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Jul 17, 2017

A Caregiver's View Of the Healthcare Debate

The wall of noise from Washington over the healthcare debate continues to bombard America’s senses and sensibilities. With President Obama’s plan clearly circling the drain, Democrats still seem willing to defend the indefensible. An admission of specific mistakes while offering concessions on their part appears unlikely.


Click the play button to hear the monologue from Peter's Radio Show for Family Caregivers.  (Listen for Peter's hilarious Trump impersonation, as well!)

While the Democrats refuse to own the problem, and instead serve as political roadblocks, the GOP shares culpability. The Republicans’ appear bent on proving that their proficiency to protest eclipses their abilities to produce results. Once again, America's seems at the mercy of political leaders who rail against a system they perpetuate.

"During the last eight years of complaining, did no Republican draft some sort of plan and stick it in a drawer in case, you know day they won an election?"

With equal fervor, both sides portray themselves as knowledgeable about healthcare. Yet, little seems forthcoming regarding their specific experiential qualifications of navigating a system they seek to alter or impose. In the three decades serving as my wife’s caregiver, I’ve dealt with virtually every aspect of the healthcare system.  Engaging more than 80 physicians,7 insurance companies, and 12 hospitals provides ample experience navigating the system.  Furthermore, medical bills soaring past $10 million developed a skill-set of resourcefulness.

OBAMACARE Forced Me to Forage For Another Plan—TWICE!

When the ACA launched, my insurer of ten years phased out my plan—while offering a more expensive one.  After purchasing an ACA-compliant plan (hardly “affordable”), my dismay compounded as my new group quickly left of the ACA. This left me to forage again for quality healthcare coverage. While my wife’s medical needs remained stable, I—like many caregivers—struggled with my own healthcare concerns. The immense crisis of tending to a disabled loved one’s ongoing needs has a way of consuming a caregiver’s resources and attention; consequently, caregivers often make do with the scraps.

A Simmering Issue

Currently, more than 65 million Americans serve as family caregivers. In addition, the caring for the massive aging baby-boomer population is driving that number higher.  According to AARP  17% of caregivers consider their own health at risk.  Furthermore, 72% of caregivers don't see their own physician regularly.  What happens to the patient when (not if) the health of those caregivers prohibit them from caring for their loved ones? As our country wrestles with a healthcare plan, a strong emphasis must address preventive care—with a specific targeting of caregivers.  Families with special needs children require consideration, as do those caring for loved ones with traumatic brain injuries.  In addition, those caring for vulnerable loved one with disability, as well as the aging are also at risk for high-stress related health issues. Those concerns, and a lifetime of experience prompts several key questions as Congress develops a plan.  Whether they either fix the ACA, or repeal and replace it, the hope is that somehow, they can put aside their  self-interest agendas, and focus on practical help for the people the claim to represent and serve.  With the political/media acrimony and resolve to never compromise on their ideology, the outlook is bleak for our country. At one time, parents used to say no to children—paving the way for those children to become adults.  Children hate limits, and it's up to adults to instruct and lead until they can put limits on themselves. When adults fail, children fail more. The same principle applies to an entitlement driven society.

Is it Sensible?

A healthcare plan requires a healthy dose of common sense. If people make unhealthy choices, why must their consequences be dispersed to others? Rather than compensating for people’s lifestyle choices, we can refuse to reward them and, when necessary, levy consequences. At the same time, there should be financial incentives toward healthier choices for subscribers. I currently subscribe to a plan that does that very thing.

The Right to Healthcare?

Additionally, the American people seem also to disagree on whether healthcare is a right or not. People who voluntarily sacrificed money, time, and labor to learn skills form the medical field. Must their profession be singled out from other professions catering to the necessity?  How about food production? Grocery stores? Plumbing? As a society, we have commissioned our government to subsidize health are for the poor, but to equate it as a right would ultimately mean potentially subsidizing every American, along with the training of every healthcare worker. Even taking all the wealth from the “one-percenters” would only delay the inevitable collapse. It is simply unsustainable. Must potential surgeons, nurses, lab technicians, etc, sacrifice and train for a profession that they must offer? Furthermore, how can the industry attract the best and brightest if government officials are the ones dictating the worth of their specialized skills and services?

If healthcare is a right:
  • Is everyone entitled to any and all medical services they desire?
  • Who makes that decision?
  • Can medical providers can only charge what the collective agrees to?
  • Will we get medicine at the lowest bidder?  Is that a good thing?
  • Do surgeons who receive less compensation make better surgeons?

In vying for votes and political power, Washington seems to have corrupted the healthcare industry, and now the “bill is due.” Sensible often means sacrifice—which should look like policy-makers doing what is best for America, not for their career or party. It should look like America tightening its belt and making hard decisions.

"Pre-existing conditions are a way of life for me, and have been for three decades.  I took jobs, carried two policies, and made sacrifices to cover it.  Now, I'm asked to subsidize people unwilling to do the same."

We either sacrifice now and accept limitations on services and amenities, or we can expect massive consequences that dwarf what we currently face.

Is Portable?

The vast population of aging baby boomers means an increasing number of families are stepping up to care for elderly loved ones. If a person’s healthcare coverage isn’t portable, the “out of network” issues serve as additional burdens. Crossing state lines to purchase and use healthcare coverage should not be an issue for caregivers. A portable plan promotes competition, which always benefits consumers.

Is it easily Accessible?

Healthcare coverage must provide something of value to subscribers. Forcing someone to purchase a healthcare plan that essentially only covers the person in the event of a zombie apocalypse is a smokescreen, because in reality, non-users end up paying for users. A quality plan needs to be accessible to all who desire to use it, without unreasonable barriers to coverage, and it should include a heavy focus on primary- and preventive-care services.

Will it be Reliable?

Families such as mine, who have diligently planned and budgeted for healthcare coverage years in advance, are put under great duress when political agendas disrupt our best-laid strategies. We caregivers, who already live in a realm where there is little margin for error, have enough on our plates without Washington imposing its limited understanding of a caregiver’s world. It’s time to unite all the players in creating a bedrock plan—one that will garner confidence and peace of mind because of its effectiveness.

A Mess of Their Own Making

The horrendous roll-out of the ACA, along with soaring medical costs, lack of access to insurance, and the exodus of trusted carriers is bad enough.  Not to be outdone, the disorganization, infighting, and poor leadership within Republican ranks compounded the problems.  Add partisan foolishness to the mix, and it’s easy to erosion of confidence from the American people.

Is it Economical?

With America $20 trillion in debt, solid financial sense must guide the conversation. We know that unhealthy caregivers make poor caregivers. Likewise, an unhealthy country is hardly up to the task of caring for its citizens, much less those beyond its borders. Imposing an costly, ideology-driven, healthcare plan on US citizens will only result in failure. We have simply to look at the Affordable Care Act to see evidence. While the ACA incorporates some good ideas, the current model contains too many subsidy paths. With America’s debt load, how can our country sustain these subsidies? Quite simply, it cannot. For caregivers (and economies) to remain healthy, we must accept what is—and start from there. A caregiver with any longevity can testify that, while we cannot always create more resources, we can learn to be innovative and resourceful. America as a country needs a healthcare direction in which economic limitations override political agendas.

Sensible, Portable, Accessible, Reliable, Economical (SPARE)

These simple guidelines can help us find our way through the quagmire, while also equipping consumers with a tool by which to measure the quality of Washington’s work. The circumstances we caregivers face each day are often grim and heartbreaking. Rather than trying to feel better about our circumstances, we must learn to be better as we endure these challenges. American history is filled with individuals who emerged to provide true leadership in the face of daunting challenges. Our national opportunity in this current healthcare crisis is to avoid the enticing trail of “feeling better.”  Rather, we can choose to put our collective shoulders to the wheel and, together, become better.