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Our vote should be informed, thoughtful and pragmatic decisions

October 27, 2012
By C. Paul Martin, M.D. , Marshall Independent

The 2012 general election will occur in just a few days. Are you prepared to select the representative leaders who will be making critical decisions which will significantly impact your lives and the lives of your children and grandchildren? Media news, "hype," and the ubiquitous political ads have presented many issues of political contention such as the state of the economy, the wars, health care, and "Washington politics," with the background of the personalities of the present administration, the opposition party" candidates, and all other variations of the political spectrum. Ultimately, we as voters have the responsibility to choose the direction of our country. Your vote in important; remember that the last Minnesota Senate election was decided by the votes of only 150 people!

As a senior citizen and a participant in the health care industry for nearly 50 years, I am concerned about the political directions and actions regarding America's health care. Of course, other issues and challenges also merit careful study before voting. My experiences in health care venues throughout the United States and England draw my attention to this challenge of our political leaders and us Americans. While, in many respects, we do have the best health care and facilities in the world, our system requires modifications, and its professionals and patients need performance directions and education. In both areas, basic tenets of economics, business and public and personal health are being underutilized, overused, and in some cases ignored. The Affordable Care Act (ACA) may be a beginning of reform, but many realistic existing and pragmatic considerations will be operative in its possible implementation.

Our present health care situation is characterized by a plethora of bias, politics, personalities, unproven "facts," patient misperception and the prominent influence of the involved parties.

The Affordable Care Act which was passed in 2010 exemplified this maelstrom of conflict. The bill was passed without any votes from the opposition party, with the votes of two senators whose states were promised "special deals" in the bill, and without the significant input of medical and health care professionals, the health care industry, and the insurance industry. The "transparency" promised by our present administration was conspicuously absent. The resulting impact of this legislation on the personal opinions of our citizens was reflective of the process: one third of the population felt they were better off, one third felt they were worse off, and one third felt no difference - all at a cost of a trillion or more dollars! Subsequent portions of the legislation now being put into effect have generally been beneficial, but many questions still remain.

I have attended two presentations by Washington consultants with health care interests who discussed the Health Care Act in some detail. Both of them felt there are parts of the health care bill which are beneficial and parts which are unlikely to promote any improvement in our health care. Most of the specifics in the law have not been published, defined, or clarified. The cost of the law is enormous; the alleged savings and economic benefits of the law are the subject of much discussion; the proposed economic gains are possibly untenable. Richard Foster, chief actuary for the Centers for Medicare and Medicaid Services has said: "The financial projections shown in this report for Medicare do not represent a reasonable expectation for actual program operationsThe recession adds a significant further element of uncertainty to the trust fund projections." (USA TODAY, August, 2010)

A local medical professional leader here in Minnesota has addressed the need for careful evaluation and prudent voting in the upcoming election. Dr. Terence Cahill, a former president of the Minnesota Academy of Family Physicians, remarked: "It has been interesting to follow the candidates and listen to how they are going to solve the deficit and address the changes in health care that need to occur. The solutions are quite differentand (voters) and primary care physicians should pay careful attention when considering their votes in the ... election." (Minnesota Family Physician, Sept-October, 2010)

These statements by a governmental consultant and a physician leader emphasize to me that we as voters need to carefully evaluate the candidates for office and vote for candidates who espouse a reasonable, pragmatic and common sense approach to the many challenges we face in health care matters and all aspects of our society.



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