It turned into the informal essay I anticipated. While feedback is appreciated, I discovered this was a process to sort through some of the muck read on a daily basis with bits and pieces scattered everywhere, and come to my opinion of the pending legislation. The process was cathartic.
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sir_dave I understand you have substantial issues with the American health care system. Nothing short of miracles can be all things to all people in this very human world. Though we owe so much to the UK, it is important to note more than water separates us at times. We don't always share the same values, think in the same terms, or express ourselves in the same way. That's not bad, that's just the way it is after a 200 year separation. For all but the most liberal of Americans, the battle is so much more than health care and insurance - it's about liberty and maintaining freedoms. The huddled masses we've invited and accepted over the decades and centuries came to the US to escape tyrannical governments, not to enslave their descendants to similar forms. What we have is unique, very personal, and extremely fragile, if we lose the gift of freedom here, there's no other place for humanity to turn. And yes, the cost for this is at times personal suffering, but the cost was no less to gain what we enjoy today.
Don't Fix That Which is Not Broken HR 3200, also known as America's Affordable Health Choices Act of 2009, presupposes large segments of the American health care system as irrevocably broken. As some in Congress would have us believe, this bill is the miracle needed to “fix” the foundational cracks ripping and tearing our nation asunder. I believe the bill, if passed, will prove to be a national disaster.
Problems exist in the American medical system, but unlike Tom Daschle, I do not believe the fundamentals of our health care system are broken. We still have the most responsive and innovative system anywhere in the world. The crisis, if it can honestly be deemed as such, lies within the ancillary institutions to health care: insurance, legal and professional associations such as the AMA.
Myths and Fairy Tales
The most often heard complaint within and without the halls of government relates to the spiraling cost of health care. Health care inflation is double that of the country’s inflation. Most of that is due to excessive administration expenses, something a bureaucratic-heavy, government-ran program will only exacerbate – without benefit of enhanced services.
Without assuming control of all health care management, as of 2008, health care expenses consumed 16% of the GDP, and is expected to rise without reform. But the “reform” being presented to American will exponentially increase the percentage of the GDP. This logic clarifies Biden’s recent remarks that “in order to avoid bankruptcy, we have to spend more.” Equal logic can be applied. Secretary Tommy Thompson discussed issues concerning Medicare in a 2008 forum debate with Senator Daschle. He said funding for Medicare adequately meets the needs, but because the funds go into a general government fund, they are spent for other programs, and then are redistributed to Medicare with a smaller percentage than the collected monies. Our government openly admits it regularly mismanages funds collected from the taxpayer and we are expected to trust these same people with an addition one to two trillion tax dollars annually? That’s a very large pill Congress asks us to swallow. Perhaps it’s not meant to be swallowed, insertion methods may vary.
Statistics are so malleable they can mean anything to whomever chooses to interpret them. For simplicity’s sake, estimates assign 45 million uninsured in the U.S. This number includes approximately 13 million illegal aliens. This brings the number of uninsured to less than 10% of the population. Also included in the initial 45 million are those who could purchase premiums, but choose against. The “real” number becomes much closer to 25 million. Congress is asking almost 350 million US citizens, most satisfied with their current level of insurance, to strip their coverage to bare minimum to accommodate 25-30 million. This is un-Constitutional in every respect, short-sighted by far, and mean to the utmost. Surely there are other solutions available, but they can only originate with a incentives in a free market system, never from the government.
What appearance might Govi-care assume
What would a government sponsored health insurance program look like? The phrase “death by denial” creates a dismal graphic image.
Massachusetts adopted universal care in 2006 in an attempt to reign in out of control costs to the state government. Instead, costs have compounded by double each year, illegal immigrants are being thrown to the wolves, and the mandatory insurance coverage isn’t working out as expected, either. The Massachusetts experiment serves as a grim preview into the country’s future should HR 3200 pass. Rationing will become a matter of fact from the first days of inception, because the only way the government could control cost would be to deny coverage. Like HMO’s across the nation, the incentive to save is too great to consider cancer coverage for an aging population, or allow live-saving routine tests, or for a physician to order an expensive test in a slightly elevated risk population. Or, as the case for medical care for Native Americans living on reservations, once the money runs out, the medical office rolls up shop until next year.
At last glance, military members or families still cannot sue military doctors for malpractice, no matter how egregious the harm inflicted. If the federal government assumes control of medical salaries, the simplest and quickest means to controlling insurance costs is to abolish the ability of patients to sue. The suggestion is not nearly as outrageous as it may appear at first glance.
Why Is It Good Enough for Me, but Not for You?
If this proposed plan is the cure-all to the nation’s health care woes, why then won’t Obama won’t commit himself and family to the proposed plan? Or why won’t Congressional members support House Resolution 615, sponsored by John Fleming, which locks members of Congress into the same insurance plans they want to offer to the greater pubic? The answer is obvious: what they want for “us” is inferior. Period. During the run-up to the 2008 election, I recall watching a program where Obama spoke about the horrors his mother encountered while trying to get an HMO to cover the cost of cancer treatments. Unfortunately, I cannot recall the source of this dialogue, but even though the story changed slightly to adjust for his current agenda, there is still a reference available.
The decision to assign health care of all Americans to the federal and state governments is not the solution. It requires only a cursory look at the proposed bill to see this plan offers no solutions, but instead compounds the cracks already present and compromises the quality available to all citizens.
One Possible Solution among Many
The idea that seems most sensible stems from a variation of practice that until recently was common: contract doctors. Fans of Northern Exposure will remember Dr. Joel Fleischman came to Alaska after attending medical school via an Alaskan scholarship. They paid for the education, and in return, he was required to commit a number of years of service to an Alaskan community. This type of arrangement still takes place in some of Georgia’s smaller rural settings, and I suspect in other areas as well.
The cost of medical school can reach into the hundreds of thousands of dollars, especially when taking into consideration specialty or multiple specialties many doctors choose. Nursing schools, while far less expensive, still place a financial burden on the student, even more so when the nursing studies extend into graduate levels. The costs become prohibitive for many aspiring students. Georgia currently extends student loan forgiveness for teachers in order to recruit new teachers from across the country. Why can’t the federal and state governments not extend this same debt forgiveness to physicians, nurses, and affiliated health care workers in exchange for equitable voluntary service on a national level? (Voluntary contract service is key to the program.)
Facilities, equipment, and medication remain to be addressed under an extended program such as this. To the extent the government is currently preparing to control all health care concerns at a cost into the trillions of dollars, it seems reasonable to suggest a modified arrangement. The government could supply clinics and hospitals with medical equipment, lease facilities from private or non-profit organizations, and finally buying prescription medications from pharmaceutical companies in bulk to distribute for a greatly reduced cost, something already in place to supply military pharmacies worldwide.
This alternate plan offers many advantages. Doctors begin private practice out of debt. The government stays separate from the doctor patient relationship. Visits to a doctor’s office or hospital become affordable, as fees for care would necessarily plummet. So too would administrative costs associated with insurance become marginalized. Finally, perhaps most importantly, the plan would offer fluidity between public and private care as personal need or circumstances dictate.
The plan is not perfect. Gaps in coverage could exist, especially in the implementation phases. More advanced procedures would require waiting. Many patients would never develop a lifetime relationship with one physician, a rarity now at any rate. Other potential pitfalls exist, not the least of which would still require an expenditure of a percentage of the nation’s GDP. However imperfect the plan might be, it’s still a far cry from HR 3200, and I suggest this plan - or any other reasonable consumer driven plan - is at the very least worth an honest national debate.
No matter the innovative means anyone can devise to help correct the U.S. healthcare system, the most essential element requires reform of allied industries: professional organizations, tort reform, and a restructuring of insurance from the bottom up. The AMA needs to relinquish some of its stranglehold on medical practices; there is no logical reason why nurses, psychologists and other advanced medical personnel are restricted from prescribing and diagnosing within their respective fields of expertise. No other consumer market in the nation shrouds costs for office visits and procedures, as does the medical community. This hallowed practice places physicians and hospitals outside the sphere of the free market and has done great harm by failing to create a competitive marketplace. It enabled a system of corruption within the insurance industry and burdened the government to the extent it now feels free to assume control of all aspects of medical care. There must also be some device in place to halt frivolous medical malpractice lawsuits. The best suggestion on this topic requires the loser to pay all associated costs with the suit, and the action stricken from the doctor’s record. Visiting a health professional should never resemble a favourable lottery draw. The last sphere of influence currently functioning more like a lottery organization than a member of the medical society are the insurance companies. For far too long now, insurance companies have been allowed to collect monies and then when disaster strikes, howl like injured coyotes and expect a government bailout. The most pressing needs for insurance reform involves portability, prohibitions against pre-existing conditions, and spiraling premium rates without realized justification.
Yet another Government Dupe
Healthcare is not a right. Our Constitution guarantees the right to life, liberty and the pursuit of happiness. To address any who may argue the right to life somehow equates to the right of medical care to ensure quality of life, I would counter the Framers intended to protect all citizens from a government who might kill arbitrarily. In a capitalistic society, and by the right of liberty, persons have a right not to excel and, indeed, fail utterly. True liberty means that we live by our decisions, whether advantageous or disadvantage to our personhood. However, we are a compassionate nation. Circumstances occur where the best endeavors and preparations fail through no fault of the person. We need some form of safety net to catch the truly unable and unfortunate, no reasonable person resents tax dollars supporting persons with real medical need.
I doubt this administration’s attempt to cram this legislation down our throats as the appropriate prescription. Because there is one plan, and only one plan, a total dismissal of honest debate, and the speed in which Congress and the Obama administration want to enact this legislation, we can know with full certainty this government is not seeking solutions, rather is acting to fulfill a suspect agenda.
