So the folks in Washington have raised “health care” to the top of the agenda, after doing whatever it is they did for banking, lending, and the auto industry. The prevalence of misinformation abounds. And the popular media is ever so prone to report the angst and rancor that prevail at “town hall meetings” and “health care forums.” The message is clear — people are angry.

But, what are they angry about relative to health care?

I see, at these public media events,  some backdrop banners that proclaim “Health Care Reform” others “Health Insurance Reform.”  The problem is, as I see it, that the message is very confusing. What are we reforming? Who will this benefit? Who will pay for it.

I have long held the opinion that the silliest thing I have heard of is a health insurance company saying, we will insure you, but not for the illness you have – the ever prevalent exclusion for “pre-existing conditions.”  That is an admirable goal – the elimination of that exclusion. Keep in mind that the pre-existing condition exclusion is a device that is used only in the private insurance sector. Medicare and other government sponsored plans do not exclude pre-existing conditions. So the decision to ban private insurance companies from writing policies that exclude pre-existing conditions is progress.

However, what is particularly disturbing to me is that no one is asking the obvious question — What is this new policy, that includes the payment of expenses for all conditions, going to cost me?  It seems  a matter of common sense that if the insurance companies have to pay for medical expenses that they did not have to pay for before — they are going to charge me more. If you do not have a pre-esisting condition, then you will be paying more for your policy to pay for the pre-existing conditions of others. And we are told that health insurance will be mandatory.

So, the result of the health care reformers or health insurance reformers proposed legislation will result in healthy people not having the opportunity to purchase a policy that is tailored to them, namel, that excludes pre-existing conditions. So the healthy must pay for coverage that they do not need. Nor can they self-insure. Their premiums will go up. I am confused. Is this health care reform or health insurance reform? 

And no one is asking any questions about this. We are all outraged about the non-existent “death panels, ” the “public option,” and other issues that create yelling and screaming and, therefore, great news bites. I think both sides are happy about this. Why? It distracts people and prevents a rational discussion about the issue.  How will this plan affect the delivery of health care to me? What options will I have? What will it  cost me?

Part of the problem with the health care industry generally is that it is one of the very very few industries where the consumer is immune to price. When is that last time you asked your family doctor what he was going to charge you for a visit? or the lab what they will charge you for bloodwork? or a surgeon what the charge is for your appendectomy?

So the public needs to be educated to think differently about health care, to understand that they have a stake in these important matters.

The message from Washington should include educating people to treat health care in the same way as you treat other consumer decisions. Ask questions? How much are you going to charge me?

Ask your doctor.

Ask your insurance company.

Ask your elected officials.