Healthcare Debate!!!

Well I didn’ t really plan to opine and editorialize on this blog but why not?  The current political, philisophical and social debate about healthcare is hitting too close to home.  So I am going to weigh in, as if anyone would care to hear my thoughts…

I am a very simple soul compared to the political pundits and heavyweights currently beating this issue to death.  What I do have is 30 years of experience in the medical field and 30 years with a small business owner spouse who has very limited access to health insurance.  Therefore, I have walked both sides of this fence.  Both as the provider of healthcare and as a consumer of medical insurance and it’s vagaries.

As I see it right now there are 2 big mistakes being made or overlooked.  The first mistake and probably the most crucial is this rush to create one wide-sweeping bill touted as a Panacea!!  This is an issue we have been developing and growing and feeding for decades.  How can otherwise seemingly smart men and women (ie. our political leaders) believe that we can fix it in one swoop.  At the very least we as smart consumers should not believe them on this promise.  This is such a complex multi-faceted issue that we should be identifying all of the different components and systematically and methodically dealing with each one of them.  As we explore and implement  improvements in one area we will definitely discover new issues and solultions for the next steps.  One huge lumbering unpopular bill will never succeed.  Even if it passes, it will not really solve many of the issues.  Which brings me to the second mistake.

The second issue I have with this particular bill is that it is very one dimensional.  Except for the consideration of malpractice reform nothing being discussed seems to deal with a foundational issue.  That is the actual cost of healthcare outside of insurance costs.  Albeit the insurance industry is a big portion of this but certainly not the only one.  In reality I believe it to be secondary.  The insurance industry is to a great extent driven by the unbelieveable costs of medical care.  How is this bill addressing some of these issues:

Why should the antiviral drug to treat Shingles be almost $50 a pill?
Why should there be a new competing health clinic and hospital on every corner of most of our cities while rural towns go without.  Healthcare building in many cities is not regulated and out of control.
Why should one microscope in the operating room cost over $750,000.  Better yet why are the surgeons who will use this microscope allowed to play territorial games with that piece of equipment?  Such that it will sit in a storeroom unused 75% of the time because one surgeon doesn’t want to see any other surgeon succeed.
Why are surgeons allowed to be persuaded by sales reps to buy the newest and greatest piece of equipment, when it in fact sits unused and obsolete within 3 months.  Never having delivered on its promised outcomes or advantages.  Already replaced by yet another miracle toy.
Why does a middle-sized metropolitan city need 4 or 5 cyberknives ( or the next generation equivalent) Why aren’t the really high end pieces shared?
Why is any healthcare professional less than ethical, competent or courteous allowed to continue to practice?

Don’t get me wrong,  I am not against innovation.  I have worked 20 years in Surgical Services, one of the reasons being that I love the state-of -the -art atmosphere.  I do believe that because of research and development in the pharmacuetical and medical equipment industries we have the best healthcare in the world.  However,  I don’t believe that the exorbitant costs are always justified by R and D.  Those poor R and D guys don’t make that much money. Trust me! 

My last question is for those who have raised our social consciousness now and want to provide healthcare to every American.  Are we ready for that healthcare to be at a substantially lower quality than what we currently expect and demand of our healthcare providers?  In order to control some of these escalating costs we must take a serious look at our “Cadiallac Care”.  People are losing their insurance and therefore their access to healthcare because the costs are more than the insurance industry can afford to provide to every single American.  We can probably provide adequate healthcare to everyone but it will most certainly not look like a cyberknife on every corner, or an MRI everytime you twist your ankle.  Do we want to take great care away from what is still a good majority of America?  Do we want to further a caste system of those who have to accept “adequate care” and those who can still afford “cadiallac care”?  Can’t we make the whole thing more reasonable for everyone???

 

Well that was certainly a mouthful for someone with no opinions.  I would love to hear your thoughts.

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