Bill Lenoir

Congratulations to President Obama for his success in passing health care reform. I do not believe the plan goes far enough, but if he had failed, his presidency would have been dead in the water. I do not want to risk having the Republicans return to power. Now this plan is the status quo. It will be far easier to improve than to eliminate it.

This struggle was far more difficult than it needed to be because the Democrats lost the battle over defining success. They didn't effectively communicate their values. Allow me to layout mine should I find myself in Obama's shoes.

This I Believe

1. Healthcare is a right not a product available only to those who can afford it.
2. Health care should be about more than just the immediate medical concerns of an individual. It should look at the larger picture, including food production, the environment, education and, heck, even urban planning (why can we not live without cars?).
3. Healthy people are fundamental to a functioning society.
4. Science informs us as to what are the safe and effective options, but the patient should select from those.
5. Resources are limited, so we need to have our priorities clearly defined.
6. If someone has the money and wants to undergo a procedure that science indicates is a safe, but not effective one, the individual should retain the right to pay for it himself.

Success Criteria

The two sides' success criteria were the fundamental flaw in the healthcare debate: cost vs. availability. I think both are too shortsighted and a focus on only that will lead to unforeseen consequences. These are my goals:

1. Everyone^a gets a regular checkup^b and any issues discovered are dealt with^c in a timely manner^d.
   1. I mean everyone! Citizen, legal immigrant and illegal alien. I realize this is a tough sell and may not be achieved all at once, but if health care is a right, how can we deny it to someone based on their immigration status?
   2. I'll leave it to science to determine the frequency and realize it will vary. I'm sure it depends on age, sex, personal and family history.
   3. The science should tell us that, given what we know, these are the options that have proven to be safe and given the circumstances of the patient, should be effective.
   4. The health system will fail if we cannot deliver service in a timely manner.
2. Most people^a are found to be healthy.
   1. The percentage TBD, but I would expect it to start off lower than I would want, but grow over time.

It is that last criteria that is key and no one has addressed it any debate I heard. It's the whole point of health care, is it not? If our system doesn't make us healthier, then it has failed.

Policy

Shit, I don't know. I don't have any experience in the field of medicine beyond being a patient. I do agree that the 3-legged stool that is the Obama plan is a good start.

1. No denial for pre-existing conditions.
2. Everyone must be insured or else no one will buy until they are sick.
3. Subsidies for those at the lower end of the economic spectrum.

I am not sure where we go from here. I do know that we need some sort of public option. I see no role for health insurance companies. What value would they add to this system? A value, at least, that is commensurate to the profit they suck out of it.