Healthcare reform problems

There’s been a lot of talk about health care reform. From what I’ve heard there have been a lot of emotionally charged statements made, that don’t seem to be all that relevant or maybe just too heavy on emotions and too short on specifics. Take for example the statement “No one should die because they couldn’t afford health care”. On the surface that is a statement I can totally get behind and I totally support the spirit in which I believe it is offered in. When I start to analyze it and pick it apart I realize that it’s pretty vague and very emotional. For those that don’t know me I love to be the devil’s advocate and pose ridiculous questions as food for thought, and/or to illustrate a point. For example if we take that statement extremely literally one could interpret that people that can’t afford health care just simply shouldn’t die, even if they get hit by a train. Of course this is an extreme example bordering on ridiculous, made strictly to illustrate a point. If one were to simply take the statistics of people that died while not having insurance it produces fairly meaningless statistics in my book as it could include people that died under circumstances where their lack of insurance was irrelevant (like in my extreme example, if you get hit by a train you’ll die regardless of your insurance status). In some cases we will never know if having insurance would have helped, as in cases where insurance declined to cover procedures that have unverified success rate. People could argue that it isn’t fair that not all people get access to all treatments, which quickly rat holes to an observation that live isn’t fair. Is it fair that some people are homeless while other live in multimillion dollar mansions? Is it fair to make me pay sky high medical bills for someone who got cancer because they decided to smoke? Smokers don’t like non-smokers to tell them to stop smoking the same way non-smokers don’t like to pay for medical issues that arise from smoking.

The health care system is in serious trouble and does require a lot of work. It is a complex problem and it’s easy to latch onto one symptom instead of digging down to the root of the problem. Common troubleshooting wisdom is that solving a symptom isn’t really solution, you have to find the root cause and address that then symptoms go away. Analyzing symptoms is a good start as it provides data points for your root cause analysis but it’s only a start.

The health care system has many components that all could be contributing to our current crisis. There are the insurance companies, the doctors, the hospitals, the drug companies and the patients. Focusing on only one aspect isn’t going to produce the best solution.

There seems to a lot of talk about national health insurance or national medicine, etc. That sounds a lot like national HMO and/or socialized medicine. Having grown up with socialized medicine in Iceland (located in northern Europe) I believe socialized medicine works about as well as HMO’s. Do we really want to the HMO’s to take over all health care; is that going to fix the problem? From what I’ve heard HMO’s are on one hand being heralded as a solution and on the other hand are used as an example why the system is totally broke.

Here are some of the other symptoms I see:

  • Drug companies charge a small ransom for the drugs, seems like they charge whatever they want.
  • Insurance companies sometimes care more about their bottom line than the insured
  • There are unscrupulous doctors and hospital administrators.
  • Hypochondriacs go to the doctors demanding quick fixes for everything in the form of a pill
  • Some people would rather have liposuction or gastric bypass than do the work of losing weight the old fashion way of watching what you eat and get exercise. Not saying those aren’t valid medical procedures that have their uses and necessities, just that there is the potential for over use.

Since the problem has multiple components we can’t solve it by attacking just one of the symptoms. Yes we need to ensure everyone has access to affordable health insurance. To keep health insurance affordable we need to keep cost of health care down by ensuring drugs are reasonable price. We also need to ensure doctors and hospitals keep their costs in check. Without that we have no hope in keeping insurance affordable. People also need to take responsibility for their own well being and start to take care of them self. Eat sensible, get exercise, etc.

The government regulates how much a moving company can charge, the same goes for utilities companies (Gas, Power, Phone, etc.) as for many other types of businesses. From what I can tell health care provided do not have tariffs.

It is a fact of life that everyone dies, it sucks big time to lose someone you love. We only have limited time on this earth and no one knows just how long they’ve got. Some people live to be 100 while we lose others in what is often described as “in the prime of their life”. Modern medicine may offer theories as to why that is but frequently those theories are proven wrong. As when a chain smoker and heavy drinker that never exercised lives to be 100 and a health nut and exercise fanatic with low cholesterol and otherwise declared fit as a fiddle by the doctors dies of a heart attack at age 40.

While recognizing that losing a loved one is probably one of the worst experiences anyone can have, there comes times when we have to be pragmatic about it. Does it really make sense to spend endless amount of money to keep someone a life artificially? I’m sure we would all be willing to pay whatever it took so that we could have few more months with a loved one. What if it was someone we didn’t know? Would you be willing to pay higher taxes so that some stranger at the opposite side of the country could have few more months with a loved one? If we end up with some sort of government health care your tax dollars will pay for it. If there isn’t some sort of limit to what procedures will be covered it will end up increasing your taxes. Health insurance, whether governmental or private, is simply a business. All business that want to stay in business do a cost benefit analysis when they spend major money. You do the same kind of analysis whenever you make major purchases (hopefully at least). Would you purchase a new car if it came with no warranty and no one was known to drive it more than 6 months before it completely broke down? The same goes for health insurance companies. While it may seem heartless and cold I can totally understand their decision to not cover a procedure that has very low success rate, etc. What is not cool is when the insurance companies denied treatment when that treatment is proven to totally cure a life threatening illness.

Whatever the solution is I believe it needs to allow for health insurance for all as well as keep all aspects of the systems more accountable both in terms of cost, fees and performance.