Once the House and Senate come to an agreement about health care reform, it’s widely expected that the number of Americans with health insurance coverage will increase, likely by tens of millions of people. But as many people have pointed out, simply having health insurance does not mean that a person actually has real access to health care. Some people will opt for high-deductible, HSA-qualified health insurance policies because of the lower premium costs, only to find that they are unable to pay the deductible when they need care. Others will find that their area is under-served by medical professionals, with long wait times to see a doctor. In addition, we know that the people of Colorado are a relatively healthy bunch, despite being near the bottom of the country in terms of the percentage of our population that has health insurance. There’s a lot more involved with good health than simply having health insurance.
Dr. Michael M.E. Johns and Dr. Edward D. Miller have written an opinion piece about the need for more physicians in the US. They point out that there is already a shortage of doctors in some areas (especially PCPs), and that significantly expanding the ranks of people with health insurance is likely to increase the demand for doctors. It is true that our emergency rooms are overflowing and that finding a doctor who takes Medicaid can be a challenge. And yes, newly insured people are likely to need care soon after they secure health insurance, as they may have been putting off seeing a doctor for some time while they were uninsured.
But what if we were to address the issue from a prevention angle instead? What if instead of working to boost the number of physicians, the government were to take steps towards making the American public healthier, thus reducing our need for medical care and additional doctors? Revamped farm bills with subsidies to make vegetables less expensive than fast food would be a good start. So would more strict laws governing pollution and toxic chemicals in our environment – things that are making people sick all over the country.
Much has been said about individual responsibility when it comes to our own health. No matter how good our doctors are, they are not babysitters, and they can’t be with us on a daily basis to make sure we’re making good choices. Neither can the government, for that matter. But the government can create policies that make the good choices easier and less expensive than the bad choices, and that just might make a difference. Perhaps the next step in health care reform should be working to make Americans healthier to begin with, rather than trying to figure out how to fix us after we get sick.