Brace yourselves for the pain of health care reform

Have you ever had that sickening feeling right before something really bad occurs, like a car crash? You know it is going to happen, and there is not one darn thing you can do about it except brace for the impact.

In the body, there is a double one-two punch with pain. You stub your toe. That is the first nerve transmission, but you know in three milliseconds there comes to your brain the real ouch. Now, multiply that by a trillion dollars and you get this gigantic sensation of dread ahead of the concussion called healthcare reform. There is both an expected bang and the agony that will follow. What better moment in time? What greater opportunity in history to create a system that would be the envy of the world from the fragments of our broken, expensive, inefficient, error-prone way of caring for fellow human beings? We all can imagine it, like licking the anticipated taste of sweets.

In our wildest fantasies, we could see ourselves seated in a nice, but not opulent, doctor's office. The wait is not long. You have already swiped your insurance card through the reader like at the grocery store. Once in the exam room, your history is added to the electronic medical record that you can access from home. You have scheduled the appointment by buying time, not being inserted into some arbitrary 10-minute slot like a letter in a mailbox. If you need more time, you purchase more, which is deducted from your health account. With the EMR, you are not only able to make appointments, but there is secure e-mail and voice mail to your clinician. Notices are sent to you as lab results or images are obtained, so you have the results with common English interpretations. If blood tests mean a new medicine, it has already been e-prescribed and is waiting for you at your favorite pharmacy.

Now, we go from the dream to the reality wreck — in spite of the sincere dream that our elected representatives could for just once get it right. But senators and representatives do what senators and representatives do: They create bureaucracy, and bureaucrats make rules. Instead of lofty noble goals, they created limits hobbling states.

The country suffers from the third-degree burns of the financial and housing meltdowns. Unemployment is up; employee health insurance is down. So it is perfect to uncouple jobs and premiums. But no. It is an ideal chance for the nation to have goals of safety and efficiencies, but not this time. Today is just right to encourage individual plans with a community state-based rating of all the citizens, so cherry picking of the healthy and the rejection of the sick would stop. But forget it.