An Apple a Day
In the mornings on my hour long commute and the evenings on my hour and half long commute, when my son hasn't talked me into listening to his favorite songs on repeat, I listen among four radio stations: Sports Talk, Local News, NPR, and JACK FM. Thus, I know a little bit about what is going on locally and in the world, which teams are good this year, and the lyrics to the latest hits. It works well.
The Sports Talk guys and the Local News are far more right leaning than what you get on NPR, so when they run similar stories, I like hearing the differences. Lately, a lot of talk has been devoted to health care reform.
I don't pretend to be informed enough to back or protest any bills being presented, and I readily admit that whenever I hear "Health Care Reform" alarms start clanging in my brain that sound like "SOCIALIZED MEDICINE! WE'RE ALL GOING TO DIE! AND WE'LL DIE WITH BAD TEETH!"
Yesterday, I shared that with a total stranger through a mutual friend's journal post on the subject. (I have very intelligent, informed friends, by the way. If you can't be intelligent or informed yourself, that's the next best thing. I'm looking at you, Sarah Palin.) The stranger's response had to do with us not needing better or guaranteed insurance, but guaranteed care. I followed up that we needed guaranteed GOOD care. Guaranteed care is like guaranteed lunch when you're stuck in a training class. I'm not sure the government can guarantee any level of efficiency in healthcare. In fact, I'm pretty sure they can't.
I do believe the system needs to change, but I also believe that human nature is to chase the brass ring, and if we are going to have the best minds and hands in healthcare, there have to be free market incentives. Instead of incentive just to get into the lucrative medical field, though, I think we need to restructure payment so that profit is outcome based. Are you a good doctor or nurse? Then you build your practice to a measurable, and at the end of the year, insurance companies give you kickbacks for how healthy your patients are.
Oh, you have to have records to prove that your patients have all had physicals and have good bills of health, and your potential for profit decreases as your patients health does. But if you've got 80% or better of your customers in solid health, then you get a hefty chunk of cash. That drives medical interest in prevention and cures, and is its own check and balance to the drug companies.
I'm not sure the government is impartial enough to run that. As my friend The Average Blogger says, "Why would you want the outfit that brought you the IRS in charge of your healthcare?" Free bad healthcare can be just as detrimental as no healthcare at all. Ask me. I grew up being treated by military doctors. All those jokes about military doctors? Funny because they are true.
On NPR this morning, David Goldhill talked about how his father died in a hospital, after catching a hospital related infection. He went on to ask what would happen if, after killing his father, the hospital had presented his mother with the +$600k bill. As a consumer, and as the customer, would his mother have been happy to pay for the snowball bill, built up by treatments required after the hospital's initial goof? If not, then why should an insurance company, or Medicare/Medicaid?
I have to say this, too. While I believe that people should all be able to access basic healthcare, and I believe that some provisions should be made for those who honestly cannot help themselves to healthcare, I have a big problem with being told that everyone should only have access to the same healthcare. Big problem with that. And I say that as a lower middle-class woman with a cracked tooth I can't afford to fix right now.
I say that as a woman who, while laid off, had to take her son to the emergency room for a three hour long, $800 visit.
I say that as a woman who has bought private, high-deductible insurance when she couldn't afford the out of pocket on the insurance offered by her small company. Who has had no insurance at all, but bought the package for cheaper visits to the Doc in the Box. And as a woman who has made career choices based on nothing but which company could offer me better insurance.
I know there are very real problems. One of my best friends can't afford care she needs. Another friend is hoarding her rx meds because she can't afford to buy more. Another best friend is scraping by because she and her brother are sharing the expense of keeping their ailing father in a good Alzheimer's facility.
I just don't think the government is the group to fix the problems. Open the conversation? Sure. Be in charge? No.
