When you hear of opposition to health care reform, look for the hidden agenda: Even though our health care system is in dire need of overhaul, so many people benefit from the status quo that they predictably oppose change. The health insurance industry, for example, takes about 13 cents of every dollar spent in health care (up to 40 cents if you purchase your own insurance as an individual), yet adds little value for that price.   That money represents income to many people, and they will fight to maintain a role regardless of its merit or expense to the rest of us.

Others, motivated by a desire to see President Obama fail, let ideology trump common sense. Equating health care reform with the apocalypse, a recent writer propagates distortions about euthanasia, baby killing and sex change operations. He obviously has neither read nor understood the various reform proposals, or willingly misrepresents them.

Ditto for our former Gov. Palin’s irresponsible comments on the topic of end-of-life counseling for elderly. The proposal to offer end-of-life counseling to elderly patients rightly allows our elders to know that they have options. While some will choose aggressive treatment, others prefer comfort care and a chance to die with dignity. She does us a disservice by equating this good medical practice with euthanasia.

Health care is too crucially important in our lives for reform to be distracted by these smokescreens. Access to health care helps us to be working, productive members of society, permits financial security and prevents needless suffering. It is essential to the dignity of human lives.

 In this country we provide care that is excellent for some, adequate for others, and out of reach for many. It costs too much for all of us. Our fragmented health care system rations health care, not by any logical means, but by making insurance financially unattainable for many and by denying coverage for pre-existing conditions. Furthermore, the financial incentives in our system encourage expensive procedures and undervalue primary care, prevention and cognitive skills.

In our own community, such incentives led to the acquisition of a $1 million MRI machine (a cash cow for the hospital), long before we funded a wellness program for the school district at a small fraction of the cost. This is because procedures such as MRIs pay well, while no money is to be made by keeping kids healthy.

Imagine living without the fear of bankruptcy from medical expenses, being able to change jobs without fear of losing insurance, or health care priorities based on science rather than profit. This is attainable if we are willing to accept a change in the status quo. 

What has gone mostly unsaid in this debate is the cost of doing nothing. The trajectory that we are on is unsustainable. We spend $6,714 per person every year (16 cents of every dollar spent) on health care. It is predicted that we will spend 20 cents of every dollar on health care by 2017. It’s not hard to imagine our economy seizing up under this crushing burden. (For comparison, the equivalent amount spent on health care in Canada is $3,678 per person, in England $2,780, and in Germany, $3,371. As a whole, the populations of these countries live longer and healthier lives than we do.) 

The nature of our political process has resulted in several imperfect health care reform proposals. They incorporate incentives to improve quality, allow portability of coverage and improve access to primary care.  They would alter the financial incentives in our system. They represent a step in the right direction, even if they maintain the current fragmented system of employer and government health insurance plans. (I, personally, would like to see a more radical overhaul, to a single payer system.  I believe this is the only truly rational way to achieve quality, access and cost control.)

We are a pragmatic people. We shouldn’t allow ideology and self-serving behavior stand in the way of needed changes. We need our representatives to support reform and work constructively with their colleagues to find the best achievable result. Please ask them to do so by calling Sen. Begich (202) 224-3004, Sen. Murkowski (202) 224-6665, and Rep. Young  (202) 225-5765.

What happens in Congress in the next month will affect all of us in the coming decades.

Dr. Paul Zimmer has practiced family medicine while living in Kodiak for the past 15 years. He earned his medical degree at the University of Washington, completed his residency at the University of Utah and earned a master’s in public health at Harvard. He helped establish the Kodiak Community Health Center To contact him call 486-6065 (daytime) or 481-7285 (evening) or e-mail kodiakzimmers@yahoo.com. Dr, Zimmer is not related to previous health care letter writer Art Zimmer.