One way or another, the current arguments in Congress over our national health care policy will bring new costs, changed services and more uncertainty to our local families, work places and medical institutions. In Washington, D.C. it’s all about politics; here, in our Sonoma County homes, it’s all about coverage, cost and care.
The Washington debate is about all the wrong questions over big tax cuts for the rich and a worn-out pledge to “repeal” Obamacare. Here, we have different questions. But this national political debate has been going on for so long, we can’t remember what those questions were.
Costs for private insurance premiums, co-pays, drug prescriptions and hospital visits have been increasing by double digits for 20 years. More of us than just the poor or the unemployed began losing health care coverage long before there was Obamacare. A decade before the 2008 recession employers were already cutting their employees’ health benefits. Lots of us couldn’t wait to get old so we could enroll in Medicare — no matter our political affiliation.
So, if we don’t want Congress telling us what kind of health care we can have, we better remember some of those original questions that we still have not answered.
In 2001, a group of local doctors ran a full-page ad in this newspaper and called Sonoma County a “Bosnia of healthcare.” 350 doctors signed the ad and urged their patients to “take personal responsibility for your health and the cost of using the health care system.” The doctors pledged to, “create an efficient, sustainable, coordinated health care delivery system in Sonoma County that meets the needs of all participants.”
Later efforts, including a 2004 conference at Sonoma State University and a county government-led Health Action Plan launched in 2007 asked these original questions:
1) How do we make quality health care more affordable for more people?
2) How can we help more people take more responsibility for their own health with better diets and lifestyle choices?
3) How can we better coordinate our local health care system to guarantee everyone has a medical home?
Match these questions against the questions now being argued by Congress. How to defund Planned Parenthood, shrink Medicaid and once again allow private health insurance corporations to restrict coverage for certain essential health benefits is what the Republican majority in Congress are asking themselves.
These are vital questions for the for-profit insurance companies, drug manufacturers and medical industry stockholders. These are unhealthful questions for the rest of us.
It’s astonishing to realize that Sonoma County is no longer a “Bosnia of health care.” That’s because most other parts of America have far worse health care costs and limited access than we do. We share in the opioid crisis, the shortage of doctors and the under-funding of our community hospitals and clinics. But we are benefitting locally from a more complete roll-out of Obamacare that many states blocked for political reasons.
The increases in annual health insurance premiums have actually slowed here and all health plan coverages are now better. By law they now include free diagnostics, pre-condition coverage, comprehensive female coverage and capped administrative fees. Thanks to expanded Medi-Cal, some 30,000 more county residents now have a medical home.
Don’t think for a minute we have settled on any real answers about our health care crisis. Premiums and hospital bills are still too high, some drug costs are criminal and caregiver charges, reimbursements and regulations are more out of whack than ever.
But don’t think for another minute (or second) that Congress, the Trump Administration or the so-called open market of medical profiteers have any better answers for us.
If we could get those hundreds of local doctors to update their full-page Q&A from 2001, perhaps we could match some real questions with real answers.
