Don't let your schooling interfere with your education.
~ Pete Seeger

Friday, August 21, 2009

Health Care Redux

The more I consider the health care system "reform" currently being debated and opposed so ardently by conservatives, the more opposed I am to it – though not, I suspect, for the reasons they'd quote. In my last post, I said I was agnostic after looking at all the good things that are being proposed. Many of the things Obama and the Democrats are trying to do are not only worthwhile, but morally imperative. However, the very attractiveness of that led me to miss the key point: it addresses the symptoms of the health care malaise, without addressing the underlying problems that create the symptoms. Because of that, it is doomed to fail.

The problems of our current health care system are as follows: 1. It is an extremely complex system, in a situation where simplicity is proven, all over the world, to be more effective and far more efficient. 2. It allows outrageous rewards for malpractice suits, which drives outrageous costs for malpractice insurance. 3. It prohibits the public payer from negotiating prices with the providers. 4. The payer in most situations is motivated by profit (not need) in a system where profit is maximized by denying (not providing) the services needed – effectively rationing health care and reducing choice far more effectively than even this bill would allow.

This bill actually addresses none of these problems. Instead, it takes a quintessentially Republican approach to legislate better results out of a failing system: Government officials meet with corporate industry officials behind closed doors to craft legislation which is then crammed down the citizen's throats. Benito Mussolini would approve; he'd call it fascism – "the merging of corporate and state power." It is a mystery to me why the folks who supported Bush oppose this plan – it is exactly the kind of thing that he would support and promote.

At the risk of being boring and redundant, the solution is simple: 1. To deal with problems #1 & 4 above, expand Medicare to include everyone, and reform the paperwork process to make it simple, easy, and able to process in multiple ways (digital, hard copy, etc.). (This has the added benefit of increasing everyone's choices on doctors, providers, and so on, because every provider is a preferred provider, and there is no out-of-network unless you leave the country.) 2. To deal with problem #2 above, limit malpractice suit rewards. 3. To deal with #3 above, require Medicare to negotiate prices. 4. To additionally deal with #4 above, cover alternative health care (acupuncture, Christian Science, etc.) and preventative care.

The current reform plan on the table operates from the same assumptions and paradigm as the current system, and merely attempts to legislate better results. But without reforming the system, we won't get better results. As Einstein said, "Problems cannot be solved at the same level of awareness that created them." While doing some things to mitigate the symptoms of our current insane system, this plan will hurt vulnerable populations – small business and the middle class – while providing huge, usurious profits to huge, corrupt corporations. It will delay genuine reform. Liberals should stand side-by-side with our conservative brethren and sistren in opposition to it.


David Carrel said...

I think that the malpractice suits are a key issue. I think my dad pays around 1/3 of his salary to malpractice insurance. And I think that most doctors are out there to help you, not hurt you. On top of that, they have to order tons of precautionary exams so that they don't get sued.
I wish we could stand together more often, with practicality, and move things forward.

Seda said...

You're exactly right, David. Across the board. Sadly, I think that often on things like this, one side supports a stupid bill (or opposes a good one) just because the other side opposes it (or supports it). Both sides should strive to be better informed and think for themselves. The knee-jerk reactions result in really bad policy.

I see it all the time. For instance, conservatives have great arguments against this health care bill; they don't need to lie. Yet again and again, I see them lying, and calling it socialism and Marxism, even though it's anything but, and calling it Nazism when it's only relationship to that is that it's fascist - but a far less virulent brand of fascism. I think that kind of violent and inaccurate language (hyperbole, lies) causes many people, who see right through it, to support the plan. And it's not just conservatives. Liberals do it, too. I catch liberals lying about stuff. It drives me nuts; we don't have to!

redforkhippie said...

I think three simple policy changes would solve 90 percent of this problem; the rest could be covered easily enough by a scaled-down version of the Obama plan.

1. Tort reform: Losing LAWYER pays. Not losing client. Not every man for himself. Losing lawyer pays everybody's legal fees. Buh-bye, ambulance chasers; hello, common sense.

2. Pharmaceutical ads: Ban 'em. Direct-to-consumer marketing of prescription drugs is widely known to increase the number of unnecessary doctor visits, which of course drives up costs. Manipulating people into thinking they are sick just so you can sell them drugs is unconscionable, but companies do it all the time, with impunity, and it's costing us billions of dollars.

3. Pre-existing conditions: Remove that phrase from our collective vocabulary. It's immoral, unethical, and basically punishes people for something they can't help.

Those changes would fix most of the problem. Beyond that, it's just a matter of caring for those who can't get coverage for whatever reason, and that could be done quite reasonably.

Seda said...

Thanks for your comments. I love it! You are exactly right on all three proposals - I'll sign onto that!

I still think we'd be much better off with single-payer, though, along with the other stuff I said. Except I actually like your proposal for tort reform better even than just limiting the amount of the reward. Maybe both?

redforkhippie said...

Definitely both. I think if a doctor makes a mistake, he/she should have to cover the cost of fixing it, and I think if that mistake keeps a person out of work, the doctor should also have to cover the loss of income. If the person passes away, the doctor should be responsible for covering funeral costs and making sure the family is not left destitute as a result of losing the person's income. And if it was a stupid, obviously avoidable mistake, a fine is probably in order to remind everybody of the consequences of negligence/sloppiness/whatever. That fine should go into a special fund to provide additional training for medical personnel, geared toward preventing these kinds of mistakes.

Money will help keep a family from losing its home when a breadwinner is hurt or killed by medical error. Money will not heal an injury or raise the dead ... so it's ridiculous to keep throwing doctors' money at problems it can't fix.

Seda said...

Thanks, great comments. I really like the common-sense approach!

LL said...

It's also filled with "pork" loopholes for labor unions and pharmaceutical companies, to garner their support. As Seda and I have discussed on another blog, it's a bad bill.

Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing. To keep our faces toward change and behave like free spirits in the presence of fate is strength undefeatable.
~Helen Keller

Reading List for Information about Transpeople

  • Becoming a Visible Man, by Jamison Green
  • Conundrum, by Jan Morris
  • Gender Outlaw, by Kate Bornstein
  • My Husband Betty, by Helen Boyd
  • Right Side Out, by Annah Moore
  • She's Not There, by Jennifer Boylan
  • The Riddle of Gender, by Deborah Rudacille
  • Trans Liberation, by Leslie Feinberg
  • Transgender Emergence, by Arlene Istar Lev
  • Transgender Warriors, by Leslie Feinberg
  • Transition and Beyond, by Reid Vanderburgh
  • True Selves, by Mildred Brown
  • What Becomes You, by Aaron Link Raz and Hilda Raz
  • Whipping Girl, by Julia Serano
I have come into this world to see this:
the sword drop from men's hands even at the height
of their arc of anger
because we have finally realized there is just one flesh to wound
and it is His - the Christ's, our