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Health Focus: The Role of Government in Health Care

Drawing the line but missing the point.

The bitter debate going on in Washington is really nothing new for health care since the opposing parties have very different views on how care should be delivered in the United States. We are unique in the world since we have an employer-based system that dates back to World War II when wages were frozen but employee benefits were not, so today if you have a job there is a good chance that you have some health insurance. Somewhere around 160 million of us get our health insurance from employer-based or individual private insurers.

Government, public insurance, is another important source of coverage with Medicare and Medicaid providing benefits to some 100 million children, elderly and poor. This leaves about 50 million without private or public provided health insurance, namely the uninsured.

When you consider that we spend more than any other country in the world in absolute dollars and per capita but fail to insure 50 million, you naturally ask the question- Why is this so?
The simple answer is that health care in America is very expensive and grows at a far faster rate than almost every other product or service we buy. This fact underlies the escalating costs of health insurance premiums and makes it increasingly unaffordable for many low wage individuals, small firms, and of course the poor who are not poor enough to qualify for a public program like Medicaid.

The debate of how to address this problem is between social conservatives who argue that the employer-based system is best versus social liberals who support a stronger role for government. Conservatives blanche at more government and point to the shaky solvency of Medicare and the financial stress that Medicaid places on states and local governments. Liberals portray the current system as lacking basic fairness as the uninsured are forced to seek care in hospital emergency departments or denied needed care altogether. Conservatives seek ‘market solutions’ whereas liberals rely of government support.

What is the role of government? We could probably get wide agreement that we need public support for the disabled, aged and the poor. However defining who is poor is where a line must be drawn. The new reform law crafted primarily by social liberals provides support by extending Medicaid income eligibility and providing subsidies to lower wage earners in the coming exchanges. Conservatives blast these provisions as overreaching and financially irresponsible.

All this wrangling is about how to make health insurance affordable but little is being said about how to address the underlying problem-- the excessive cost of health care in America. Isn’t it time that we stopped relying on politicians for solutions and instead took some personal responsibility? Why don’t we individually declare a war on obesity? Think of this. Nearly one-third of children ages 10–17 and U.S. adults were overweight or obese in 2007. And with the strong association between obesity and many chronic diseases, including type 2 diabetes, cardiovascular disease, several types of cancer, musculoskeletal disorders, sleep apnea, and gallbladder disease- isn’t it smart to shed some pounds? A slimmer nation will be healthier and less costly to care for. Let’s make it happen- THIN IS IN!

John Sardelis is an Associate Professor of Health Administration at 's Long Island campus in Patchogue.

Patchogue Patch encourages our readers, writers, political officials and anyone in the Patchogue-Medford area to submit their personal views on current events and issues as articles for our Opinion section. Articles submitted should not exceed 500 words, and all submissions will be considered. Please note that these pieces are not necessarily representative of the opinions of Patchogue Patch and represent that of the author. Submissions should be sent via email to michael@patch.com

Kate Fenton February 23, 2011 at 02:15 PM
The ACA healthcare reform has focused too long on insurance reform, with all of the resources going to access and increased services. Reform in quality, including patient education and support, coordinated care, and individual responsibility must take place for healthcare in the United States to stop spiraling out of control. Government involvement should not focus on mandating insurance purchase and access alone, preventative education imperative and is often one of the first programs cut during difficult economic times. The Department of Health and Human Services Public Health incentives have been grossly underfunded. Perhaps the government should “tax” the large for profit insurance and pharmaceutical companies to help offset the funding of educational programs targeted at the at risk population. The ACA is a band aid to a cumbersome, highly politicized health care system; its greatest achievement is bringing the problem to forefront of the American Public’s attention. The first step in reform and recovery is admitting there is a problem, now we all must become educated, active and responsible “consumers” as we weed through the mess.
michelle cheslak February 23, 2011 at 09:12 PM
This current healthcare system is a mess ! We hear constantly about the different ideas and suggestions for the future of our healthcare system. Politicians continue to agrue of what should be implemented in the healthcare system. You can call my glass half empty, but this feels like an ever ending debate of healthcare. I agree that the future rest in the hands of educating the people and taking into personal account of our own health. The price of cigerettes has increased, why not increase or put a high tax on the fast food and unhealthy foods. Yet we all have ideas how to fix it and we continue to eat at mcdonalds.
Louanne Charles February 25, 2011 at 08:39 PM
Sometimes the saying "If it ain't broke don't fix it" is irrevelvant. We should look to resolve issues before they occur. From both a political and individual perspective, we need to take a greater approach to prevent problems even if there is no major concern. I try my best to be as "health conscious" as possible and it is often taken offensively by others because I eat right size portions, drink lots of water, consume fruits and vegatables from time to time, and try to get enough exercise. However, because I am of moderate size for my height, or what some would consider small framed, and do not have any major health issues, negative comments are often made like "are you on a diet?" and "why do you need to exercise?". You see the misconception is that only people who are heavy/overweight or have major medical concerns should watch what they eat and exercise regularly. The reality of it is that this is the type of society that we have grown to accept. It is time for use as individuals to take the first step in the betterment of our lives and of our health overall. Let's not wait until something is wrong to try to find drastic ways to resolve it - at mot times, when its already too late. As for govenmental influence, just as they have pay-for-performance incentives for physicians who actually meet their guidelines, maybe its time to have a pay-for-initiative incentive for individuals who follow recommended governmental guidelines for preventive care.
christine diah February 26, 2011 at 12:46 AM
It is sad that so many americans are without health insurance coverage especially those with challenging medical conditions but as the health care reform takes effect, we hope that this will change . Most of the HMOs will not support the reform and there are many people that oppose the reform. So, helping the uninsured to get health care coverage will always be a challenge in this country.
Jeremy Engdahl-Johnson March 01, 2011 at 04:06 AM
What is the economic burden of diabetes? Proper mgmt and control could save 49,000 lives and $196 million annually. http://www.healthcaretownhall.com/?p=2699

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