Health Care Reform

Divergent Views of Healthcare Reform

I want to point you to a rebuttal of my last post on healthcare reform.

Dr. Rocky Bilhartz is a thoughtful cardiologist and an excellent writer.

In a blog post titled Divergent Visions, he offers a completely different view of right care. Go read it. So what if you don’t agree.

Christopher Hitchens said in Letters to a Young Contrarian that “time spent arguing is, oddly enough, almost never wasted.”

Dr. B makes good points. I was most drawn to his take that central planning mandates more bureaucracy. Yeah, I guess that is true.

Two things we can all agree on: health care policy is damn hard, and we need more input from caregivers who actually care for patients.


4 replies on “Divergent Views of Healthcare Reform”

I agree with you, although there is a valid point to be made about Americans being obese and inert. Walk down the aisle an any grocery store and behold the mountains of junk food. Turn on the TV and see mostly junk programming. There is apparently a lot of profit to be made by keeping Americans addicted to various toxic inputs. Are such profits good for our society? Do they add value? I think not.

I’m at a loss to understand the this guy’s snark. Why does this exalted cardiologist continually refer to you as “One”? Have I missed something?

Also, to add a little snark of my own. I believe that most truly gifted writers avoid the use of “irregardless” in their prose.

From where I sit, you’re both circling around the problem but neither of you nail it.

Your point #1 and his point #2 offer different views on profit. I’d like to re-frame the argument.

Monopoly driven health care must go!

Competition is what drives down costs, not profit. Profit is the prize worth competing for. We (in American health care) have kept the profit but lost the competition. I can give examples for non-insurance covered services like Lasik or the Oklahoma Surgery Center, but you are already familiar.

I would argue that most of the consolidation and lobbying over the past dozen years in health care has been about reducing competition. Make your hospital system larger – reduce competition. Buy up all the local practices – reduce competition. Lock in a big contract as an exclusive provider to an insurance company – reduce competition (and capture those patients with ‘good’ insurance). Lobby the FDA for a patent extension based on a trivial improvement – reduce competition. Lobby the federal government for another hoop to jump through (all in the name of patient safety, of course!) before a competitor can set up shop – reduce competition.

I wonder how things would go in American healthcare if we set up universal insurance via the federal government AND let invited market based forces back into the delivery of care.

I’ll make one bold prediction. If we won’t do it in this country, the rest of the world will do it for us. Medical tourism, long distance ‘visits’ and the like will continue to rise. Before you scoff, think of the parallels with American manufacturing, or computer programing.

Think about how much our lives as Americans would improve if we had an additional 2% of GDP to spend on something besides marginally helpful healthcare! Think of it as a health dividend instead of a peace dividend. Spend some of that on things like parks, fresh food, and greenways and we might just create a virtuous cycle!

Competition is the key. Some regulation is needed, but we’ve let the bureaucratic administrative types swing the pendulum too far.

Like most right-wingers – “Two” being well known to fall into that category – “Two” considers individuals to blame for their own suffering. If Americans are less healthy than Europeans, it is because they are fat lazy slobs. It is not because they are not paid enough to buy good food, or because their government subsidizes the farming only of starch and grain-fed factory meat, or because their food is more (and more and more) loaded with Roundup … and so forth. Everything is a failing of the individual patient, either a character flaw or a genetic defect to be drugged against; nothing is the fault of the system.

“Two” also offers a rather pathetic straw man in claiming that “One” claims that the life expectancy gap is caused by people being killed by overtreatment. Some certainly are, of course, but “Two” doesn’t want to hear about that. Which makes “Two” a really bad choice of physician for someone who wants to make sure he doesn’t get stampeded into unnecessary procedures. Since right-wingers are not known for caring much about the public interest, I must commend him for being so selfless and civic-minded as to reveal his opinions.

Nothing will ever be fixed as long as things like the $15 charge for a wooden tongue depressor appear on your ER Bill, or a $75 charge for a “complimentary” hospital admissions kit (2 paper slippers, and a map of the hospital layout) appear on your outpatient procedure bill. Yes, that actually happened to a friend of mine. It said on the bag and on the bill “complementary”.

Wild, wild west, indeed.

Comments are closed.