I have been in the business of health care since 1981.

In the 1980s, conditions for health care in Lake County were different than they are today. Those were the days when health care delivery was based on decisions made between a patient and his or her physician. Patients depended on their physicians' training and expertise to guide them in choosing their options for treatment. There were no government regulations for the Medicare program on what services could be provided, how frequently and how much could be paid for them. It was before the era when the major of insurance companies recognized how much money they could save by adopting and building on the restrictions developed by Medicare. The vast majority of Northwest Indiana residents were employed and their companies provided comprehensive health insurance benefits to cover the costs of the care plans developed between doctor and patient.

Unfortunately, the golden age of full employment in Northwest Indiana with the accompanying comprehensive benefit package has passed. Fewer families than ever have access to group insurance and those who do are paying more out-of-pocket for premiums and deductibles than ever before. Too many medical decisions today are based on standard protocols developed by insurance companies based on "norms" and standard responses to treatments; and, of course, on keeping the insurance companies' costs down and profits up.

Physician groups and health care facilities are making lower percentages of profit than ever with the per-service reimbursement from Medicare and other insurance carriers declining every year.

It appears that no one is happy with the current state of health care.

Patients are dissatisfied with the limitations on their access to care and their inability to influence the choices available to protect or restore their health. Physicians are frustrated with the amount of time and resources consumed in satisfying government and insurance carrier requirements for prior authorizations; complying with standard protocols; submitting and repeatedly appealing claims to collect less and less on each service.

Is it time for health care reform?

The answer from all constituents seems to be, "Definitely!"

The real consideration for all of us, though, is who do we want to be in control of our health care?

Do we want the government to play a larger role modeled on the restrictions of the Medicare program?

Do we want the insurance companies to make more of the decisions that impact us based on their profit?

Or, do we want more freedom to make health care decisions based on the advice of trusted physicians and our own needs?

As every politician is focusing on health care reform and expanded access to care, make sure that your legislators are focusing on your needs and those of your family.

The opinions expressed are solely the writer's. Beverly DeLao is administrator for the Hammond Clinics.