Unhealthy Interest

Dinosaur Mom Seal of Disapproval goes to Maryland Surgeons, who saw my mother-in-law on Monday, called on Tuesday to schedule her for surgery next week to remove her gall bladder, and then called me today to say – oops! – they don’t take Medicaid after all so they would have to cancel her surgery. This would have been a little easier to take if they hadn’t specifically told me earlier in the week that they did accept Medicaid and if it hadn’t come in the midst of poor Babushka having a gall bladder attack this afternoon, with me scrambling to get the kids handed off to my mom and Dino Spouse trying to get the doctor to give his mom some pain meds. Baba‘s primary care physician, who is looking more and more like a Seal of Approval candidate, is trying to shame Maryland Surgeons into reversing their decision; hopefully she will succeed before Dino Spouse has to break it to his mom that she’ll be stuck with that gall bladder longer than expected.

This leads me into something I started writing about a couple of weeks ago, which is my thoughts on health care reform. While I am trying to stay better informed on current events these days, I was slow to tune in on the legislative progress of Health Care Reform because I thought it would only annoy me. I am a big ol’ socialist, basically, and I don’t want some namby-pamby “public option” – I want the government to fund a national medical system, period.

After reading this book and having a lengthy discussion of the topic with my father over Thanksgiving weekend, however, I have become concerned about the terms of public debate. Patching together pieces of existing inadequate systems is not going to solve our country’s health care problems, but all the bills under discussion take that as their approach. The common threads that run through the whole crazy quilt now and under the proposed legislation are:

• Most of the money that gets paid to medical service providers in this country passes through the hands of private health insurance companies.
• It costs more to become and be a doctor in the U.S. than anywhere else in the world.
• Medical service providers let their business practices be dictated by health insurance and malpractice insurance providers instead of proactively developing industry best practices and standards.

As I understand it, hospitals and doctors established the first health insurance plans in the 1930s along the same lines that we know prepaid legal plans or auto insurance today. Then employers started offering health insurance to circumvent post-WW2 wage caps. Then Medicaid and Medicare – both run through private health insurance providers – came on line in the mid-1960′s. Up until that time, most medical service providers were independent medical practices and government or charitable hospitals and clinics. When governments started running out of money in the 1970′s, the push to privatize hospitals and clinics started. Come to think of it, that’s about the time the federal government tightened up on higher education grants and lending, too, which contributes to the increase in the cost of getting a medical education since the mid-1960s.

No one blames Geico for the high cost of auto repair. There again, you can take your car to the garage and get it serviced without showing proof that you have insurance or means to pay for the repair up front. If your mechanic got most of his payments through Geico, however, he would soon develop a price structure targeted to what Geico would pay out for specific types of repair, and his interest in serving customers without Geico coverage would plummet.

Maybe if doctors and other medical practitioners took a fresh look at what they need as an industry to do their work humanely, cost-effectively, and safely …

Maybe if the government stopped trying to tweak the existing, broken system and took a fresh look at what The State’s legitimate interest in the health and welfare of its citizens really is and how best to serve that interest …

Maybe if the public stopped looking at health care as a commercial service and started looking at it as a public good along the lines of, say, interstate highways … after all, no one complains about funding freeways on the grounds that illegal aliens might use them or that people might use them for immoral purposes.

I have pontificated long enough.