Old Rant: Health Care

            The debate should not be about who gets health insurance.  The debate should be about who gets health care.  The answer is everyone, but not unlimited health care, because that leads to rationing.  As the Supreme Court in Canada has stated, access to a waiting list is not access to health care.  The US Government cannot afford to pay for unlimited health care for every American from cradle to grave.  No government that has tried has been able to pull that off.  Ask Cuba, the Soviet Union, Sweden, Germany, or even Canada.

            The delivery of medical care in the USA is so convoluted, so impossible to fix, that a new system needs to be devised.  Medical care designed by the folks who brought you the IRS tax code would be a disaster.

            What the US Government can afford is preventive care for every American, continued disability coverage for the truly disabled, and protection from bankruptcy for catastrophic conditions, i.e. a limited number of the most important medical benefits only.  Private insurance can then be allowed to cover whatever else the public perceives it needs by spreading the risk among the entire population.

            Every person in the US should be guaranteed Life, Liberty, and the Pursuit of Happiness.  Doesn’t the Declaration of Independence state those are inalienable rights? There is no life if it ends unnecessarily and/or prematurely from a preventable or easily treated disease or injury for lack of care.  The burden of being bankrupted in order to treat preventable and easily treatable diseases and injuries certainly interferes with liberty and the pursuit of happiness, especially if one is chained to a location, a spouse, a job, or a situation in order to have health insurance.

            The US Government should guarantee the following medical care to all its citizens, and, in turn, require all of its citizens to participate in this prevention in order to qualify for care, unless scientifically determined otherwise (not religiously or preferentially determined). Most of this care can be administered by nurses or technicians and in bulk at discounted prices, on a sliding scale based on ability to pay:

      1.   All vaccines determined by CDC to be in the best interest of the population

2. Preventive dentistry, also determined by CDC
3. Treatment for all injuries or illnesses that (CDC determined, based on the best, changing, scientific evidence) require hospitalization, surgery, or chronic medication.
4. Preventive medicine evaluations in a timely manner, again determined by CDC, based on scientific evidence.  This includes, but is not limited to: vaccinations, laboratory studies, prostate exams, breast exams, colonoscopies, smoking cessation, diet information, etc.
5. Medical care that would reasonably be expected to extend a person’s life with good quality for a year, or more. [Statistically for the average person, keeping an octogenarian alive on a respirator in the ICU for three weeks likely costs more money than all the above.  If grandma, or her heirs, wants to spend her or their last dime on delaying the inevitable, so be it.  Few patients of limited means choose to bankrupt surviving family members when given the choice of dying with dignity versus weeks to months of expensive prolongation of a terminal illness.]

Private insurance could be used for all other medical encounters, treatment of minor injuries and illnesses, cosmetic surgeries, admissions and surgery that CDC thinks are not scientifically indicated: like a vast number of knee, back, and neck surgeries, many prostate procedures, and other procedures like cataract removal for nursing home patients who don’t read, and procedures and tests done for legal defense purposes only, etc.

Recently an asymptomatic 84 year-old member of my family was sent by her primary care physician to the cardiologist for an evaluation because of a minor change in her EKG.  The family physician was being overly cautious to avoid a suit.  The cardiologist was being greedy.  He wanted Medicare to pay for an extensive work-up: echocardiogram, treadmill, catheterization, and, if necessary, a stent or by-pass for this family member.  Her retort was, “Are you nuts?  Do you think I think I’m going to live forever?”

The greed displayed by every profession participating in health care knows no bounds. Doctors, lawyers, hospitals, health insurance companies, pharmaceutical companies, medical supply companies, and patients all want to get their piece of the health care pie.  It’s capitalism at its worst.  This hybrid of private and public insurance with government regulation doesn’t work.  Let’s separate the parts.  Preventive medicine is in the best interest of the population and the government.  A healthy population that doesn’t go to the ER except for real emergencies will save money.  Preventive medicine keeps people healthy; regulated so that it is available, required for all and not over-priced, it will save money for local, state, and federal governments.  As such, the Health Care Industry, or at least the portion necessary for Life, Liberty, and the Pursuit of Happiness should be regulated like a utility.  Watch carefully; the greedy bastards will slink off, to find other ways to make money: home mortgages, speculating in oil stocks, or whatever.  Health Care will not be affordable as long as it is thought of as the next Tulip Bulb sweepstakes.