Asking the Tough Questions: Of Ourselves and of Our Candidates
Questions to Ask Ourselves
Wherever our healthcare system is headed in the future, we should ask ourselves some important questions along the way. We are each a patient or potential patient, voter or potential voter. We have a role in deciding what our healthcare system will look like in a year or ten years, but we also have a responsibility to figure out what we're willing to do to get there.
Below you'll find questions to consider as you figure out what kind of healthcare system you want in America. Background on these questions can be found in The Issues sections of this site. You can also follow the links in the questions for more information.
1. Do we have a moral obligation to provide healthcare to everyone as needed or is healthcare a commodity that should be subject to the same marketplace influences as other commodities?
2. What should the government's role be in providing access to healthcare for Americans?
3. According to a study in The Journal of the American Medical Association, nearly 40 percent of physicians have manipulated insurance reimbursement receive needed care. For example, physicians have exaggerated patients' symptoms to allow them to stay in the hospital longer, and changed patients' diagnoses for billing purposes. In our current healthcare system, is this justifiable or unethical?
4. Do insurance companies and HMO s use unfair practices to control spending?
5. Should employers be required by law to offer health insurance to employees?
6. Should employees be required by law to participate in employers’ health insurance .
7. Should everyone be required to have health insurance. much as drivers are required to have auto insurance?
8. Our system of health insurance is linked to employment. Coverage is usually provided by the employer, with some contribution from the employee. We now have many people working part-time, or freelance, or working through other non-traditional arrangements.
Should health insurance continue to be linked to employers (our “employer-based system”) or is there another preferred approach?
9. Who should decide when a healthcare service is medically necessary: the doctor who is treating the patient or the insurance plan who is paying the bill?
10. “Evidence-based medicine” tries to reduce variations in practice, reduce inappropriate care, and reduce waste by using results of studies of large groups of people as the basis for medical guidelines. On the other hand, some feel that
it is bad medical policy to apply general rules to all cases and that medicine requires that the physician use his or her knowledge of the particular patient in deciding on the course of treatment along with the patient. What do you think?
11. Some feel that healthcare is a commodity like VCRs or computers and that it should be distributed according to the ability to pay in the same way that consumer goods are. Others feel that healthcare is a need and that it should be distributed according to need. What do you think?
12. Currently, individual health insurance policies are much more expensive and/or do not offer the same services as group insurance. However, in most states the law does not allow people to form a group for the purpose of getting health insurance .
Should individual policies cost the same as group policies? Who should pay the individual’s additional cost? (the individual? the government? the insurance company?) Should it be legal for people to form a group themselves, such as through the internet, for the purpose of getting a group insurance policy?
13. How much, if anything, would you be willing to pay every month so that everyone could have access to basic medical care? Nothing? $25/month? $50/month? More? What should “basic medical care” be? Who should decide?
Asking the Tough Questions…of our candidates
This questions below are presented courtesy of the League of Women Voters Education Fund (www.lwv.org) and the Henry J. Kaiser Family Foundation (www.kff.org). It contains excerpts from a nonpartisan public education initiative to inform citizens, stimulate dialogue, and give the public a greater voice in the health care debates during the 2000 elections.
The following are sample questions you may want to consider in beginning the dialogue with candidates on healthcare reform:
Do you think that all Americans should have health insurance .
Should the federal government help people who don't have health insurance .
If yes, should the federal government make a limited effort to provide health insurance for some of the uninsured. or make a major effort to provide health insurance for everyone?
Do you favor a specific proposal to reduce the number of uninsured Americans?
If no, why? Is this because you don't believe the government should address the problem? Or for some other reason?
If yes, please describe the features of this proposal, especially how it reduces the number of uninsured .