Well, the proposal, as understand it (bearing in mind it is over 1000 pages long & I have NOT read all of it!) will do a good thing and some bad things.
The good thing is it will bring health insurance to more people. Those people are currently not getting good care, they go to the ED only when they are desperate, and they get emergency care that is very high quality but they don't get the follow up care that is needed to provide good overall care. Getting more people insurance is a good thing, no doubt about it, a VERY good thing.
The first bad thing is that it does NOTHING to control cost drivers. Unhealthy lifestyle, demand for expensive testing whether appropriate or not, demand for maximum care even when that won't change the outcome, physicians need to do tests to protect themselves against lawsuits -- none of these are addressed directly.
Secondly, it won't stop insurance company executives from paying themselves ludicrous amounts of money. Not that that is a huge cost driver, but it sure sticks in the craw of physicians and patients!
Thirdly, it WILL cut reimbursements to physicians. Now, some physicians are very generously paid indeed & could easily survive a pay cut. Pediatricians, general internists, family practice physicians, and obstetricians all do NOT make all that much money. They earn $100,000 - 200,000 a year before taxes. Good money but not great. Most of them have $25,000 or more per year in STUDENT LOAN repayments, plus they have mortgages, car payments, children to raise & send to college, and retirement to save for. Physicians don't get 401K matching payments, so they have to put away all of their retirement money themselves. If their pay is cut by much, they will simply quit practicing medicine, reducing the supply of physicians in the most needed categories, those that provide primary care. We already have a shortage of these types of physicians in some parts of the country.
There are other shortages too, including rheumatologists (who treat patients with severe arthritic conditions), and neurologists, who treat brain & nerve disorders, including things like multiple sclerosis & stroke. These folks are not well-paid, because they have to spend a long time with each patient to explain things to the patient, because it is complicated and because frightened people have a harder time absorbing information quickly. Many of these types of specialists will also decide not to practice medicine any more if their pay is cut.
So there's my perspective. Am I against health care reform? No. But I am severely unimpressed with the current proprosals.
