Health Reform Has to Be More than Health Coverage
Too much of the public discourse and debate around health reform focuses on the issue of financing — who pays and what they will pay. For many Americans, having an insurance card and guarantee of payment do not equate to health or even access to health care. Millions of Americans live in communities with no hospital, few doctors and only a handful of limited specialists within miles.
We get bogged down in whether or not we should have a single payer system or employer and individual mandates, without the benefit of a fuller understanding, agreement and commitment to what we are trying to achieve. If what we are trying to achieve through health reform is some level of health care coverage for all Americans, we have truly missed the mark. The current structure and financial incentives for health care financing are often contrary to maintaining the health of a community or population and do little to ensure equitable distribution of our health care resources, particularly in areas of greatest need. The financial incentives and interests of the various healthcare industry stakeholders are not aligned with prevention and disease management, much less serving the chronically ill or rural, urban and racial/ethnic communities. What is the value of an insurance card if you can’t get to care in a timely manner, or experience disparities in health care?
One writer suggested while there are disparities in health, there are no disparities in health care. Data indicate this is far from true. Too much of the health reform debate and legislation are being framed by and for the insurance, pharmaceutical and health care industries. Where is the discussion in health reform about eliminating health care disparities, realigning the financial incentives to drive the equitable distribution of health care resources and setting standards and goals for the delivery of care? Maybe this is where the discussion should start.
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