{"id":178,"date":"2009-06-26T22:35:00","date_gmt":"2009-06-26T22:35:00","guid":{"rendered":"http:\/\/jimgworld.com\/blog1\/2009\/06\/26\/178\/"},"modified":"2010-05-15T14:44:39","modified_gmt":"2010-05-15T19:44:39","slug":"178","status":"publish","type":"post","link":"https:\/\/jimgworld.com\/blog1\/?p=178","title":{"rendered":"Political Health Care"},"content":{"rendered":"

Michael Kinsey had a really good op-ed piece<\/a> in the Washington Post today regarding the Obama Administration\u2019s impending health care reform<\/span> initiative. Mr. Kinsey focused specifically on the issue of whether federal reform will cause health care rationing<\/span>. In other words, under the newly designed national healthcare system, would anyone (or everyone) be denied the maximium possible health care for certain diseases or conditions? It got me thinking about the whole health care reform issue. <\/p>\n

As Mr. Kinsey points out, under today\u2019s \u201clibertarian\u201d health care system, people certainly do get different levels of health care. The richer and more important you are, the more health care you get. Health care is rationed according to wealth, or according to whether you\u2019re lucky enough to have a job that provides health insurance (and within that group, how good your health plan is). Obama\u2019s health care initiative will basically socialize the health care system; not that the government will operate it as was tried in Britian and other nations. There will still be private doctor practices and hospital corporations and insurance companies involved. But the overall system will now be designed and regulated by the government. There will still be some room for capitalism, perhaps much room. But the federal government will now provide the overall \u201csystem design\u201d and its playing rules. <\/p>\n

Why should this happen? The best motivation is to give everyone access to an acceptable level of health care. There certainly are too many working-poor people today who don\u2019t have health insurance, and only get treatment in the event of an emergency through hospital charity care. Obviously, they don\u2019t get the same level of health care that President Obama or the president of Microsoft gets. Under the federal upcoming reform, everyone will have access to some basic level of health care. <\/p>\n

The problem comes in as to what will or won’t be considered \u201ccost effective\u201d under the cost containment provisions of the new plan. The federal government will now have a whole lot of say as to what treatments can or cannot be provided (unless you are rich enough to afford any kind of treatment you want, whether or not it meets some \u201caverage effectiveness threshold\u201d; thus, a multi-millionaire with a rare or serious disease with no sure treatment could still get a drug that has a 1 in 5 shot of working; but the average citizen could not). <\/p>\n

That might not be any worse than it is for the majority of us who rely upon health insurance, and are subject to our insurance company’s decisions about what they will or won’t pay for. We\u2019ve gone long past the days when the doctor was in charge and the insurance company just picked up the tab. Now the government is going to take over the treatment decision-making role played by insurance companies; how can that be any worse? <\/p>\n

The problem is that the government is now running a national system which has to deliver health care at a cost that is acceptable to a majority of the public (i.e., without significantly raising taxes). As such, we\u2019re now going to mix medicine with politics. <\/p>\n

It certainly will burden taxpayers to give good healthcare coverage to the many poor families who cannot afford it. Obama hopes that he can keep the tax burden in check by wringing out efficiencies, via national standards for medical practice. These national standards will try to eliminate wasteful practices such as doctors ordering too many tests and bringing in too many specialists. As the article points out, there are plenty of studies showing that in cities where there are lots of expensive specialists giving lots of expensive medical tests, people are no better off in their health outcomes. Also, if everyone can get health care when their problems are still small, a lot of emergency care expenses can be avoided, saving lots of money.<\/p>\n

The conservative opponents of a federal health care plan say that the places where things like this have been tried, such as Canada and England, governments have not been able to bring costs down far enough to avoid the massive tax increases needed to bring about universal and equal access to health care. To avoid such tax increases, those government supposedly begin to ration care. People have to wait a long time to see specialists and get high-tech treatments, if they are available at all. More and more treatments are limited or blacklisted; promising new innovations are not approved immediately. Wealthy people thus start using private clinics, more and more. <\/p>\n

But since the market for innovative, speculative treatments would thus be limited, health care companies and drug manufacturers might cut back on their research and development efforts for new cures. The rapid technological progress that has occurred in the medical field over the last 40 or 50 years might slow down. Government would have to take over the R&D; effort in health care; could it be as effective and successful in healthcare innovation as private industry has been?<\/p>\n

I myself honestly don\u2019t know what to make of all this. Having seen government in action for over four decades and having worked for government for several of them, I\u2019m not overly optimistic that Obama\u2019s plan can accomplish its goal of providing health care that is at the same time effective, affordable, innovative and fairly distributed. Sometimes a government agency can \u201ccatch a groove\u201d and do amazing things, like NASA in the Moon race era. But remember, that was followed by the NASA of the Space Shuttle age. If we get a Space Shuttle bureaucracy, then there could well be Orwellian consequences from our federalized health care system. <\/p>\n

America will be taking a big risk, should President Obama get his health care plan enacted and implemented. Perhaps it\u2019s worth the risk, given the unfair mess that health care has become, and given the many other nasty side-effects of a capitalism-driven health care system. America leads the world in coming up with life-extending and life-improving treatments, but the trade-off is that not everyone can afford such treatments; a lot of people can\u2019t even afford basic antibiotics or heart medicine. Health care capitalists are famous for coming up with administrative mechanisms that make life more miserable (HMO\u2019s; care “accounts” that require you to seek out the lowest-cost treatment options when you are weak and sick; pre-existing condition limitations; etc.); and also for spending lots of money on marketing and advertising. Then add in all those crazy tests and specialist referrals that your neighborhood doctor orders in fear of malpractice lawsuits, and the whole thing starts to look like a real burn-out. <\/p>\n

The free market hasn\u2019t come up with anything to make it better for everyone. So the Obama government is now about to administer its treatment; a lot of good can be done, but there\u2019s also an awfully big downside risk from politicizing the health care field. Let\u2019s hope and pray that the politicians and bureaucrats can somehow stick by the doctor\u2019s prime directive: i.e., \u201cfirst, do no harm\u201d<\/span>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Michael Kinsey had a really good op-ed piece in the Washington Post today regarding the Obama Administration\u2019s impending health care reform initiative. Mr. Kinsey focused specifically on the issue of whether federal reform will cause health care rationing. In other words, under the newly designed national healthcare system, would anyone (or everyone) be denied the […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7,8],"tags":[],"_links":{"self":[{"href":"https:\/\/jimgworld.com\/blog1\/index.php?rest_route=\/wp\/v2\/posts\/178"}],"collection":[{"href":"https:\/\/jimgworld.com\/blog1\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jimgworld.com\/blog1\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jimgworld.com\/blog1\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/jimgworld.com\/blog1\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=178"}],"version-history":[{"count":3,"href":"https:\/\/jimgworld.com\/blog1\/index.php?rest_route=\/wp\/v2\/posts\/178\/revisions"}],"predecessor-version":[{"id":1549,"href":"https:\/\/jimgworld.com\/blog1\/index.php?rest_route=\/wp\/v2\/posts\/178\/revisions\/1549"}],"wp:attachment":[{"href":"https:\/\/jimgworld.com\/blog1\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=178"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jimgworld.com\/blog1\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=178"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jimgworld.com\/blog1\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}