A Medical Accident
Today's topic: Health Care. Medicine in the United States costs more than in any other country in the world. In fact, the average for the rest of the developed western world (which basically means us, western Europe, Canada, Australia, New Zealand and maybe Japan) is about half the cost per capita. What does all of that money get us? It gets us one of the lowest life expectancy rates of the entire group. It gets us higher infant mortality than Cuba (yes, you read that right, Cuba, home of Fidel). In other words, the current system of health care in this country is a pathetic joke.
How did it get this way? Malcolm Gladwell has a rather persuasive argument about this in the August 29th New Yorker. The basic idea is this, Bob has something that he should probably go to the doctor for, but doesn't, because he doesn't have insurance, or doesn't want to, or can't afford the co-pay if he does. Instead, three days later he's in the ER with a much higher bill. Fundamentally, the health care system is designed EXACTLY LIKE the prevention system that failed so miserably in New Orleans two weeks ago. Prevention doesn't happen because the system is geared to keep people away from the doctor to avoid "frivolous" costs.
This presumption utterly fails because of one simple fact. Even if going to the doctor were "free," the vast majority of people don't want to go. The added incentive of having to pay, just makes it even less likely. Net result, care that should be done is not, resulting in increased illness (people don't go to the doctor when they have something other people could catch and get those people sick too) more serious illnesses (people don't go until they absolutely have to meaning they now have something harder to treat) and the added stress this causes shortens life expectancy.
At this point comes the argument, "Well what about the people who always have something they think is wrong but nothing is?" This argument completely misses a significant point. If you eliminate the personal cost of health care, the hypochondriac goes in a couple of times, the general practitioner realizes there is an issue and refers them to a psychiatrist. Because that is also under a "non-pay" system, they actually go, and the problems that had been showing up at the clinic stop because their actual problem (some variety of mental illness) is now being treated.
At the same time that this is going on, HMO's and insurance companies are both working to maximize profit. Everyone has heard the horror stories about the person whose HMO gave them the run-around for treatment to the point that, what would have been easy to deal with if caught early is now crippling.
It is time to change what we do now
How did it get this way? Malcolm Gladwell has a rather persuasive argument about this in the August 29th New Yorker. The basic idea is this, Bob has something that he should probably go to the doctor for, but doesn't, because he doesn't have insurance, or doesn't want to, or can't afford the co-pay if he does. Instead, three days later he's in the ER with a much higher bill. Fundamentally, the health care system is designed EXACTLY LIKE the prevention system that failed so miserably in New Orleans two weeks ago. Prevention doesn't happen because the system is geared to keep people away from the doctor to avoid "frivolous" costs.
This presumption utterly fails because of one simple fact. Even if going to the doctor were "free," the vast majority of people don't want to go. The added incentive of having to pay, just makes it even less likely. Net result, care that should be done is not, resulting in increased illness (people don't go to the doctor when they have something other people could catch and get those people sick too) more serious illnesses (people don't go until they absolutely have to meaning they now have something harder to treat) and the added stress this causes shortens life expectancy.
At this point comes the argument, "Well what about the people who always have something they think is wrong but nothing is?" This argument completely misses a significant point. If you eliminate the personal cost of health care, the hypochondriac goes in a couple of times, the general practitioner realizes there is an issue and refers them to a psychiatrist. Because that is also under a "non-pay" system, they actually go, and the problems that had been showing up at the clinic stop because their actual problem (some variety of mental illness) is now being treated.
At the same time that this is going on, HMO's and insurance companies are both working to maximize profit. Everyone has heard the horror stories about the person whose HMO gave them the run-around for treatment to the point that, what would have been easy to deal with if caught early is now crippling.
It is time to change what we do now
posted by Mike N | 12:37 AM
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