Tuesday, September 01, 2009

Curing Health Care Ignorance

The greatest strength and greatest weakness of the Modern Liberal is optimism. This optimism is expressed as an undying faith in government (so long as it is a liberally run government) to solve all the problems of the world.

Take, for instance, the detainees at Guantanamo Bay (Miss Gitmo, if you're nasty). Here you have a bunch of guys who have been detained. Not arrested, not tried, not indicted by a grand jury. They're simply detained indefinitely. The liberals wanted these guys released because it's unconstitutional to hold someone without charging them with a crime.

But these dudes are terrorists, and nobody wanted them released. So the optimism of the Modern Liberal meets its ancient opponent: Reality. Barack then decides that instead of detaining them indefinitely, they'll be given "prolonged detention." It sounds nicer, and he even promises to create a legal mechanism to make it all legit.

So instead of doing what they set out to do (free the illegally detained), they're simply going to change the law to legalize their indefinite detentions. That's the kind of clever angleshooting (poker slang for circumventing the rules) that George W. Bush lacked.

And now to health care. does Barack want universal health care? No! At least, not tomorrow he doesn't. He does by the end of his first term, or at least that's what he said in 2007.

So what does he want? Why is it that I don't know what he wants? Why is it so hard to know things about this guy and where he stands on issues? Does he still smoke?

Barack's campaign wrote checks that his policies can't cash. HEALTHCARE IS EXPENSIVE. People live for 80 years now. They spend the last 30 of those years going to the doctor once a month. They spend the last 20 of those years taking 5 pills a day. They spend the last 10 of those years in nursing homes, taking 15 pills a day. They spend the last 5 of those years in intensive care wards.

That shit costs money.

We're able to do things with cancer that we couldn't do 10 years ago. So now a patient that would have died at age 40 in 1990, lives to age 60 in 2009. But that's 20 more years of kemo, pills, and doctor visits.

That shit costs money.

We're able to give EKGs at physicals, have an MRI machine at every hospital, and give people face transplants.

That shit costs money.

So as the cost of health care increase, the costs of health insurance also increase. That's how insurance works.

So I simply don't see how the government is going to reduce costs. Maybe Barack can explain it to me...

So he wants:

1. Cheaper healthcare
2. Choice in healthcare
3. Healthcare for all

Well that's great, but HOW? How do you make an X-Ray machine cheaper?

One proposal makes sense until it's scrutinized a bit (like most liberal policies). 46 million Americans are uninsured, and can't afford to pay their hospital bills when they get sick/injured. So the hospital has to eat the cost, which increases what they charge insurance companies, which increases the premiums insurance companies charge their customers.

Makes sense. If you insured these 46 million people, then this expensive conga-line of charges wouldn't have to take place.

But remember, insurance is based on that whole group principle. It's more expensive to properly insure 46 million people then to give 46 million people medical coverage. Or if insured by the government, it costs the same (that's if the government gets its numbers right, which it usually does, right?)

So including 46 million people among the insured DOESN'T reduce the costs of giving them care. Health insurance is based on the principle that it costs $100/year to care for 10 people, so each person pays $10, even though some people might need $15, or $20 worth of care, and others only $5.

It costs $X to give 46 million people health care. It will cost $X (and possibly more) if they're insured, and it will cost $X if they're not.

Then there's the argument that doctors give unneeded tests in order to fatten their wallets. I talked to my physician about health care reform and he was really offended by this notion.

I remember one time, I had blood in my urine. I drove from Ithaca to Boston to see MY doctor, in MY hospital, because the facilities in Boston are 1,000 times better than some farmer's hospital in Central New York.

I spent the day in Faulkner Hospital, getting bloodwork, peeing into cups, getting X-Rays. The tentative diagnosis was a kidney stone, but my physician wanted to make sure I didn't have bladder cancer. So I went to a urologist, and my bladder was "checked" in one of the most traumatic medical procedures imaginable. And if you're guessing where they put the tube-camera, all I can say is "I wish."

I guess that test was "unnecessary" according to some Super Liberal health care reformist, because I didn't have cancer. And I'm sure that Harvard/Pilgrim (my insurer) called up my physician and asked him why some 20 year old was getting a day of treatments and tests meant for a 50 year old.

But that's what's so great about my private sector capitalist health insurance. MY DOCTOR determines what tests are necessary and unnecessary. But he's watched by the bean-counters at my insurance company. Harvard/Pilgrim doesn't want things getting too expensive because there's COMPETITION out there. And I keep tabs on my insurance company, because if there's something cheaper out there, I'm switching.

The liberals also want to cover people with preexisting conditions, and somehow that will make things cheaper? It's just a fact that an 80 year old diabetic man with three kinds of cancer is more expensive to care for than a 25 year old woman who's at her ideal weight and exercises everyday. So how is insuring the expensive-to-insure, going to reduce costs?

One mantra of the liberals is to pay doctors/hospitals for "Quality" of their care, and not "Quantity." How the fuck do you do that? How do you measure the quality of a doctor's care?

I guess you could go by how healthy his/her patients are. But wait a minute, wouldn't that encourage doctors to fill their patient rosters with fit young people instead of the old and sick? My physician's patients are mostly 50+ (he was my mother's doctor, so I'm one of the few people under 30 that are under his care). How do you measure the quality of care for a physician like him? All his patients are getting progressively sicker, so I guess he's a bad doctor. Meanwhile, Dr. Greedy has the US Gymnastics team for his patients. They're all in perfect shape, so he must be a great doctor. GIVE HIM A RAISE!!!

Health care is not perfect. It's expensive, and people still die. But there's nothing any government can do about it without resorting to socialism. I guess you could make the richest 1% of the country pay for health care. And that sounds nice. But that means less people EMPLOYED by the richest 1%.

But what's another 5% unemployed in a consumer-based economy? At least they'll still have health care. They won't have anything else, like the freedom to go out and make a living for themselves, or the ability to positively contribute to society. But they'll have health care. It will be a long-line, inefficient, the-mayor's-brother-in-law-is-the-nurse kind of health care, but they'll have it.

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