Vail Daily letter: Who do you trust? |

Vail Daily letter: Who do you trust?

Joy Warren
Vail, CO, Colorado

I had reservations about attending last week‚s town hall meeting where Jared Polis, Vail Valley’s U.S. representative, was to discuss health care reform with members of the local community. The media portrayal of these events with shouting and “in-your-face exchanges” certainly did not seem inviting to me. However, my curiosity got the best of me and I decided to go, as an observer.

I left the Wednesday meeting smiling. Yes, there were passionate exchanges on both sides of the issue. But they were civil and respectful. The questions were thoughtful and probing and revealed the diversity of background and experience that resides in this community. I felt proud to be part of it.

And, boy, was I impressed with Polis. In a very concise and straightforward manner, he outlined his understanding of the significant components of the House and Senate bills. There was no doubt that he had done his homework.

Then he opened the meeting to questions. His answers were direct, informative and evenhanded (albeit it was clear that he was a supporter of health care reform, including the public plan option).

Hearing so much cynicism and public outrage at the perceived uselessness of elected officials, it felt good to know that it was possible for a public servant to live up to the higher standard we envisioned when we elected them. And I did leave the meeting more informed.

Most interesting, I thought, was the way Polis framed the issue. “It’s a matter of trust. Who do you trust more? The private insurers or your government?”

Depending on the side you take, the answer may seem easy. However, it did give me pause for thought. Is that trust formed by a preconceived bias or a lack of a deeper understanding of the issues? Is it based on your life experiences, or is it genetic?

Or maybe trust isn’t the issue at all. Maybe it just boils down to self-interest. But my hope is that, as a people, we are able to frame that issue in a broader sense. Maybe there can be some common ground.

Over the past several weeks, I have closely followed the health care debate, and I promised myself rather than being part of a group that can only offer reasons for objections, I would outline five priorities that I would like to see legislated, “trusting” that these ideas would make positive change. And I planned to contact my legislators to share my ideas.

I also like to believe that regardless of “trust issues,” there are certain concepts we can all agree on. Seems like cost control and competition might be two of them. Therefore, I promised to define my priorities within these terms.

So to answer Polis’ question about trust, I guess I will say I trust the government more, not because I am against the insurance companies. I do have a business background, and I do understand the benefits of the profit motive. It’s a good thing. But uncontrolled or unregulated, it can go awry.

So I am trusting Obama and Polis when they say that the public plan option will offer greater competition and cut costs. As I understand it, it is a not-for-profit agency, not an open-ended, government-funded one but an agency where administrative and marketing costs can be reduced. It is an approach where the playing field is leveled, requiring greater competition from the private insurers yet without forcing them off the field.

Furthermore, insuring the currently uninsured will bring million more into “the pool,” spreading risk, thereby reducing costs.

That accounts for two of my legislative wishes. Three more ideas that I think are important: medical standards, salaried physicians and tort reform.

I believe patients and doctors should be informed of the “probable” best outcome of selected procedures. The point here should be an advocacy for more information, more informed medical decisions.

Again, this gives rise to trust issues (and fear of death panels), but it seems to me the approach to developing and implementing these standards could be done in a manner encouraging rather than mandating better practices. What is controversial about more information?

Fourthly, I believe doctors should be compensated for their overall service performance, which would include their contribution to their patients’ wellness, not dependent upon fee for service.

Finally, I’ll mention tort reform. In speaking with many physicians, it seems this is high on their list as a way to control costs. It is certainly not their objective to practice “defensive medicine.” Unfortunately, this is not even being mentioned in the current legislation – it’s a political hot potato. So we’ll wait for that discussion once we have made some inroads to the current reform effort.

August isn’t over yet, so I am sure the conversation will continue. I am going to remain optimistic.

This is such an important issue. I’m hopeful that the purely political aspect of the debate will be minimized and that regardless of differences in our trust issues, we will find common ground to make change for the better.

Joy Warren


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