A Bit 'o Random Musings on Politics, Religion, and Anything Else That Passes Through My Crazy Head

Monday, September 7, 2009

"Socialized" Medicine? Sign me up!

Call me a socialist, but I am so pro-health care reform, it's not even funny (After a my post on likeable things about President Bush, I had to make up for it by getting back to my liberal roots). I'll illustrate my health care views with a simple example from my time in Russia as a missionary.

I served for seven and a half months in a the town of Barnaul, which is in Siberia. As you might imagine, there was a lot of ice. On one cold winter night, my companion slipped and fell on some ice, twisting her ankle. Luckily, we were only three blocks from home and 1 1/2 blocks from a local clinic. We entered, and she was seen immediately by a doctor, given an x-ray within 15 minutes, and it was determined that nothing was broken (though she was in a lot of pain, poor girl). As we were leaving, I asked the nurse/receptionist where we should pay. I'll never forget the look on her face, or on my (Ukrainian) companion's face. They looked at me like I was completely insane. Why would we have to pay for basic medical services? Then it dawned on me that this was all paid for by the government!

Now, I will not pretend that all my interactions with the Russian health care system were that positive (some of them were downright scary), but on that visit at least, my companion was cared for more quickly and effectively than she would have been at the typical U.S. emergency room. I am not suggesting that socialized medicine is perfect (or that we should model our system on Russia's!), but I am saying that every civilized country in the world recognizes that health care is a national responsibility. Every country, that is, except America.

Depending on which poll you cite, about 8 in 10 Americans who have insurance are happy with it. Of course, citing those numbers doesn't include more than 40 million Americans without health insurance (Tangent: WSJ article about estimating the number of uninsured). It also glosses over the fact that 85% of Americans are concerned about rising health care costs. Others are "uninsurable" because of pre-existing conditions. For all too many people the American health care system is a nightmare of inefficiency and insufficiency.

For all the scare tactics about some "government bureaucrat" standing between you and your doctor, right now you have company bureaucrats standing between you and health care - we have a system with some very scary incentives. I am lucky to have a job with health insurance, through a large HMO. Think about that: this company literally makes more money if I don't go to a doctor. They have a profit incentive to deny me health care. On the other hand, doctors in our current system have an incentive, under fee-for-service plans, to push more expensive options. I have an incentive to consume more health care than I need because I'm not (directly) paying for it. These incentives often don't lead to the best treatment. A friend emailed me recently a story (not verified) of a doctor who treated children on Medicaid and was denied access to a badly-needed medication to prevent blindness. Horror stories like this may well occur (if they do, we need to change that), however my private health insurance plan does the same thing - I just received a three page list in very tiny print of all the drugs my health insurance doesn't cover (including such drugs as Prozac).

One of the best articles I've read on the bad incentives currently in place for doctors, patients, and all participants in our health care system was written by a man whose father died of an infection he picked up in a hospital. David Goldhill writes about what he learned in his search for answers in "How American Health Care Killed My Father" in Atlantic Monthly. I don't necessarily agree with his solutions, but he does a really good job of fleshing out the problem of how messed up our current American system is.

Here's a news flash: often the best run parts of the American health care system are (gasp!) the government run parts. People who are on "government plans" actually like it. Medicare recipients rate their health care higher than those on private insurance (see this article). The Veterans Administration is generally better at providing care, according to a study by the RAND corporation.

There are so many people saying "we can't" do health care reform. "We can't" afford it. "We can't" make a system that preserves the positive aspects of choice and competition. "We can't" have a public option because it would hurt those poor big health insurance companies. Congress "can't" possibly understand an issue as complex as health care reform.

I believe in the problem solving abilities of America. I believe that we can find a way to preserve competition and choice while also providing a basic safety net for everyone. My main problem with current proposals is that it doesn't take reform far enough - we need to be doing more to change the way health care is funded (again, see Goldhill's article cited above). We are going to have to make some tough choices, and yes I may have to pay slightly higher taxes because of it. Who says that because something is a difficult and complex issue that "we can't" tackle it with American ingenuity? How about some "can-do" American optimism? Yes we CAN!

1 comment:

  1. AMEN AND AMEN! How did you like the speech tonight? I thought he did a wonderful job.