Response paper- “Now What?” essay, from The New Yorker

The “Now What?” essay begins with a public memory and history of President Lyndon Johnson signed Medicare into law on July 30, 1965.  It describes what kind of issues President Lyndon Johnson faced after he signed the bill and his resolution to overcome any difficulty for the bill to survive.   Soon after Medicare bill passed into law the American Medical Association waged a war trying to stop the program and doctors weren’t to give up the fight again the socialized medicine.  Ten thousand physician members of the Ohio Medical Association declared that it would refuse Medicare. Many hospitals, especially in the South, were segregated and the law required them to integrate in order to receive Medicare dollars. Alabama’s Governor George Wallace was among those who encouraged resistance. Two months before coverage was to begin, half the hospitals in a dozen Southern states had still refused to meet Medicare certification.  Hundreds of thousands of elderly and black patients would have found their hospitals and doctors’ offices closed to them. Johnson recognized the threat and outsmarted his challengers by sweet-talk and compromised with the doctors, giving the A.M.A a seat on the advisory council that oversaw rules and working with it on a series of thirty “improving” amendments to the legislation. President Johnson was not compromised with the hospitals, however Medicare became possible because hospitals decided to abandon segregation rather than lose federal dollars.

This essay also points out some of the problem that President Obama will be facing after he signed health reform into law last week. Even though this bill could prove as historic as Medicare but it battle has just begun.  History could be repeated itself; however, this time the environment and situation are different because both the A.M.A and hospital associations were support of the legislation, the public was dropped and most insurers favored the bill. President Obama’s opponents come from party politics. Conservatives are casting the November midterm elections as a vote on revoking the health reform law, and also may take advantage of the administrative difficulties of creating state insurance exchanges and insistence that health reform is unaffordable. If they regain the power then the health reform would be banded. The best way to protect reform is to prove the doubters wrong.  The cost of insurance has increased dramatically over the past decades, far exceeding the general rate of inflation in most years.  According to Atul Gawande, “In 1965, health care consumed just six per cent of U.S. economic output; today, the figure is eighteen per cent. Nearly all the gains that wage earners made over the past three decades have gone to paying for health care. Its costs are curtailing all other investments in the economy, and, if they continue to rise as they have been doing—twice as fast as inflation—the reform’s subsidies not to mention America’s prosperity will indeed prove unsustainable. The reform package emerged with a clear recognition of what is driving costs up: a system that pays for the quantity of care rather than the value of it. This can’t continue.”  The health reform bill only survives and resistance is defeated if our local communities and clinicians would be participated.

Atul Gawande’s essay on the health care reform law is targeted everyone in United State.  People with or without health insurance is favored the bill and wondering what will be the next step? Can the bill survive? How can we pay for it?  Insurance companies and doctors will find a way to work around and fight against the bill because it will cut into their profits.  Obama administration and democrats hopefully would work together to find  resolution to defeat their challengers and protect the bill to win the November Midterm election; while republicans would be used every parliamentary tool available to try to revoke health care bill and  regain the power of the house.  Why I am not surprised to see this battle between two political parties because Politicians on both sides will do anything to secure contributions and funding.  The main thing that both sides head towards is money and wants to save money just in different ways. Most conservatives are against this reform because they are rich and don’t want pay more taxes to fund this plan.

Everyone in America wants to be healthy, but it is very difficult when many Americans cannot afford health insurance. The Health Care system is believed by most people as a need for change because of the problems that the system faces today cannot be handled. Every month, 2 million Americans lose their insurance. 37 million Americans have no insurance and another 22 million have poor coverage. Losing or changing a job often means losing insurance.  Becoming ill or living with a chronic medical condition means losing insurance coverage or not being able to obtain it.  Long-term care coverage is inadequate.  Families exhaust their savings trying to provide medical expenses for disabled relatives.   Problems like these are issues that politicians are constantly working to come up with a solution but no one has been able to create with a perfect one yet. President Obama proposed Universal health care plan to revolutionize medical health insurance which basic health needs can be paid by a single government payer. The goals of this system are to cut medical costs, make the delivery of health care more efficient, and to promote preventive medicine, health, and primary care. While these changes are positive in many ways, they are also creating concerns among both the health care consumer and provider.

In my opinion, I think that increase in medical proceedings is one of the most important factors of health care crisis. However, our current health system is based on money. Health Insurance is one of the nation top problems, the cost is rising for premiums, and many businesses just cannot afford it.  Most employees rely on their employers to provide them with health insurance; however, most employers are hiring part time employees, therefore not qualified for benefits, like health insurance. From this problem a majority of Americans on nationwide basis do not have health insurance. This brought up a huge issue at congressional debates, but little is done about it. We need to find some way to make sure that every citizen of the United States is able to have affordable healthcare for themselves, and their families.

Through some examples and evidences that Atul Gawande presented in her essay I learned that health care is a very unpopular issue, as fixing it would require taxing on wealthy and an issue that many governments cannot afford to touch. It is also not as easy as the political experts might have you believe or issue driven as the media might try to convince you. It’s a difficult plan with far reaching consequences that must be weighed.  Health care reform has been addressed and recognized of these issues. The current party in power finds it difficult to pass unpopular legislation that it could be held accountable for.  The fight over health care reform shows, the political atmosphere of 2010 resembles neither 1965. 

With healthcare reform passed last week, the next big legislative battle will be over financial regulation reform. This is hot political topic and an issue that will be heavily discussed for the next few months. From the politicians point, there are two ways of viewing the health care reform cost issue.  One, Mr. Obama opponents remains of the insistence that health-care reform is unaffordable to win the Midterm election to regain the power of the house, and the other, Obama administration must defeat their doubters and protect the reform.  From my point of view, Republicans are not backing up President Obama with healthcare reform because they think that healthcare is a Democratic issue, but they are wrong. Healthcare is a nationwide issue. It seems that Republicans currently in Congress could not come up with any plan to resolve healthcare problem; but will not stop fighting and preventing Democrats and President Obama from having a political victory of healthcare reform even though it already has been passed. Republicans are satisfied with the way healthcare is now, they just want to use the health care reform cost issue as a tool to achieve their goal of win the Midterm election. The good news is that American realizes the cost of insurance having increased dramatically over the past fourth decades.  The current state of health care in America is inefficient or useless and change is needed but there are conflicting opinions on how drastic the change should be.  Many people believe that the bill will be a good thing and help many Americans stay healthy; while some believe the bill will not improve anything except wasting money and the cost to maintain the reform is too high.    When it comes to the U.S government it is no surprise that the cost of healthcare has been an upfront issue.

Everyone has an opinion and regardless of which side you take, one thing is clear; we want to have a better health care system which is costly efficient to the nation.  The goal of “Now what” essay is to provide an overview of some of the different ideas and the readers can form their own opinion on the new battle of health care reform and how it can be defeated.  It is our responsibility to ensure that our legislatures work on behalf of us not on the insurance and pharmaceutical companies’ side. I believe our country could benefit greatly from a universal health care program, if given the proper time to develop a comprehensive plan. However, if a weak plan is implemented too early, a new problem could develop that is far more a problem than the one we face now.

Words cited:

1.       Now What?, Copy  of essay ( http://www.newyorker.com/talk/comment/2010/04/05/100405taco_talk_gawande?printable=true)

References:

2.       http://www.americanprogressaction.org/issues/2009/02/health_in_crisis.html

3.       http://news.google.com/newspapers?nid=1828&dat=19860710&id=_E0gAAAAIBAJ&sjid=tKYEAAAAIBAJ&pg=6606,4525903

4.       http://moneywatch.bnet.com/economic-news/blog/maximum-utility/who-benefits-from-health-care-reform/539/