The New Health Care Reality

Abbeville, Louisiana –  Dr. Marilyn Marshall

The New Health Care Reality

Recently, the Supreme Court of the United States heard arguments over the constitutionality of The Affordable Health Care for America Act passed by Congress in November 2009.

• Read House version H.R. 3962 introduced in 2009

The issue is whether the federal government can require individuals to buy health insurance if they choose not to, in order to provide health insurance to millions of Americans currently without coverage.

The constitution grants individuals freedoms and rights. It certainly seems reasonable that individuals purchase what they choose. But the notion of access to health care being a right was enshrined into law when Congress made it illegal for hospitals and doctors to deny care in emergency situations, whether the individual has insurance or not.

In cases where these individuals do not have insurance, the costs are borne by those who have insurance. These costs come in the form of higher insurance premiums, higher deductibles, and higher co-pays–the so-called out-of-pocket expenses.

Due to age, accident, or injury, most Americans will eventually require access to health care. There is no buying insurance when you need it because no one is capable of determining when the need will present itself.

So why should these individuals get free health care at the expense of others? The case before the Supreme Court illustrates that it is not always easy to find harmony with a perceived freedom and a perceived right, particularly when exercising a freedom results in the negative consequences of shifting costs to others and no penalties for engaging in behavior with negative health effects.

Medical practitioners and providers have a duty to manage these negative consequences as they relate to health care, providing health care when needed and absorbing or shifting the costs when patients don’t have insurance.

Too many patients are far too removed from the costs associated with unwise choices made about their health. These patients feel free to indulge as they please then seek that magic pill to ameliorate the health consequences of these actions. Surely, these patients see their activities as freedom, while doctors call this non-compliance and add to the overall costs of their care.

Your Body. Whose Bill?

Study after study concludes that there is a direct correlation between diet and exercise and the advent of many preventable diseases such as diabetes, heart disease and strokes, obesity, and cancer.

These preventable diseases will consume larger amounts of our health care dollars unless the focus in health care becomes prevention.

The CDC estimates more than 40% of the adult population will become obese. If the projections hold true the entire health care system will be unsustainable.

• Read more: US Obesity Trends from the CDC

Regardless of the Supreme Court’s ruling, the concept of shifting health care costs over to the insured must be abandoned. A system of incentives must be put in place to reward patients for prudent health care decisions and a system of penalties for activities that add to cost. Welcome to the new realities of the American health care system.

More about the health care reform debate

• NYTimes.com Times Topics: “Health Care Reform and the Supreme Court”
• HealthCare.gov: The Affordable Care Act, What’s Changing and When (timeline)
• TheRoot.com: “The Supreme Court and Health Care Reform” (Blog)
• The Huffington Post: “Why Health Insurers Are Counting on the Supreme Court to Uphold ObamaCare” (Blog)
• CATO Institute: “Bad Medicine” (White paper)