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Sick of Health
Pardon the pun, but I’m sick of seeing and hearing the ideological bigotry being used by both sides in the current health care reform debate. Even the fallacy that the debate could be encapsulated by “two sides” makes me angry. The very idea that being able to shout louder than someone else or that a few words written on a poster contribute anything to a debate on such an important issue is absurd in the extreme. This behavior, including the meaningless chanting of simplistic slogans, effectively shuts down all objective discussion and obscures the real issues.
So stop talking, stop citing extreme anecdotal examples, and stop using pre-made, emotive labels designed to perpetuate already polarized thinking.
Maybe this is a revolutionary idea, but why don’t we start looking at factual evidence backed by legitimate research. Yes, I know this is a new concept, but just bear with me for a while, you never know, then we might come up with some reasoned and sane conclusions.
Here’s an initial, outrageous idea to open up your thinking:
Starting in 2011, our children’s schooling will no longer be funded or provided by the state or federal government. All parents and children are expected to pay in full for their academic education, which will be provided by private institutions. Emergency treatment for difficult math and long word problems will be available at certain schools, but wait times can be quite long.
This policy will be introduced on the general premise that no one ever died as a direct result of not being educated. However, people die as a direct result of health problems. In view of this, all funds currently provided by all levels of government to education will be reallocated to health care. Silly idea because that’s not how we do things, and imagine the increased incidence of illiteracy… Oh wait a second…
Now that you’re smiling broadly and instantly ready to take on new and radical ideas, here are some facts:
• The United States of America does not have the best health care system in the world
• The United States of America does not have the worst health care system in the world
• The United States of America has one of the most advanced healthcare specialties in the world
• General health care delivery in the United States of America and its health outcomes do not compare well with most other industrialized countries
• The United States of America has the ability to provide expert treatment to patients of all ages
• The United States of America has an illogically high incidence of infant mortality, short life expectancy, and avoidable death rates
Okay, that smile has worn off a bit, so here are some factual statements and observations:
• I don’t know which country has the best healthcare system in the world, but neither does anyone else reading this
• The United States of America spends more (per capita) on running its healthcare bureaucracy than any other country in the world. Sometimes by a factor of three or four over countries with effective universal systems.
• There is no particular reason why employers should continue to be responsible for the provision of health care. It is a hateful practice that can be extremely harmful to the interests of both employees and employers. The practice has its origins in the wage freezes of World War II, but now seems ingrained in American working life. Why should your employer decide what health coverage you get? Your family doctor doesn’t tell you where to work!
• There is no reason why a national, universal health care plan should increase individual or government health care costs. Individual tax costs will increase, but if a scheme is implemented effectively, there will be no health insurance premiums to pay. Employers should no longer have to pay their share to insurers and there should be no co-payments. In case you missed it – NO CO-PAY! Your employer may even pass their savings on to you as a pay raise.
• Effective preventive health care contributes enormously to the quality of life and the longevity of that life. In the current situation in the United States of America, there is little incentive for health insurers to finance preventive care. The premise is that as people change jobs and health insurance, the financial benefits of preventive medicine could be enjoyed by organizations other than those that originally funded it.
• Seen from afar, the citizens of the United States of America are disease-obsessed hypochondriacs. This hypochondria is fueled by a constant bombardment of television commercials for prescription drugs that contain information that should only be evaluated by competent medical professionals. Trendy acronyms only exacerbate the obsession; why not obsess over health and wellness?
• Market forces and human nature are generally inadequate in health care. Physicians are encouraged to treat when treatment may be unnecessary. Pharmaceutical companies need a constant stream of new diseases, gullible or mercenary doctors and new drugs to keep them in business. Health insurers must be able to promise educational care from cradle to grave and yet be able to deny treatment on every possible occasion.
Now that the smile has been replaced by a scowl and you’re thinking of yelling or painting a sign, here are some comparisons that will restore your faith in man’s inhumanity to man.
• Universal schemes can only provide the greatest good for the greatest number and will spend any given amount of money
• Private plans will drop you if it looks like you might have a long-term illness
• Universal schemes will always treat acute cases first and will generally do so well. less urgent cases can wait a while for treatment
• Private schemes will treat your acute or less urgent conditions entirely on financial considerations, but will get you back in the car almost as soon as the anesthetic wears off, often leaving you back (with another co-pay) in a couple of days
• Universal programs often provide unintentional long-term housing for the homeless
• Private systems always use the latest and most expensive treatments, regardless of whether they are superior to proven treatments.
• Universal schemes are often unwilling to adopt new procedures until costs and/or patient benefits have been established
Here’s a dirty word:
It’s actually two words, but you get the drift. Most universal or national health programs operate this policy. Supporters of the status quo in US health care policy consider it blasphemy. It is a good example of the emotional labeling so evident in today’s health discussions.
Single payment simply means that payment for drugs and treatment comes from a single source. This single source is the organization that operates the health service, almost invariably the government. Drug companies and doctors loathe this policy because they can’t go head-to-head with numerous payers (with different priorities) among themselves. Instead, they must deal with a single body whose sole objective is to balance cost and patient benefit, more simply known as value for money. The bureaucracy of the VA health care system “sorta-kinda” works similarly to single payer.
This means that many doctors will get less for the work they do. Pharmaceutical companies will no doubt claim that they will not be able to research new treatments. Personally, I can live with that because the doctors who earn substantially less will only be those who have focused financially on their practices. Pharmaceutical companies will continue to research and develop because that is what they have to do in order to exist. Perhaps these new pressures will force them to focus more on effective remedies? Am I the only person who wonders if pharmaceutical companies develop new products and then look for a disease to treat? The purpose of a health care system is to look after the recipients of that health care, not to make a few professionals obscenely rich.
The bottom line is that the current healthcare systems (in terms of delivery and outcomes) in the United States of America are ineffective and probably beyond repair in their current form. Federal and state politicians are afraid of the pharmaceutical lobby dying and not being re-elected (but then I repeat myself). The AMA represents solely the interests of the medical profession and has objected to any proposed initiative that benefits patients at the expense of its members. I don’t think the insurance companies care one way or the other because they think they’re still going to get a big piece of the pie no matter what. When they realize that single payment can become a reality, they will get the rest of the politicians that the pharmas lost.
It should not (and cannot) be beyond the wits of the US government to spend time researching the health schemes that work most successfully in other industrialized countries. Surely, somewhere in this nation, we have officials with the ability to judge and evaluate the best of them and surely we have the expertise to implement such a scheme here.
According to the Organization for Economic Co-operation and Development (OEDC), in 2003/2004, per capita health expenditure in the United States of America was $6,120 (15.3% of GDP), the expectation of life was 77.5 years and child deaths, per thousand, were 6.9. During the same period in Japan, health expenditure per capita was $2,249 (8% of GDP), life expectancy was 81.8 years, and infant deaths, per thousand, were 2.8.
Here are some of the latest kickers. How can the country that considers itself the most advanced economy in the world allow its citizens to be denied preventive health care because of corporate greed? How can you allow some 700,000 families each year to go bankrupt to seek health care? How can you let people die for lack of health care?
For those who say the government can’t afford universal health care, consider this: In 2003 (according to the World Health Organization) the US government spent more, per capita, on healthcare than each of the UK and Swedish governments. Two countries that have universal health care, citizens of those countries had no co-pays, and both countries generally achieve better health outcomes than the United States of America can boast.
Net personal spending on health care would decrease significantly under a properly implemented universal scheme, and a single-payer scheme would have the potential to reduce billions of dollars in wasted administrative costs.
Ultimately, President Obama’s scheme will not work because it does not address the underlying fundamental problems. Supporters of the status quo will be happy to see the percentage of GDP spent on health care increase to 20% in the unfounded belief that the market will deliver effective health care and that we already (of course) have the best health care Of the world. We’re basically screwed!
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