Healthcare, Hopelessness, and Merry-Go-Rounds

Uncle D. sent me a link to a Knox News story about a 48-year-old Dickson, TN woman, who has nephrogenic systemic fibrosis. According to the report, the disorder is known to affect only 200 to 250 people globally. The woman has fought for two years to gain TennCare coverage for an experimental treatment that has improved mobility in some patients with the disorder.

A Davidson County Chancery Court judge ruled April 21 that the treatment is medically necessary.

Gordon Bonnyman, director of the Tennessee Justice System, said the court decision is important because it could lead to insurance funding of treatments for other rare diseases.

Insurance funding for medical treatments? For people who have diseases?

NO WAY! (That was sarcasm.)

Uncle D. went on to point out these types of things do not just happen in the US: but anywhere the government plays the role of Universal Bandaid Distributor. He says this “bureaucratic baloney” is an unavoidable problem in government-funded health care.

I’m inclined to agree.

Universal Health Care, as well-intended as it is, will never be perfect because it comes with a government-funded budget and is regulated by government policy. Since government-funded budgets are endlessly insufficient: this leads to head-scratching on how to make the system more efficient and/or the budget more sufficient, which leads new, additional or expanded policies and programs, which would require a much larger budget, therefore more taxes, in order to, uh, reduce spending and make health care affordable. (See example here.) These policies, of course, might raise other issues for which new policies must be implemented… and in the end you’re still paying for another convoluted government bureaucracy, which resembles all other convoluted bureaucracies.

Of course, the upside is Americans will no longer be uninsured.

The downside is they might die because they are hopelessly tangled up in a system, which offers them fewer choices and less control: and one that may not notice how sick they are because they’ too busy debating the wisdom of policies, discussing how to manage surgical wait lists, and struggling to place a dollar amount on human life with questions such as: Which services will be covered? What if treatment is experimental or life-prolonging, rather than life-saving, should we pay? How much will we pay? Will we need limitations? What are those limitations? How do we spot exceptions to our rules? Are there exceptions? I think we need a system of appeals and a new Department of Regulation for this!

Honestly – look at the federal programs we have now. Ponder for a moment upon the disaster of government-funded health care we’ve seen on a much smaller scale – and explain how this would be any different. You know, it seems to me entertaining the notion that people won’t get lost in a national health care coverage system isn’t just idealistic: it’s downright delusional.  And what about when skilled physicians reject the additional paperwork, the administrative tasks and the “negotiated” government prices that comes with government-funded health care? What if they opt to work for those who can afford them without the hassle… (unless, of course, you mandate that all doctors must work for the government in order to be licensed and we don’t want to go there.) Wouldn’t this be a small hindrance in the struggle for a “higher standard of health care for all”?

In which case, we’ve created a bigger government and changed nothing?

Of course, Uncle D. thinks the solution to the health care “crisis” is simple. We boot pharmaceutical and insurance lobbyists out of DC because “someone has to be messing around with shit up there for a gawddern roll of hospital gauze to cost 15 gawddern dollars ” – and then, we “cut employers a break if they provide coverage, offer taxpayers deductions for selecting and purchasing their own private insurance – and allow doctors to make medical decisions while requiring the insurance companies to follow along without decisions falling into the hands of an appeals board made up of accounts and lawyers.”

The standard Republican plan – and yes some of these things would help. Some of these things are good. In fact, I can follow D’s plan right up to that point where I trip over the poor people, who are, you know, dead.   Most of us agree there has to be some option for people who don’t have access to or can’t afford private health insurance. Even if you’re one of those heartless hard-core Republican bastards who agrees only because you know the uninsured tend to drive-up the cost of health care for the insured, you agree.

However, the problem with offering both private and government-subsidized health care is the same as it’s always been. You either (1) create incentives for maintaining private health coverage and/or restrict access to low-cost or free coverage by setting eligibility standards or (2) you create a situation, which encourages people to drop private coverage and migrate to the government-funded coverage – meaning you’ve evolved into a universal health care system anyway, wherein there are taxes levied and, in order to manage spending, limits placed on services covered and/or stringent regulations as to what treatments are considered acceptable – which means less choice and fewer options.

Either way, aren’t you right back at square one – still making people jump through hoops for health care coverage? So, the only thing that has changed is who gets to arrange the hoops? I mean – don’t get me wrong. I’d love to believe a national health care plan would work. I’d also like to believe Tupac Shakur and Elvis are still alive – but all three are unlikely.

So – no, I do not think “the government” is the magic solution. In fact (and I do so hate to be the person peeing in the swimming pool of optimism here, but it is what it is…) I don’t think there is a magic solution. There never was. It doesn’t exist. It never will. Therefore, I have serious doubts that the “insurance/health care” problem/crisis will ever be “repaired” or “reformed.”

Meaning 20 years from now, we’re still going to be on this merry-go-round, debating health care and reading similar stories of tragedy wherein bureaucracy of some type (be it private or public) has run amok. Some years the merry-go-round might move faster, some slower – but we’ll be there nonetheless, still feeling dizzy, overwhelmed and in need of a cold beer.

Okay, maybe we all aren’t feeling the beer thing – but you get the point, which is (a) the need for health care is consistent. Therefore, the problems associated with the task of ensuring that all Americans have access to health care will be equally consistent and so, we should just accept that the management of this problem will not be repaired, reformed or eliminated by any candidate, party or passage of time… or (b) it’s hopeless, and we should all starting drinking posthaste.

Again, I went with (b) – but that’s just me.

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4 thoughts on “Healthcare, Hopelessness, and Merry-Go-Rounds

  1. I’ve gotten sick when traveling in countries with socialized medicine. Their national heath care even includes foreigners like me just passing through. You go to see the doctor, he sees you on the same day you call, he diagnoses you correctly, you get a prescription, you leave. On the way out you pay a sort of co-pay or fee of $5 or $10 that covers your share. Same for drugs which are sold at or below cost.

    Seems to work real well. Cheaper and less of a hassle than any health care I’ve gotten in the US.

  2. However, I will agree that if the US government in particular gets into this, they will run a health care system that would make Stalinist Russia seem like the nurse at Disneyland.

  3. Meaning, the two most important things in any American Variant of National Health Care will be:

    1. Guaranteed obscene profits and bonuses for health care industry executives.
    2. Guaranteed obscene profits and bonuses for pharmaceutical industry executives.
    3. Elimination of the ability to sue for malpractice.
    4. Elimination of product liability for pharmaceuticals.
    5. Elimination of peer/scientific journal review.
    6. Collection, storage and analysis of volumes private information about patients, all of which will be reported to the government and used to monitor you.

  4. I guess that was 6 things not 2.

    Let’s make it 7:

    7. Any visit to medical care will be cause for a criminal background check, so that if you have any outstanding parking tickets, or aren’t in the system and are thus a ‘non-person’, after you are stabilized, police will arrive to transfer you to the local jail.

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