Lee Kirksey, MD  
Cleveland , OH

Specialties: Peripheral Arterial Disease, PAD

Interests: vascular, specialist, treatment options
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Is Universal Coverage Enough...No!!

Sep 13, 2009 - 2 comments

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Like many of you, I have watched intently as the heated debate regarding healthcare reform plays out in front of us. To be clear, the discussion to date is more about universal healthcare coverage than it is about reform of how we manage medical illness. As a practicing vascular surgeon, I see the consequences that lack of insurance has with Americans. No American should feel comfortable with the  contrast that in the wealthiest country in the world, 20,000 people per year should die from otherwise treatable illness because of lack of insurance.  The idea is horrifying and I think it is a moral imperative that we make a decision about how to care for all Americans.

That was the socially conscious part of me. The Ted Kennedy liberal if you will. The fiscally responsible part of me cannot understand the discussion that does not include any mention of how we plan to address the purple elephant in the room, Childhood and Adult obesity. In a little over 3 decades the obesity rate has doubled in adults and tripled in children. By various studies, obesity is responsible for up to 30% of our increased health spending over that time. Diseases like diabetes, heart attack and stroke and arthritis all brought on and worsened by obesity cost hundreds of billions of dollars to manage each year.  These disorders occur disproportionately in people of lower socio economic class and minorities.

So I don’t understand the reasoning that America, the most overweight and obese country in the world will now provide healthcare to all citizens.  Obesity is clearly a cause of multiple costly chronic diseases.  The rate of obesity is increasing at an alarming rate to the extent that this generation of adolescents may be the first generation to routinely die before their parents.  In some groups of Americans, the rate of obesity and overweight is expected to be nearly 90% within 30 years.  

Without any well elucidated plan laid out to me to address the obesity epidemic, I ask all of you to tell me where the money will come from to support our obese Country.  I referred to it as the purple elephant because Im not the only one that knows the absence of logic about the feasibility of this type of reform without a multi pronged attack successful attack on obesity.

To be clear, the theory of universal coverage makes complete sense from a moral and ethical standpoint.The practicality of me, my children and generations to come paying for it with increasing taxes because it was poorly thought out does not.

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389974 tn?1331015242
by swampcritter, Sep 15, 2009
Dr Kirksey, you have hit upon a point that deserves a great amount of thought.

The bill being debated is health insurance reform, not how to make Americans healthier, not how to reduce the costs of health care.

The basic message seems to be that our health care costs are high because of evil insurance companies. Our inability to control our diet, exercise sensibly, our drug addictions, and smoking -- oh that can't possibly have anything to do with it!

That is what makes the bill popular. Its easy to blame a faceless insurance company for costs.

649848 tn?1534633700
by Barb135, Sep 19, 2009
Wow, am I ever glad to see this post...........I've been concerned for some time about this issue...  When the whole health care debate started, the talk was "health CARE reform" --- okay, that made sense because health care IS too expensive, but as time went on, it shifted from concern about CARE to "health INSURANCE reform"; as though if everyone has insurance, it doesn't matter about the cost of the CARE because it's covered by insurance so we aren't paying for it ourselves anyway.  And to think of having to pay for covering millions of people who don't even TRY to take care of themselves because they will get "free" health care -- when I can barely afford to cover myself is extremely scary!!!!

I also agree with your statements about obesity, etc.  I, personally, am not obese, but because of thyroid issues, I AM overweight.  I have struggled and struggled to get back, at least close to my "pre-thyroid weight" and when exercise and diet aren't cutting it, all I hear from my doctor is "you aren't THAT much overweight"............diabetes, heart issues and some cancers run rampant in my family --- why on earth would anyone think I should be satisfied to be 30 pounds overweight???  Not only for the health issues, but my self esteem and confidence as well, which is another whole health issue...........

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