Tuesday, January 18, 2011

Untangling the Healthcare Situation

The problem of health care has a simple solution. Take note of the word 'simple'. I intentionally avoided 'easy', because like many of the problems in this country we often mistake the two, going for the quick and lazy solution. It's this pattern of borrowing, blame, avoidance and pushing things under the rug that has led to one of ugliest periods in this country's history. Health care in this country is in shambles and instead of really thinking through the issue from the ground up, we're standing around arguing over the merits of a new structure built on top of the rubble of the previous one.

Last year's bill was weak to begin with, watered down by endless partisan yapping and vile amounts of lobbying money. At best, it was a Band-Aid for a bullet wound. This half-assed, middle of the road approach left no one happy.

Instead of focusing on the repeal of the bill though, I'm going to suggest that we take a step back and look at the bigger picture. Now, take another step back and then another. Let's go all the way back to this: What kind of world do we want to live in? Not in a practical sense, but in an ideal one. A truly idyllic health care system. What would it look like?

I think we'd all have a similar vision. Small, personal and community-based clinics, where all we had to do was walk in and say 'It hurts here', pointing to our elbow. We'd get great preventative services from doctors and nurses we knew on a first name basis, drugs would be prescribed as needed and we could trust that the doctor had no one in mind besides us when he handed us the bottle. We'd walk out of the office without having paid a bill. Our medical records could be accessed by us at any time and doctors would communicate with each other in a way that made us feel included in our own health plan.

Does anyone think that that doesn't sound nice? Okay, so getting to that place might be really difficult. In fact, it might not be realistic as soon as we'd like. But we have an obligation to get as close to that as we can, as soon as we can. And yes, for those of you reading this on the political right, I'm talking about socialized medicine. But I'm also here to tell you this: socialized medicine would be the biggest boon for capitalism since the industrial revolution.

Without getting into the squishy warm fuzzy reasons we should all be looking out for our neighbors and doing our best to help the less fortunate, let's look at more pragmatic monetary reasons. Let's dig out exactly why socialized medicine is good for a capitalistic society.

In my description for the ideal health care, one aspect of our current system was glaringly absent: Insurance. Let's define it: "The act, system, or business of insuring property, life, one's person, etc., against loss or harm arising in specified contingencies, as fire, accident, death, disablement, or the like, in consideration of a payment proportionate to the risk involved." The concept of 'health insurance' is flawed at it's very core because every single person needs health care on a continuing basis; your entire life is a 'specified contingency'. Needing health care isn't something that 'might' happen to some of us, like having your car stolen or being caught in a hurricane. Every single person in this country should be seeing a physician on a regular basis if for no other reason than preventative care and routine physicals.

They aren't though because they can't afford it. I could probably dig up a statistic about how much the 46.3 million people under the age of 65 who aren't covered cost the country every year in emergency room visits. That number though, wouldn't reflect the larger cost. How much time did the hypothetical 25 year old uninsured pizza delivery driver spend on the couch, not working when his eye got infected? He didn't have insurance and waited until it got serious to go to the emergency room. Instead of a cheaply preventable situation, we now have one where we pay for his diagnosis and treatment, but he also loses out on work during his recovery. That's money out of his check that is no longer going into our economy. Instead of a guy working and spending his money on video games or his girlfriend, we have a guy on the couch, costing us money.

What I'm getting at here is that a healthy, active workforce is one that not only generates more goods, it's one that spends more money. The whole point of insurance is to defray costs, right? So let's take that to the ultimate level and defray the cost for everyone. Let's put every person into a health care system that doesn't charge the patients, that isn't running a for-profit system that grows when it makes us 'less sick' but not well. Let's not bankrupt a functioning member of our society because he can't make a medical payment. It doesn't pay - for any of us.

Doctors, nurses and everyone who works hard in the medical profession deserves to be well compensated. But they deserve to be paid well because they pulled a tumor out of your brain and nursed you back to health, not because they have to charge you exorbitant fees to pay for the dozens of hours they spent filling out insurance paperwork. The insurance companies are worthless middlemen in the health care world. They serve no real purpose.

I want to live in a world where a doctor makes his living by preventing as many health problems as possible and treating the ones that he can't. I don't want to pay him to do that, because I'd like to think that he does it because he has a calling to help people. I will, however pay taxes into a society that respects his calling and makes sure that he and his family can live comfortably to perform that service to all of the taxpayers.

No one is out there suggesting that fire or police services should be for-profit entities, so why health care? It's about time that we realize that our society is better off when companies aren't getting rich off of our misfortune. We'll be a healthier, stronger, richer country when insurance stops profiting from our neighbors illness. The only upside to having a system as broken as ours is that we have very little to lose by scrapping the whole thing and starting fresh.

The solution isn't easy. It's going to be very difficult to root out our enemy. The insurance companies and the power structures in place are deeply entrenched and have every motivation to keep things the way they are. No one in the current administration, including Obama, have the political will or currency to make the real changes necessary.

I can dream though. And blog.

No comments: