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Friday, August 21, 2009
Talking health care reform in Carrboro

LAST TUESDAY NIGHT I was having a drink on the patio outside Panzanella in Carr Mill Mall following a meeting at Club Nova intended to help the board catch a new vision of the future of a great organization.   I have the privilege of serving on the board of this program which works with people with severe and persistent disabilities.  The other board members are some very smart, well educated and earnestly caring people; how I got on this board, I have no idea.

This group confounds one observation I believe generally holds true (often attributed to Winston Churchill):  "Anyone who is not a liberal when they are young has no heart.  Anyone who is not a conservative when they are old has no brain."

As we sat in the warm evening air, we discussed the sad state of care for those with mental illness before the conversation moved on to the current debate on health care reform.  I tried to stay out of the amicable agreementfest that was substituting for a serious discussion of the troubles reform was having but only could do so for so long.

I began my comments by saying I really didn't want to get into a political discussion because I doubted that any one of them would agree with me on much of anything.

In 1992, when Hillary Clinton was given the task of reforming our health care system, I observed, she blew it by following a faulty, secretive process.  The country was ready then for real change but not for change imposed from the top from behind closed doors.

The current effort, I noted, trying to hurry through Congress a 1,082-page bill that many of those sponsoring it hadn't read, and certainly didn't understand the implications of, wasn't a process that would have been used to implement so much as a new rule on snack bar hours at Club Nova, where members and staff diligently work together to make things work in genuine consensus.

My explanation for why so many ordinary people now felt like someone was trying to sneak something by them was simple: someone was trying to sneak something by them.

We also talked about spiraling medical costs, after it was mentioned how in our personal experience so many seemingly unnecessary medical tests get ordered these days.  I asked, "Do you know why that's so?  I'll give you a hint: My wife is a lawyer."  I then added that any reform effort that claimed to contain costs but did not include tort reform was not serious -- which was a kind way to word it.

In my next statement I might have been a little more diplomatic if we hadn't just spent 30 minutes talking about how Medicaid rations care via strangulation administered with bureaucratic red tape.  In that context, I had a hard time not rebutting our table's consensus that further nationalizing health care will solve all our problems.  "Correct me if I'm wrong," I asked, "but Medicaid is a federal government program, isn't it?"

One person pointed out that she gets her Social Security check every month.  My response was that collecting money from taxpayers and writing checks were things that government was very good at.

At that point the guest speaker at our board meeting pointed out that one individual at one of the health care town hall forums had asked, "The government runs Medicare and it’s going broke.  The government runs Medicaid and it’s going broke.  The government runs Social Security and it’s going broke.  Tell me why I should trust the government with my health care?"  Then he added, "It was a good question."

It was a heartening moment for me, a meeting of the minds, suggesting that perhaps real health care reform is possible.

Coming soon, maybe, a new column: Fixing what is broke without breaking what isn’t in American health care.


Gary D. Gaddy has a private health insurance policy with a $20,000 deductible and pays his doctor bills from a Health Savings Account.

A version of this column was published in the Chapel Hill Herald Thursday August 21, 2009.

Copyright   2009  Gary D. Gaddy


Authored by Gary G. Gaddy at 8:24 AM EDT
Updated: Wednesday, October 21, 2009 4:07 PM EDT
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