Thursday, August 06, 2009

Health care

Democrats are trying to enact health insurance (or health care) reform, and Republicans (and Lap Dog Democrats) are trying to kill it.

I really don't understand why any thinking person would be against health care for all. It just seems so fundamental to being a productive citizen. The opposition is entrenched interests that are making good money off the current system and don't want it to change.

Folks who want the free enterprise system to control health care, and say it will lead to the best system, are either sadly uninformed, total tools of corporate interests, or just plain stupid. No one shops around for the cheapest doctor. Few people have the knowledge to, few have the time to, and it's just not how health care works. After you've stripped and been poked and prodded and probed, you're not of a mind to go looking to save a few dollars by repeating the experience. Besides, who what their spleenectomy done by the cheapest guy in the phone book?

Health care is not a free enterprise system. If it were, doctors would not enjoy the monopoly they do. We'd let anyone deliver health care, and figure that a rational and efficient consumer would pay for the level of expertise and credentials necessary for their particular health issue .

Health care, like infrastructure, like peace and security, is too integral to a productive populace to allow it to be hijacked by folks bleeding it for money. That is, I don't think that health care should be a profit making endeavor, any more than police work or fire prevention is. As a society we need it and it should be supplied by the government. If private industry can find needs not served or ill served by the government, then fine, move in and make money there.

I'm not saying that docs, nurses, hospitals, etc., all should be owned by or employees of government. Individuals earn a living and are paid, but the don't exactly make a "profit." For profit hospitals and for profit insurers and administrators either ought not be allowed, or they should be regulated like a utility. Instead of delivering electricity or water, they deliver health care. Deliverers of health care should be paid enough to do the job, but should not have incentives to increase "profit."

I come to this view informed in large part by my experience with Boise's VA hospital. I only started using it after I returned from deployment, and for the 20+ prior years I used private health care. I gotta say, the VA is at least as good as the private suppliers, and in most cases, it's better. Example: when I need a prescription refilled, I call and tap in a little info using my phone keys, and about 3 days later the prescription arrives in the mail. 90 day supply, $24. BTW, the Dept of Defense is allowed to negotiate pricing with drug makers.

17 comments:

snafu918 said...

That's funny I've been saying the same thing for a while now. For profit ventures should not be allowed in healthcare.

At the end of the day how can people live with themselves when they work for a company that basically makes money from the misfortune of their clients? Of course this line of thinking applies to all insurance companies in general.

Sisyphus said...

Nicely done Alan. And overdue. The Hippocratic Oath is exhibit A on why market forces play very little role in the practice of medicine.

Here's a post on the recent City Club meeting where the speaker was making the same point. I'm sorry I missed the meeting.

http://www.boiseweekly.com/CityDesk/archives/2009/08/04/jarvis-on-health-care-at-city-club

Its a myth that people shop for health care. He also points out that the system now is filled with perverse incentives which allows providers to actually make more money by providing mediocre care.

BlueinIdaho said...

Snafu, that comment "how can people live with themselves..." does nothing to further the discussion. You can pose that question to many other professions: lawyers, computer repair experts, auto mechanics, disaster recovery workers, plumbers, etc. How can they live with themselves?? I work in the health insurance field and I'm not opposed to reform. We do know the system needs work, but to fix it you don't simply replace the management. The discussion shouldn't be about pointing fingers and disparaging people, it should be about solving problems and coming to a workable solution.

snafu918 said...

BlueinIdaho, firstly my comment was not meant to be inflammatory, however it seems in your case that I hit a nerve. I do think my original comparison is more correct that you think and I think that you are rationalizing your position to protect your own conscience which I understand, and can sympathize with. To some degree you're right you can pose that question to most professions, however, in nearly all the other cases we're not talking about life and death professions whereas in healthcare and health insurance we are. It's not just a business you work in, you work for a company that feeds off of society like a carrion vulture feeds off of nature eating the dying and diseased.

Companies that build weapons and export them to war zones overseas are respectively the same though they aren't hurting our own citizens at least.

Ok, I admit this comment might be a bit trollish as this is a fun discussion.

BlueinIdaho said...

No, the only nerve is yours. I'm quite proud of the work I do, as I see my company work with thousands of people each day in an effort to make certain that they receive effective care and not just wasteful tests and chemicals. It is people that do not take the time to understand the system that are causing this latest attempt at reform to generate shouting and shoving at townhall meetings, and I would count you in that group based upon your posts. You apparently have some sort of chip that hasn't been able to be effectively removed from your shoulder. Perhaps you can call your case manager at your insurance company to find appropriate care.

snafu918 said...

Take the time to understand the system? Are you kidding me, no one in this country understands "The System".

Next you have mistaken me for a conservative nut apparently and I don't blame you as I haven't given you any reason to suspect otherwise.

I voted for Obama, and I support his efforts at reform/nationalization of health care in this country.

You are also right that I've been screwed one too many times by a health insurance company and none of my issues were life threatening I could not imagine the stress and pain that an insurance would cause me and my family if I had a life threatening illness.

BlueinIdaho said...

If you want to understand the system, all you need to do is ask those that currently work in the system.

No, I wouldn't place you in the conservate nut category. I realize this issue has become heated for both sides, but just like abortion, nothing gets solved yelling over picket signs.

Fwiw, I support Zeke Emmanuel's reform, because I believe it could be efficient and ease us all into a better system. Employers need to get out of the healthcare quotient, it's bad for them and bad for their employees.

snafu918 said...

What about my response qualified as "Yelling over picket signes" I merely said I agree that when it comes to health care it should be a non-profit industry?

BlueinIdaho said...

That was in reference to the subject immediately preceding the phrase: abortion. It has recently been reported that many townhall meetings to discuss healthcare reform are being lowered to the same level. Thankfully, we have a president that typically rises above the screaming and shouting.

snafu918 said...

As a follow up BlueInIdaho you said:

"in an effort to make certain that they receive effective care and not just wasteful tests and chemicals"

This is one of my chief complaints about health insurance. I chose my doctor and I trust them if they say a test/treatment is needed who the hell are you as an insurance agency to say otherwise? You see this as a benefit and the rest of us see this as a reason that all of you should be fired and your companies shut down.

BlueinIdaho said...

Snafu, a recent survey of physicians reports that the majority of them order unnecessary tests, medicines and procedures because of pressure from the patient and/or to lessen the likelihood of a medmal claim against them. Additionally, I have viewed reports of physicians performing the wrong procedure, procedures performed while under the influence and referring to their own facilities to pad their profit.

Those that work in health insurance are no different than you. They have families, friends and want to make sure their work does more good than harm. It's easy to paint people as evildoers who are stuffing money in their pockets, but that just demonstrates ignorance.

snafu918 said...

"It's easy to paint people as evildoers who are stuffing money in their pockets, but that just demonstrates ignorance."

How is it ignorant to say that people who stuff their pockets with money at the expense of peoples health and lives are committing acts of evil?

"Additionally, I have viewed reports of physicians performing the wrong procedure, procedures performed while under the influence and referring to their own facilities to pad their profit. "

Ok so at the end of the day the Docters office sends the bill to the patient and the patient get's screwed, or has to spend a bunch of time fighting back and forth between the insurance company and his doctor because neither one wants to pay the bill and they are both pointing the finger at the other. Sounds like a working system alright.

"a recent survey of physicians reports that the majority of them order unnecessary tests, medicines and procedures because of pressure from the patient and/or to lessen the likelihood of a medmal claim against them."

First, sounds like we agree that the medical malpractice laws do need some reform, which might help with the above described situation.

Second if I'm the patient and I go to visit my doctor and I have a very real fear about a disease shouldn't the tests that I ask for get run? What's the price of my mental well being?

I truly hope that one day you don't have a disease that causes you to truly need your health insurance, but I imagine that once that day comes you might start seeing things different. Though as you're an insider and you know "The System" perhaps I'll be wrong and you'll forever be able to navigate this hateful maze that is the healthcare in this country.

BlueinIdaho said...

Snafu, you interpreted the evildoers comment incorrectly. I stated it was easy to paint people as evildoers...just as it is easy for some in Idaho to paint democrats as pinko socialist commies.

If the person is insured, the doctor sends the bill to the insurance co, it's denied if not necessary and the physician eats the charge because of his contract. That seems fair and workable, no?

If we're talking about tests that are unnecessary but you just want them because you saw a nifty ad on tv which created your mental state, then you should pay for it...not your insurance.

I lost both parents to "disease" and they fought hard for a cure. Their insurance co's paid for the necessary treatment and thankfully their doctors were ethical enough not to order one of those million dollar treatments that, at the most, extends life (questionable term considering their physical state) three weeks.

This is a complex issue that people need to understand in order for a real solution.

snafu918 said...

Ok then simple question, you said "This is a complex issue that people need to understand in order for a real solution."

Do you honestly feel this scenario is possible, if so how likely do yo think it is that it will happen?

BlueinIdaho said...

Do I think people will take the time to truly understand the issue? Not really, but as I alluded to earlier, Obama is a reasoned thinker who will attempt to create a workable change.

Now, I must go and thoughtlessly deny some claims...j/k. Enjoy your day.

snafu918 said...

I asked: "Do you honestly feel this scenario is possible" In other words do you think it's even possible for a person to understand our healthcare system as well as all the different complexities that tie in?

I would assert that it's too complex to fully understand in it's current iteration.

Riva said...

This is interesting. My question is, are CATS covered under family health care plan?