Health Care. Or Not.

Earlier this morning Mike posted a letter to the editor written by a doctor (one assumes a doctor of medicine, rather than of philosophy) which very nicely addressed the dual issues of shared responsibility and avoidance of scare tactics in addressing the problem of health care reform.

Health care is something you tend to think about most in two parts of your life: first, when you have small children who always need some sort of maintenance; second, when you get older and find that all your constituent parts don't work quite as well - individually or together - as they once did. I look at what my children go through in getting care for my grandchildren, and what we (well, my sister, actually, as she's doing most of the work) are going through in arranging quality care for our father, who remains unable to do much for himself after his stroke earlier this year.

Health care reform, real health care reform, in this country requires, as the good doctor said in his letter Mike shared with us, shared responsibility. This means:

1. Taking responsibility for living in a healthy way so that you don't need more than basic health care most of the time. That means eating right, not doing anything stupid like smoking or taking drugs, getting the right amount of exercise, not engaging in activities you know are likely to cause injury (sorry about that, all you extreme sports people and dumbasses who refuse to wear motorcycle helmets because it limits your freedom to incur deadly brain injury), and seeking medical help when a problem first starts, rather than waiting until you have one foot in the grave and the other one on a banana peel, when your problem will be more difficult (and expensive) to solve.

2. Finding lawyers who care more about justice than about the size of their fees; who don't encourage their clients to file enormous medical malpractice suits grossly out of proportion to the injury suffered; and finding judges and juries willing to stand up and say such suits are fundamentally stupid. Somebody's paying those gigantic settlements, lawyers' fees, and court costs. Surprise! - it's us.

3. Working with the pharmaceutical industry to find ways of keeping the price of prescription medicines down. The outrageous cost of drugs is driven partly by research and development costs, partly by advertising (how many Viagra, Cialis, Levitor, and other drug ads do you see in magazines and on prime-time TV each day?), partly by an opaque pricing structure, and partly because of the enormous cost of insurance against the inevitable lawsuits.

4. Getting people on all sides of the argument to stop demonizing the options recommended by other sides, and whining shrilly about the negatives of any solution but their own. Nobody's interests are served without a clear, thoughtful analysis of the pros and cons of each proposed solution. Example: what does "socialized medicine" actually mean in the context of the debate? Why is a "single payer" plan any different in end result from the patchwork system we have now? And don't just say that it's because "government bureaucrats are making decisions about my health care." Oddly enough, bureaucrats are making those decisions already...it's just that they work for a profit-driven health care industry, and not for "The Government."

Health care in this country is the best in the world...if you can afford it. The problem is that there are too many people who have an economic interest in the issue: doctors who endure a very long and expensive course of training and certification and then - understandably - want to be paid appropriately (and avoid the threat of catastrophic malpractice suits); insurance companies and medical care networks who want to maximize earnings while minimizing costs; lawyers who stand to make millions of dollars by successfully prosecuting malpractice lawsuits (often of questionable merit); and average folks who have a hard time balancing the competing needs to eat, live indoors, and pay for medical care.

I don't know what the ultimate solution is, although I strongly suspect that it's some version of a government-funded single-payer insurance system. Every possible approach to the problem has good and bad points ... the issue for us should be to stop endlessly harping on the bad points and demonizing those who support positions we don't, and start working together to create a system that keeps people healthy.
I suspect the doctors and lawyers will continue to earn their livings regardless of the outcome.

And I also suspect that my grandchildren will still be listening to the same noisy debate when I am old and decrepit. Or older and more decrepit than I am now.

Have a good day. Be safe and live healthy.

More thoughts tomorrow.

Bilbo