Newsletters

Fall 2009

Healthcare Reform and You

Congratulations if you have health insurance and are happy with the cost and the benefits you receive. Unfortunately, for many this is not the case. The number of uninsured is high, especially in New Mexico. The cost of health insurance is also high, and rising every year faster than the rate of inflation. If you are fortunate enough to have insurance, you may find that “co-pays” and “deductibles” are more than you can afford, impossible to understand, and sometimes charged in error. You may have difficulty finding and keeping a primary care provider, or have long waits before getting an appointment or having a test completed. You may be restricted in the hospital, lab, or X-ray facility you can use. Drugs may have to be obtained by mail order (no more friendly neighborhood pharmacist), with rules about generics, brand names, and “tiers” of drugs. With Medicare, you may encounter the “donut hole,” where you lose your drug coverage until you have first spent a specified amount of money. Medicare is running out of money as the population ages and there are fewer younger workers to contribute to the pool of available funds. Technological advances are pricey to develop and expensive to maintain. It costs about $1 billion to develop a new drug before it is approved for use, but it may not be affordable even if it is available.

For these reasons and many others, our entire healthcare delivery system has rightfully come under great scrutiny. The three areas of major concern have been identified as coverage, cost, and quality. Universal health insurance coverage of some type is generally felt to be a desirable goal and is consistent with policies in most other Western countries. Cost containment, with inevitable restrictions on some types of medical care, is a necessary but contentious part of the package. But what about quality? Are there safeguards to assure that the medical care is as good as it can be? Is preventive healthcare available when it is needed? With bone density testing for osteoporosis, for example, Medicare cuts in reimbursement are so severe that most facilities are being paid far less than the cost of providing the test, forcing some to close down and others to restrict their services. The result is likely to be fewer patients with osteoporosis being diagnosed, fewer being treated, more broken bones, and higher fracture-related costs to Medicare.

What to do about all of this? First, stay informed. Organizations such as the AARP are a great source of information. Second, don’t listen to bizarre rumors. There are no “death squads” for seniors being planned. Finally, make your thoughts heard. Tell your senators and congressman how you feel about your healthcare, so that we can get the best healthcare we can afford for ourselves and future generations.

E. Michael Lewiecki, MD                                    
Lance A. Rudolph, MD

This page update 09/30/09