Monday, August 24, 2009

A Rational Voice from the Other Side

I suppose it couldn't be more obvious that I am a supporter of health care reform. Although, in all honesty, I still don't know if I am a supporter of this particular approach to health care reform. We definitely have a broken health care system, that's for sure, but how to go about fixing it?

Here is an excellent piece opposing the current plan, and detailing exactly why. Marcian Angell, in a piece from the Huffington Post. Clearly I like the Huffington Post, but I do look to other sources. A sampling from the article:

So it's crucial to ask just why we are spending so much more than other countries. Where is all that money going? Yet, that question is seldom asked in the current debate, even though it's not logical to try to fix something without understanding why it's broken.

I'm putting this here because it was one of the few pieces opposing the current approach to health care reform that doesn't descend into histrionic hyperbole at any point. Unlike many arguments of the opposition this piece is not seeking to frighten people into fleeing from health care reform.

It also mentions the thing my husband and I talk about frequently, which is expanding the boundaries of eligibility for Medicaid.

I agree with a great deal from Angell's piece. It also brings up other countries in an appropriate manner. Why do they have lower overhead? Simply put, they don't treat health care as a for-profit endeavor.

In this debate it is important to carefully consider both sides of the argument. This piece does so without trying to scare anyone witless, without engaging in conspiracy theories, and without suggesting that we're doing swell as we are (because that would be a falsehood of smoldering pants proportions).

I do realize that in many ways this is a more radical approach to reform. We have a situation that may need a tourniquet, and we aren't going to be able to fix it with a bandage, no matter how attractively packaged. We have to start somewhere, maybe it is with Obama's plan even if it is a temporary fix, while we work on the other issues that come with treating health care like a money maker.

I suspect a balance between the two is needed. We have to fix this situation, and it really can't wait for the perfect solution to get the process started. Perhaps Obama's reform combined with a targeted committee to bring health care costs down.

If we do one without the other, the situation will continue to worsen. Marrying the two approaches may be our best bet.


Kathryn said...

That is a well balanced piece. It misses a couple of points, however. As long as we continue to focus on sick-care rather than wellness we will have a problem. But sick care makes more money.

And docs are not trained to utilize inexpensive, natural health care techniques rather than drugs. Nor, in many instances, are they allowed to because it falls outside SOP.

Also, one of the reasons that procedures are run that may very will be unnecessary is the CYA system where they are afraid of being sued.

I certainly agree that the current system is broken. And i am afraid that any system brought in at this time will simply be to try & fund our current broken system. It doesn't make sense to keep doing the same things & expect different results.

I was all for the drug ads when they first started, thinking that patients could then be better educated & make informed decisions. Boy was i wrong! All they do is drive up the drug costs & give a lot of misinformation as well.

I wish there was a simple answer to this. Maybe expanding the medicaide system is the only explanation. Give that a try anyway, before trying to expand this to the entire nation.

DUTA said...

Here's my humble opinion as a non american. I look at the question of where will the money come from and not only where will it go to.

America's printing money like there's no tommorrow. This printing has nothing to do with real economy. China's preparing an ultimatum for Obama's visit: stop the printing as it endangers our dollar reserves . The messages conveyed through Geitner and Hillary didn't help so far.
Every Friday another bank gets closed.

So where would the money for reforms come from. I think Insurance is perhaps the root to all evil because it has gone out of control and proportion. Something has to be done about insurance companies and structure first.

Pauline said...

Yes, yes - a balanced and factual approach is surely what we need. The following article speaks to both yours and Jo's concerns:

Land of shimp said...

I thought it was well balanced also, Kathryn. It address the fact that not having access to health care is one of our problems, but not the entire problem.

The piece Pauline added does a great job of briefly contrasting the medical systems of the world, and breaking it down into a short, understandable examination of differences while addressing a pretty glaring flaw in the US system even for the insured: that insurance companies have systems in place to try and drop coverage for people when they begin to make claims. That being covered isn't a guarantee of care, or payment for care.

As long as we continue to focus on sick-care rather than wellness we will have a problem. But sick care makes more money.

In this we disagree to an extent, Kathryn. I think the first step is making sure people have access to some form of health care. I think that's the primary concern, and where reform must begin. Issue of treating illnesses, as opposed to promoting wellness are far secondary to me and here's why:

People, just people general, do have the capability to find out what constitutes wellness care, and many of those choices are able to be implemented without the oversight of a physician. Good nutrition, adequate exercise, etc.

Although I agree with the spirit of your comment, that we practice treatment of illness over promotion of wellness, promotion of wellness is something that can be implemented by the individual.

An individual, when ill, does not have the same capability to treat that illness. I can look up herbal treatments for migraines, as a for instance, hop on down to my local organic grocery, and purchase what is needed to implement the care. The cost isn't exorbitant, either.

However, a person with a sinus infection can not easily diagnose that problem, nor write a prescription for an antibiotic.

I'm also not as sold on natural care as others are. I've got a lot of friends who eschew Westernized medicine in favor of alternative treatments (even overseen by alternative-care physicians) and my completely unscientific findings are that the success of those treatments is dependent on individual response. It suits some individuals much better than Westernized medicine, but the success rate is very individual. That's only from what I've observed, and I know more people that practice alternative care than Western.

My focus is on allowing access to treatment for all. Health maintenance really relies so much on individual choice. I'm not looking to impede the choices of anyone. If someone wants to eat donuts for breakfast, chances are that isn't likely to keep them healthy, but I don't seek to change that choice.

Provision of a wealth of choice options is more what I'm focused on. Currently people with no access to health care due to financial circumstances have no choice (well, financial ruin is not what I'd call a valid choice).

Provision of the ability to choose. not dictates of the choices to be made.

I respect your opinion, but I'm not occupying the same space on the issue. I've tried alternative methods of treatment personally, and I have to say, I don't personally respond well to them.

Hello, DUTA! Thank you for stopping by! That's an interesting point. I spent a little bit of time looking at bank closing stats yesterday.

I'm just going to admit that I don't feel as if I'm qualified to comment intelligently on economic structures at length. My understanding of economics is rather basic. I will say that I do think we need to take some time, and study the economic structure of other medical systems to better emulate what is clearly a superior handling of cost issues, in order to solve this problem.

Land of shimp said...

Pauline, thank you so much for providing that link. It was a clearly written, concise treatment. It would help greatly in dispelling some myths about other systems. Hopefully it will be widely read.

As I said, I support reform, but I don't blindly support reform. I have a feeling this is something we will be doing in stages for decades. There will have to be a lot fine-tuning.

A great place to start would be in the simple admission that we have things we would be well served to learn from other countries. Evidently that's a really difficult mindset for many to adopt.

Land of shimp said...

Heh, wow, lots of typos above! I apologize. That's what I get for trying to think in the early morning hours, without enough coffee in my system!