There is an amazing public debate going on about national healthcare reform. Some of it is heated. Some of it is based on truth. Some of it is based on misstatements of fact (to be kind) or inaccuracies (less kind) or outright lies (opposite of being kind). But almost all of it is based on a very passionate debate on what is best for our citizens when it comes to healthcare reform, and who can argue that a healthy debate is not a good thing?

I thought I’d take a moment to weigh in on some facts and observations.

1. Our country spends 17 percent of our Gross Domestic Product on healthcare. This is far more than any other industrialized nation. I just read an article about the Scandinavian healthcare system, and the three countries that comprise Scandinavia each spend about 9 percent of their GDP on healthcare. Now I will deviate from facts and suggest that 17 percent is simply not sustainable. That percentage is projected to grow dramatically and will become a weight on our economy. We spend far more than other countries, and yet we still don’t provide healthcare coverage to all. We need to reform our healthcare system, and if not now, then soon.
   
   
2. The option of a government plan for health insurance is scaring people. Why? Because many citizens are not convinced that the federal government can do a good job (often pointing to the Postal Service, which does a good job by me.) On the other side, some people point to our fine military and note what a terrific and heroic job they do on a day-to-day basis. Others point to Medicare and indicate that it is one of the largest governmental payers already and the federal government doesn’t mess that up. They go on to point out that Medicare has an exceedingly low overhead for administering the entire program (3 or 4 percent) as compared to most insurers which can range between 15 and 25 percent.
   
   
3. The so-called “Death Panels” never existed, but if they ever did, they are dead. The provision would have paid doctors to have conversations with patients regarding their options at the end of life. This isn’t a bad thing – I think every individual should consider their personal choices about end-of-life care and share their decisions with their families and physicians. Sometimes at the end of life, hospice is the best thing if the patientso chooses. New Jersey ranks 33^rd in the nation in use of hospice care, and we should do better for our citizens.
   
   
4. Health insurance coverage does not equal access to healthcare. I worry that if all Americans were insured tomorrow we would not have enough primary care physicians to treat everyone and would have long wait times for appointments. Some in Massachusetts are experiencing this with up to six-month wait times. Those wait times aren’t necessarily the fault of Massachusetts’ healthcare reform law, but rather the lack of resources to fully support the plan. We need to devote resources to ensure we have enough doctors, nurse practitioners and physician assistants to provide access to healthcare for all Americans. (And that’s needed regardless of whether Congress passes a reform bill.)