Real Health Care Reform?

Posted: January 18, 2010 in Politics
Tags: , ,

Sorry I’m late with the blog. This should have been done on Sunday, but I had a lot to do this weekend. Also, there was some Doctor Who action. I slacked. I’m sorry.

I’ve been arguing this week about Health Care in America. It always amazes me that people out there are arguing against reform. The right and the center, funded by the Insurance companies, have been fighting reform since Teddy Roosevelt proposed it way back when. He was a man who understood the value of healthcare – he grew up as a sickly asthmatic kid.

There are two types of reform that need to happen in this country. The first is health insurance reform, which has for all intents and purposes been defeated. The other (which looks like it will pass, barring craziness in Massachusetts) is health care reform, which will be at best, weak and ineffectual.

But wait, you say, the bill includes insurance reform, the White House says so.

But wait, you say, the bill includes cost controls, Ezra Klein says so.

Both of these ideas are mere illusions.

Let me tackle these illusions in order. First, the illusion of insurance reform.

We’re told that this bill will increase the number of individuals covered by medical insurance. This is indeed true. This is not a reform. Anyone who tells you that it is is a shill for the insurance companies.

We’re told that this bill will protect people by preventing companies from denying coverage due to preexisting conditions. This too, is true. But it won’t improve health outcomes.

The problem with all of these is that they have at their heart the cause of the health care crisis in America: Insurance companies. Until these vultures are driven from anything to do with medical care in this country, America will continue to suffer.

These are companies whose very business model is to profit from the deaths of Americans. Collectively, the insurance companies make billions (yes, billions, with a b) of dollars in profit every year. Collectively they have billions (yes, billions, with a b) of dollars of administrative costs every year. That’s all money which individuals like you and me pay either out of pocket or through our employers to them which DOES NOT GO TO HEALTH CARE.

The reality is simple: Health insurance companies suck dollars which could be spent on actual health care and the CEO’s use those dollars to (borrowing a phrase from Jon Stewart) “dip their balls in gold.”

Second, let’s discuss actual healthcare reform. I’ve been told that healthcare in America isn’t broken. We have the best system in the world, why should we change it?

While true, health care in America is on the cutting edge in a lot of ways, access to that care is strictly limited to those rich enough to afford it. See for example Rush Limbaugh. He’s living proof that we have the best healthcare in the world… for people making shit-fuck tons of money. However, for the people who aren’t making shit-fuck tons of money, getting access to care is a non-trivial exercise.

In my opinion the best way to reform the health care system is to turn the healthcare industry into a public institution, just like our law enforcement agencies, or our emergency responders. This week, I’ve had irrational conservatives argue that making doctors and nurses government employees will cause all the good ones to flee the medical profession. Apparently they think that the only reason that people go into medicine is that they are motivated by gazillions of dollars. If doctors and nurses were government employees, then their salaries would be limited to control costs. Without the incentive of making millions of dollars, the best doctors would flee this country (or medicine entirely), and we’d be left with a second-rate health care system.

This I consider to be patently untrue. The police and fired departments are government employees. I really want to hear someone argue that the agents at the FBI or Secret Service aren’t among the best in the world. These individuals aren’t paid millions of dollars. Yet we have some of the best people on the planet working at the FBI, tracking down the most heinous serial killers, kidnappers, etc. The employees of the Secret Service don’t make millions, but they track down foreign counterfeit rings, and protect the leader of the free world.

Another reform which is desperately needed in to curb the practice of the AMA limiting the number of doctors which are allowed to graduate every year. We have a shortage of doctors in this country. We need GPs in every town in this nation, yet Medical schools are told how many students can graduate in each speciality every year to ensure that the supply is limited. This way they can make sure that the prices for their services can remain high.

Consequently, most doctors going through their residency work eighty hours a week or more simply because there aren’t enough doctors. There are plenty of reports of doctors being on call over 120 hours a week. This inevitably leads to them making mistakes. Whenever someone is extremely tired, they are prone to making mistakes. In my opinion, we should have enough doctors in this country so that NONE of them are working more than sixty hours a week. This would have the benefit of cutting down on a great deal of the fatigue related mistakes which are made in hospitals around the country.

Then there is the issue of tort reform. Medical malpractice insurance is one of the largest costs born by those who practice medicine. Once doctors are government employees, the government will bear the cost of malpractice. This will give the government an incentive to eliminate doctors who perform poorly. This will reduce cost and provide for better patient outcomes.

Finally, one last thing which will be a great benefit to both the government and patients alike. Every doctor will be subject to public ratings of their performance. This will introduce transparency into the medical profession, so that patients will have access to doctor’s disciplinary information. When doctors make mistakes, patients should have the right to know about it. This will give them better information so that they can choose the doctor which is best for them.

  1. Ellie says:

    Have you heard of the company called Hello Health? It was started up by some doctors up in Brooklyn who realize that they’re treating in a flawed system and are using the power of the information age to help them renovate the system even if our government fails to do it. I hope that this model becomes wide spread, I would love to have it where I live.

  2. fewa says:

    Nicely put! I agree. Also, good work with the writing every week, hope you can keep it up. I should do the same…

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