Monday, March 12, 2012

Personal Diatribe #x

I saw an article last week that said one of the reasons health care may be so expensive in this country is that it, um, just costs more. Someone did a study on the price of 23 different procedures across affluent countries (my term--I don't remember what they said, but you get the point), and for 22 of them, we simply charge more. Sometimes way more.

I don't like the Obamacare notion of forcing everyone to buy health insurance. Take a country reeling from recession and depression, with high unemployment and underemployment rates, gas prices that take up an average of 10% of each family's monthly budget, and on and on, and I have to wonder how people who can barely afford to get by should be forced to buy coverage.

Clearly everyone needs coverage. When I was in second grade and broke my arm, my mom took me to the doctor and wrote a check. The insurance industry has changed all that, and now no one can afford to write a check for a trip to the doctor, let alone the emergency room.

Right-wingers don't like Obamacare because they don't think people should pay for other people's benefits. But don't we all do that anyway? We all paid 4 million dollars for Obama's RV, we all pay our share for the military, the FBI, Tim Geithner, and all of things, at least supposedly, benefit people besides ourselves. Why stop at health care? Because many people eat too much, don't exercise, and smoke and drink and do other bad things?

Ultimately I don't think that's what matters. What matters is that the average person, whoever that may be or however much they may make, can't afford health care OR the insurance that started out as a concept to keep it affordable.

Before you can do anything, you need insurance reform. Lose the state restrictions, make it competitive. Then reform the pharmaceutical industry. Then you have to have a single payer system, you know, the same thing that makes sense for all of those other "affluent" countries that charge less for angioplasties.

After you stop laughing, imagine if we did something like treated health care like the army. Instead of paying for generals and infantrymen, we pay for doctors and nurses. Assuming we can stop invading other countries long enough.

I think the core of the problem is that the patient is not the customer of the doctor, it's the insurance company. The medical establishment doesn't need to make you happy, they need to make the insurance company happy, because that's who butters their bread. Which means health care is ultimately run by insurance companies which is the tail wagging the dog.

I have a doctor friend from Rumania who was complaining about all of the overhead and time now taken by computerizing everything she does. What used to take ten minutes now takes forty. She says more and more, it's just like Rumania, only cleaner.

Unfortunately we don't seem to be able to do any better than that.