Time fo find people 'medical homes'

By Dr. Michael J. Pramenko
Grand Junction CO, Colorado
September 28, 2007

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    It’s heating up.The debate on health care reform is picking up speed as the premature presidential race accelerates. Unfortunately, this naturally leads to polarization of opposing views regarding a critically important issue for all of us. And this cheapens and oversimplifies the discussion.

    Our health care system, now responsible for one-seventh of our whole economy, can’t be corrected with one liners and political scoring points.

    We need cooperation. We need compromise. We don’t need political hoopla.
Thankfully, the continued work of the 208 Commission is a good example of how a group of people with differing views can work together on a critical issue. It would be premature to grade their efforts. However, they are making progress and we all should support their endeavor.

    Last spring, Club 20 faced the same task. A group of individuals, with significantly different political persuasions, met to develop a health care reform plan. After months of discussion and debate, we agreed on a bold plan for reform. And like the 208 Commission, we agreed that an individual mandate would be an important element in the foundation of health care reform.

    Why an individual mandate?

    To answer this, one must first understand how our current system operates. In America, anyone can go to the emergency room and receive care if they need it. In that sense, we do have a socialized system of health care. Nobody is turned away based on their inability to pay. As a result, we all pay an indirect tax for this universal health care. Those with health insurance pay more to help cover the cost. Businesses charge more for their American-made products to help cover the cost. Hospitals charge more for everything to defray the cost of treating the poor.

    An individual mandate seeks to distribute this cost more evenly amongst the population. At the same time, by increasing the number of insured individuals, fewer people will need to use the extraordinarily pricey emergency room. Why? They will have health insurance and access to physicians offices where medical care costs much less than emergency room care. They will have a “medical home.”

    In addition, those individuals will then have access to preventive health care. That’s a big deal. The whole system saves money when preventive health care is enhanced. Case and point: It’s much cheaper to treat diabetes early than to ignore it and treat the heart disease, kidney disease and vascular disease that result from ignoring the problem.

    It makes sense. Many Republicans and Democrats alike are beginning to agree on this important element in health care reform. Again, the 208 Commission and Club 20’s health care reform committee each include an individual mandate in their proposals for health care reform.

    The alternatives include the continued acceleration of health care premiums at an alarming rate to cover the cost shift of the ever-increasing uninsured population. Or, as some suggest, we can restrict medical treatment to only those people with the financial means to pay.

    You decide.

    Indeed, the system is designed to help anyone in their time of medical need. An individual mandate simply asks everyone to help finance that very same health care “safety net.”

    You may not need it today. However, if and when the time comes, there is a place where doctors are available 24 hours a day to save your life. Whether it’s a heart attack, car accident, severe infection, or a premature infant — a physician is available to step in and save a life. Currently, that system is strained under the stress of dysfunction.

    It’s time to work together to make it better — for everyone.

    Dr. Michael J. Pramenko is a family physician at Primary Care Partners. A graduate of Dartmouth Medical School, he did his residency training in Grand Junction at St. Mary’s Family Practice Residency. As president of the Mesa County Medical Society, Dr. Pramenko currently serves on the Colorado Medical Society’s Congress for Health Care Reform as well as Club 20’s Health Care Committee.