I studied engineering in college. Like most engineers, I believe that the most important step in problem solving is making sure that the problem is well defined. Most of the confusion and disagreement surrounding healthcare seems to be caused by a lack of a real problem definition.
Unless everyone agrees on what problem we're trying to solve with healthcare reform, there's no real way to have an intelligent discussion about it. Right now, everyone is talking about reforming "healthcare". When it's one word like that, healthcare seems to cover doctors, hospitals, insurance carriers, agents, consumers, employers, and just about everything else in this world.
I suggest that we break this issue into at least three smaller (but still massive) categories:
- Medicine - What can doctors, pharmaceutical companies, hospitals, etc. do to make the actual cost of medical care cheaper? This includes topics such as medical I.T., HMOs, medical research, and hospital networks.
- Insurance - Insurance is the main way major medical bills are paid, so it is obviously important to make sure that most people (if not all) have insurance, that it's affordable, and that it's being paid for and selected by the right people.
- Financial Aid - This is very different than insurance. By definition, insurance isn't meant to cover preexisting conditions (As I mentioned earlier). Also, the price of insurance right now is fine for many Americans but a lot of people want to help low-income people with these costs.
Let's say we all accept that these three different categories. How does this change the discussion?
The main difference is that we aren't trying to magically put together a plan that allows everyone to have good insurance that costs the same for everyone and doesn't cost very much. It's impossible. A lot of people have expensive medical conditions. If insurance covers those people and they pay the same as everyone else, that means everyone is going to have to pay quite a bit. The math is pretty clear.
With my proposed definition, it's obvious that insurance isn't what should cover those preexisting conditions. Sorry to sound like a broken record, but insurance is all about RISK and I don't understand how risk is involved when we're talking about buying Insulin for a diabetic. That person needs the Insulin no matter what. It's not an issue of risk. It's an issue of...wait for it...Aid.
So let's make sure everyone can get insurance (to cover future expenses), and provide aid for the sick, poor, and elderly. We're doing ourselves a huge disservice by trying to squeeze a square peg through a round hole.