MILEPOSTS
Today's Government Healthcare Issues
By KRISTY ROBINSON

Why do we need a public option in Obama's health care plan? Many Americans, including some adult children of aging parents and older Americans, ask that question. What these voters and the general public may not realize is they already have not just one but TWO giant public insurance programs and they work. They work very well indeed.

In fact, the federal government already accounts for 35 percent of the expected $2.5 trillion in health car spending this year between Medicare, the V.A., Medicaid, children's programs, military personnel and federal employees.

The V.A. Medical Benefits Package offers a rich public insurance plan run by the US government. It is a public option for veterans. This superb health care plan serves men and women. I recently took a client to a doctor’s appointment at the V.A. in Nashville and asked the doctor to put my card in the file of my client. The doctor said, "The V.A. hasn’t used paper files for our patients in over a decade, its all computer based, every detail."

Electronic medical records are one of the main planks of the Obama plan. They can stop expensive duplicative tests and polypharmacy, plus they allow physicians to work together as a team. The V.A. has had this system in place for years. The V.A. benefits include: preventative care, outpatient care, diagnostic and treatment services (like emergency room care), surgery, substance abuse programs and mental health care.

Medications, both over-the-counter and prescription, are also part of this public health insurance plan. On top of this last benefit, long ago the V.A. negotiated with the drug companies to get all its drugs at a great discount.

Let's look at our existing Public Option Number Two: Medicare. Even with its flaws, this dazzling insurance program covers all people of 65 and over plus younger individuals with disabilities. For over 45 years Medicare has done a great job as a publicly run insurance program.

Under the Medicare benefits payment system, elders get outpatient services—the same way they would get them with other types of health insurance. They are eligible to receive services from any hospital or community mental health center that
participates in the Medicare program.

As a health insurance program run by the federal government, Medicare provides lowcost hospitalization and medical and prescription drug insurance for the elderly. It was created by the Lyndon Baines Johnson administration in 1965 and it was fought against much like the current health care plan.

The basic idea for Medicare is for the government to provide health insurance as part of Social Security. Part A covers hospitalization; Part B pays for doctors' services, outpatient hospital care, outpatient physical and speech therapy, some home healthcare, ambulance services and some medical equipment and supplies.

Part B coverage is voluntary. The monthly premium is automatically deducted from your Social Security check each month. If you don't receive Social Security benefits, you will be billed for Part B.

Obama's health insurance plan is trying to rid Medicare of inefficiencies such as duplicative tests ordered by physicians and polypharmacy (where many doctors order the same drugs, with the left and right hands having no idea what the other is doing). As previously stated, this is already in place in the other public option the V.A. Medical Benefits Package with the electronic records system.

Currently the sticking point that is getting all the media attention is the so called "death panel." As a care manager of elderly people, I was consulted, along with a team of doctors, family members and a chaplain discuss the pros and cons of
keeping an elderly person alive on a ventilator when there was no living will in place and no hope of life returning or if the body did return, the brain was damaged. This panel of people who were experts in their fields by no means was interested in making this difficult decision for the family; we were simply presenting the facts as we knew it for the family to make an informed decision.

If each person were to discuss their end of life wishes with their doctor and loved ones before they are in a medical crisis then there would be no need for such a discussion.

Everyone needs to formulate a list of what he/she wants included in this legislation and then communicate this information to his/her congressional legislators. A well worded communication from a constituent will be better received than shouting outside the legislators’ offices that you're opposed to euthanasia.

If no health care reform legislation is enacted this year, the status quo will preV.A.il for MANY years. People will lose their health insurance if they lose or change jobs. People will declare bankruptcy because they can't pay bills for health care received. People will continue to ignore chronic conditions and become more ill. Health insurance will be a commodity only the rich can afford.

I encourage you to share your opinions with your congressional legislators now.

Kristy Robinson is a certified geriatric care manager with Robinson Kelley Care Consultants. She lives on Highway 96 with her three children and husband Scott. She can be reached at 615.397.1078.