Let’s Not Lose Healthcare

For many people, the temper of a presidential election year is electric. It’s an opportunity to change the world around them, debate important issues and shape political discourse. For others, it is more than a year of inescapable, non-stop shouting, mudslinging, petty party politics and unsubstantial messages spoken in television-friendly sound bites. If you subscribe to the latter philosophy, you may think that this kind of circus actually distracts from the real work that needs to be done.

That may be true to a certain extent, but the delay is momentary. While modern political debate may have lost a little of its elegance and patience, it’s a necessary process—more than simply electing a national leader for the next four years—that helps to engage people and encourage discussion (friendly, we hope) about issues critical to the American people, resulting in a willingness to get involved and/or stay informed. We receive and process tremendous amounts of information so quickly—news feeds on our BlackBerries, text message alerts to our cell phones, streaming real-time video online—that picking where to begin (and what’s true and what’s not) can be a challenge. Too much information can be a blessing and a curse. When it comes to politics, however, more information usually is a good thing.

The current problems on Wall Street—bank failures, talk of government bailouts, mortgage and credit crunches—have dominated the news. As both Republican and Democratic candidates have framed it, there is a struggle between Wall Street and Main Street. While the media and public attention may be focused on finances, other critical issues remain. One of those, of course, is healthcare.

The debate is based on people’s ability to afford healthcare through health insurance and the quality of healthcare (clinical quality, availability, safety, access to technology). The dominant solution revolves around ensuring that all Americans have affordable insurance. The split between the right and left sides of the aisle comes down to how to do this. In general, Republican candidates favor market-based solutions while Democrats seem to favor universal health plans sponsored whole or in part by the government. When both camps address clinical quality and safety, the discussion turns to the expanded use of electronic health records. Each campaign seems to agree on the value here.

Sen. Barack Obama’s plan for access would create a taxpayer-funded national health insurance program that would be similar to the plan available to members of Congress. People who don’t qualify for Medicare or Medicaid but still need financial help would receive an income-related subsidy to either buy into the national plan or to go toward the purchase of a private plan. For those who want to keep or buy private insurance, Obama would create the National Health Insurance Exchange, a watchdog group that would make sure private insurers offer options at least as generous and comprehensive as those offered under the national plan. It also would make it illegal for insurers to deny coverage based on pre-existing conditions. In addition, the Obama plan would expand Medicaid to cover more categories of people and expand State Children’s Health Insurance Program eligibility for children.

Sen. John McCain’s healthcare plan would not create any new insurance programs. Instead, it would make the number of people who can afford coverage larger by offering tax credits of $2,500 for individuals and $5,000 for families to go toward the purchase of an insurance plan. The McCain camp has said the rebates would be budget-neutral, because the money would come from raising income taxes for employees geared to the amount their employer spends on their healthcare.

In order to give people cash to spend on healthcare, however, Congress would have to approve raising income taxes for people whose employers pay for their healthcare. That seems to be an unlikely outcome no matter which party controls Congress. The Obama camp also will have to provide details on how much new plans and oversight will cost. If the billion-dollar financial market bailout proceeds, decisions will have to be made. Pennies will be pinched, and the issue of fixing healthcare will be put on the back burner yet again.

I contacted both campaigns to discuss their respective plans’ impact on medical technology. The McCain campaign did not respond. The Obama campaign said they would try to “get an answer for me soon.” As of press time, there was no response. Well, perhaps I’ll be able to use this space to discuss the impact of a new president’s policies on the medical device industry, post Nov. 4. There will still be plenty to talk about. The modern healthcare debate goes back to Lyndon Johnson’s Great Society, and it will continue for years to come. But it’s important that it be discussed even after the political ads, the speeches and the shouting all go away. We all have a stake in this, and those of us who work in the medical technology industry are uniquely positioned to shape the outcome (no matter how you voted). In his Supply Chain column this month (page 30), Chris Oleksy reminds us that we’ll all be patients someday.

He writes: “We all can engineer the correct solution to healthcare and medical device reform if we focus on the right person, doing the right thing, at the right time, in the right place. It won’t be easy … it might not be cheap … but it also isn’t optional. The quality of our lives depends on it.”

Now, that’s right.