This is a picture of me and my advisor here at PAHO, Dr. Shirley Alleyne. Dr. Alleyne is a Barbadian, which is somewhat unusual for a PAHO technical officer. Most of the time PAHO brings outsiders into country/regional offices to bring new perspective to the region. Dr. Alleyne is an MD, specializing in psychiatry. She did med school at the University of West Indies but completed residency in Syracuse, NY and a fellowship at Yale so she has experience with America and American culture. We generally have weekly chats about NCDs (non communicable diseases), Caribbean culture, and other health issues. Yesterday's discussion started out with Dr. Alleyne asking me what I thought about Obama's health reform. She wanted to hear an American's perspective and as I'm the only American in the office, she asked me. I have been reading some, but I am by no means on expert on the topic. I don't really know what's best, but I don't think I agree with universal health care. As I started explaining my thoughts, she started going off on how the reform will never pass because Americans are capitalists and we don't really want to take care of everyone. Now, I agree that we should take care of the poor, we need to provide disadvantaged populations access to services, but I'm not sure throwing $1 trillion into government programs is the way to go. The more I talked and the more she did, the more flustered I got. I do believe in personal responsibility and I don't really want to pay for the drug addict in Philly or the smoker in Kansas who can't pay for cancer treatment. Now, I understand there are lots of hard working people who simply don't have insurance or who have health challenges that are no fault of their own. The American system is expensive and we still have low health outcomes in many areas. Where should we be putting our money? How do we help those who have no opportunity to help themselves? Will/Can the private sector step up? Do we need government to be in charge of health care? I think government should govern, not execute the daily decisions of our lives, but how do we do that? How do we find the tide that rises all the boats? Is there such a thing as a compassionate conservative?I'm asking for your thoughts. I got quite frustrated yesterday because I wasn't able to articulate my position and I came off sounding like the bad guy, the mean, uncaring, rich, white girl who doesn't know what it's like to not have access to health and education. I'm really interested in hearing what you think. I'd love for this to become a forum for ideas to be tossed around. Next time someone asks me about health reform, I want to have a few more concrete answers.
p.s. countdown: 10 full days left in Barbados; 5 days of work
Hmmm, that´s the million dollar question, or in this case, the trillion dollar question.
ReplyDeleteI´m not great at explaining my viewpoint on this issue either, so I´ll have to think about it for awhile.
Ashley hasn't commented yet? I'm shocked. Maybe she's getting ready to make her own post on the subject as a comment may not be sufficient! :)
ReplyDeleteI've been thinking about this a lot lately, and I want to just put this idea out there.
ReplyDeleteSo the first thing is there is no magic fix-all. I remember hearing the saying that "A good plan violently executed now is better than a perfect plan executed next week." So, although the system proposed by Obama is imperfect, we are getting to the point where a half-good plan is better than nothing.
One of the problems with our system is that there is very little competition between insurance providers. As a working person, I have never had to choose my health care plan... my employer does that for me. However, if I was able to select from many different insurance providers, sort of like I do with car insurance, providers would be in direct competition for each other and the overall cost of healthcare would decrease.
Driving costs down has never been adequately achieved by anything but real bona fide competition.
Another unrelated idea, is making the American more responsible for personal health choices. For example, just like life insurance, if someone is engaging in high-risk behavior, their premium will be larger. Why should I have to pay for someone else's bad decisions (e.g., smoking)?
Ok that's it for now. Wow I wrote a lot! What other ideas do you guys have?