Just saw the CNN report on 13 million uninsured 20-somethings in this country. New to the job force and turning down their health insurance.

What are they thinking?!?! Do they believe that they can just go out and buy what they need in terms of medical goods and services on the free market? Good grief! This is America for goodness sakes.

So what are they doing in lieu of buying insurance?

Radical things like minding their health– watching what they eat, working out, bundling up before they go out in the cold, washing their hands (oh, these kids – they’re like modern day hippies shunning the norms of society).

They go to the doctor only when absolutely necessary instead of for every little ache and pain. They go to retail clinics (like Minute Clinic and The Little Clinic) where they know the costs BEFORE they buy (oh my, what are these kids coming to wanting to know the price before they blindly incur the expense). They look things up on the internet (It may be MY chronic disease but shouldn’t the doctor know more about it than me? He treats it, and I only live with it…every single day of my life).

But why should these 13 million have insurance? In case something happens.

Hellooooo – they’re 20-somethings and invincible.

But seriously, why should they? Because it underwrites the rates of the older portion of the population. If they don’t get healthcare, they don’t offset the risk pool – they don’t underwrite the older segment of the population. And we know what that means – our rates will go up because they aren’t contributing monetarily (and taking less out than they put in) as we expect them to do.

But we can still get them. In New Jersey, children can stay on their parents insurance to age 30! Thirty!!!! In many other states it’s only 24 or so.

So now I’ll set aside the sarcasm.

What we are seeing is the revolution. The new generation is taking a stand. We have a product – health insurance – AND THEY ARE NOT BUYING! The business world should get the message here. These folks are going to opt for surgery overseas, retail clinics and internet consults. They are going to cost shop prescriptions and doctors. They are going to demand affordable access to care and they are going to want to know the price AHEAD of time. And they are going to return health insurance to truly being insurance – a safety net for catastrophic situations instead of the all you can eat buffet for $20 we have bad for soooo long – too long.

Do NOT think that it is the sage old regime of healthcare executives and politicos in D.C. who are going to change healthcare. It is the 20-somethings. They alone are able to break out of the old ways of thinking. It has been that way generation after generation. THEY have the new ideas. THEY are taking a more rational approach. They are getting organized and THEY are not content to go along with the system as it has been.

Yes, they are 13 million without health insurance…and growing. THEY will change healthcare.

Dr. Stanley Feld, “Top Health Blogger” by Wellsphere, claims that the healthcare reform agenda has already been set by Obama and Daschle.  You can read his post here.  He has some good points regarding reform and the need to involve physicians in the process.  However, his post struck a chord with me when he wrote about everyone believing that doctors are at fault, and that the government is out to change the way that doctors practice medicine.

I feel that most people agree that the quality of care in our system needs to improve.  Some might agree that reimbursement patterns must shift to reward high quality healthcare and wellness.  Few might agree that doctors are going to have to change the way they practice medicine, whether its integrating information technology and electronic medical records, or estabilishing stronger doctor patient relationships.  I would like to hear your opinions…

In the meantime, I wrote a response to Dr. Felds opinion piece.  It is available below:

“Dr. Feld,

I respect your opinion on the involvement of patients AND physicians in healthcare reform and policy. But without reading the by-line, about half way through your piece, I could tell you were an MD incapable of writing an unbiased piece on healthcare reform.

Problem: Unfortunately, not all doctors are out to service the best interests of their patients and some are most concerned with the thickness of their wallets. When I go to the doctor, why can’t he tell me about how much the services will cost?

Problem: We pay doctors only when patients are sick. You don’t make money if you keep me healthy, now do you?

Problem: The average patient does not understand medicine or the CONFUSING healthcare system.

The worst part of it all - is that I would argue that most MDs do not understand the system either. While I agree with you that “Socializing” healthcare is not the appropriate answer to our problem, I whole-heartedly disagree that the government is trying to “FORCE DOCTORS TO CHANGE THE WAY THEY PRACTICE MEDICINE.”

Let’s not equate “changing the way doctors practice medicine” with “changing incentives and reimbursement.” This is about keeping more people healthy and increasing the quality of care delivered. This is about rewarding physicians for delivering high quality care and keeping their patients healthy. This is about asking doctors to do their job efficiently and accurately. If to do this doctors have to change the way they “practice medicine,” then I might argue that they entered medicine for the wrong reason to begin with.
Transparency. Accountability. Competition. – Its time to make some changes in healthcare!”

Monday (10/6) at SHOUTAmerica’s first leadership conference I had the pleasure of hearing Senator Corker brief the audience on his recent accomplishments in bi-partisan healthcare activities.

Here are his four opening points:
1.    Congress does little communicating across party lines – this needs to change
2.    30% of healthcare delivered is wasted, i.e. it does not actually help people get well/healthy
a.)  That directly translates to 5% of our GDP wasted
3.    800,000 Tennesseans and more than 45 million across the country do not have health insurance coverage
4.    Healthcare is not a right, rather a moral obligation
a.)  Everyone deserves access to affordable private healthcare

He was cautious to make the distinction between what Republicans are striving for (preservation of choice) and what Democrats are striving for (universal coverage).  Corker wants the best of both worlds.  He wants  to preserve choice while finding a way to cover everyone.

Throughout the hour and a half speech/discussion I had several points of contention/questions.

1. Is choice our number one priority when we have 45 million uninsured Americans, 9 million of which are children?
2. Should we be providing tax credits as an incentive to purchase health insurance coverage?
3. Should the federal government mandate health insurance coverage?
4. Should all health insurance be community rated?
5. Should we separate health insurance benefits from the employer?

Choice should never be our number one priority (should I never say never?).  We need to focus on increasing access, coverage, and quality, while simultaneously reducing costs.  Choice isn’t even in my top 3 priorities for healthcare reform.

The American government has used the tax-credit concept for years with respect to financial saving.  Despite the tax incentives, Americans still fail to reasonably save the money they earn.  Why would the concept be any different applied to healthcare?  Just because a $5000 per family tax-credit is issued does not mean people will purchase a policy costing $14,000.  That’s still $9000 left for a family to cover.

I still haven’t figured out all the reasons why health insurance coverage has not been mandated by the government. Obviously cost is one (look at the difference between auto insurance and health insurance, we are talking thousands of dollars).  But what are some other reasons, and possibly coverage should be mandated and subsidized by the government up to a certain % of the poverty level.

Community rating all health insurance would mean that risk would be spread equally over large groups of people.  If you have high blood pressure and high cholesterol you would pay the same as the same price as a healthy individual your age.  This could be a good thing if the price groups change/account for age, smoking, family size and location.  It certainly provides a way to increase coverage and reduce costs for high-risk groups.

Health insurance benefits have been linked to our employers for years.  Is this practice too entrenched in our culture to separate it?  No.  However, I think the idea has its pros and cons.

Pros:

1. Makes healthcare portable.  Individuals will no longer feel tied to their dreaded job due to health benefits.  Their coverage and chosen plan could be taken with them to any place of employment.
2. Leads to more individual responsibility.  An individual will have to better understand what they are purchasing.

Cons:

1. Less guidance on aggregating large numbers of people to spread insurance risk.
2. Decoupled benefits will reduce competitive advantages between employers. Not that this directly is a bad thing – but will we see employers giving employees the money in their pockets that they used to see by way of health benefits?

All and all I still haven’t figured out the details of my proposal for healthcare reform.  Fortunately Senator Corker seemed to have a solid “moderate” stance on the issue!

The SHOUTAmerica Conference was a huge success!  About 100 student n leader, presenting almost a million students across the country, attended the conference to hear CEOs, Senators, House Reps and health care educators speak about the current healthcare crisis.  By the end of the conference once puzzled students emerged engaged and ready to make a difference!

The new LiveBlog on the SHOUTAmerica documents the conference, student sentiments, and speakers.

Check out Christoper in Part 3.

SHOUTAmerica has partnered with change:healthcare inc. to address consumerism and transparency…  both part of the current healthcare crisis and debate.

Download the press release.

In recent months, as the days pass and the election approaches, the future of our healthcare systems seems less and less stable.

In researching new developments in healthcare reform and activism, I came across a “haunting” video while exploring a new site geared toward engaging individuals in sustainable solutions to the impending healthcare crisis - SHOUTAmerica.

By haunting, I mean honest and accurate in that is paints the dark picture of our healthcare future.  Check it out.

The point of the video is not to be haunting but rather motivational.  I walked away from it thinking… if we do not start to consider our personal healthcare decisions (at the very least) we are allowing healthcare to control our country’s economic path and future. [Scary thought.]

On top of the video, SHOUTAmerica has a lot to offer. Community, awareness, action, education. In the first blog post Times are Changing, So Should Healthcare the author says “My interest in our cause runs especially deep… Upon my graduation from a top 20 university, I found myself too old to remain under the insurance of my parents and too easy to ignore the gravity of not having it… I have come across countless stories detailing the difficulties healthcare expenses bring to bear on millions of Americans and their families. But while it is important to sympathize with their plight, we must now also turn our focus to action… The long-term interest of this country is dependent upon comprehensive healthcare reform that has remained elusive now for decades, usually dying on the table on Capitol Hill.”

The more we can share and spread this type of sentiment, the sooner we will see change.  Unfortunately, this type of passion (displayed above) is not wide spread or at least those that feel this passionately have yet to unite.

To those that feel passionately about healthcare reform - Get involved!  I think that SHOUTAmerica will provide the much needed platform for unity.