would be wrong for the reasons mentioned above - they include passage of only the least contentious reforms, in a compromise with Republicans; and House approval of the existing Senate bill, for which the support has been almost entirely Democratic.
Passing only the most popular parts of the bills would only create new problems. For example, if Congress requires insurance companies to cover all preexisting conditions but does not require that everyone purchase insurance, the commonsense response for most Americans would be to wait until they get sick to buy insurance. It would be like requiring car insurers to sell coverage at accident scenes; insurance premiums would skyrocket, and the insurance system would fail.
And if Congress does require everyone to purchase insurance, there must be provisions for those who can't afford it - pointing again to the need for a comprehensive bill.
The only sensible way forward is House approval of the Senate bill. The Senate and House bills have much in common: Both would eliminate the worst insurance-company abuses, create consumer-friendly insurance markets, help people afford insurance, change the way doctors and hospitals are paid to reward high-quality care, increase the number of primary-care doctors, and encourage preventative care.
The two bills differ in some important ways, including how we pay for reform and how much help low-income Americans will get. But these differences can be reconciled later through a process known as budget reconciliation, or in the three to four years before the legislation is fully implemented.
Despite all the talk during the past week of watered-down health-care reform, Americans will have to take a big step forward if they want to substantially improve the fairness and security of the system. It's up to the president and Congress to lead us in taking that step. Baby steps won't work.
At this critical moment, the president and Congress must not abandon the American people who elected them to solve this problem. They should move to pass the Senate bill and fix our failing health-care system.
Solving real problems, like curing tough diseases, is hard. Like doctors who muster the courage to prescribe a difficult but necessary treatment, our leaders must have the courage to put patients ahead of politics.
Dr. Valerie Arkoosh is a professor of clinical anesthesiology and critical care and of clinical obstetrics and gynecology at the University of Pennsylvania School of Medicine. She is also the president-elect of the National Physicians Alliance. She can be reached at firstname.lastname@example.org
This editorial appeared in the Philadelphia Inquirer January 26, 2010
Reprinted with permission
Link to original: http://www.philly.com/inquirer/opinion/82664417.html