Thoughts on Health Care
Care for the suffering is among the provisions of the contract which defines social beings. This has been recognized since long before the Enlightenment and the framing of our Founding documents.
There is no situation in which living creatures are more equal than when ill or injured. And there is no such thing as "choice" when it comes to care. It is either good enough or it is not. .The expectation of care at the forbearance of our fellow creatures is compelling. It is among "inalienable rights" that cannot be endowed nor abrogated by human institutions.
The mindless application of for profit "free" market process as a mechanism to provide for this universal need proves catastrophic; both as to quality and cost.
The U.S ranks 37th in the world in overall quality. Life span is shorter and neonatal mortality greater in some cases by several; percents. The cost in the U.S. is the highest among developed nations.
There is no place for either competition, or psychological marketing gimmicks persuading patients to certain courses. I believe private health insurance, or at least that provided by employers, should be done away with.. Removing private insurance as the sole option immediately frees up at the least 25% of the 30% profit they apply to cost. Medicare administrative costs run about 3%. Why is it those who love a government run military are those most fearful of a government administered health care program?
The polls indicate, fatigued by struggles with private corporations, the people would support such a move. We risk nothing in change that utilizes the rich sources of information now available. The timidity of the Administration and the members of both parties in Congress to legislate true reform is astounding. A cynic would believe it is based on fears of loss of personal wealth and power. Personally I prefer to think it is simply a manifestation of hubris of power.
For profit plans claiming to give "consumers" more choice have just made the ill more vulnerable to confusion by the usual lies and half truths of advertising. This also seems to have relieved care providers of the need to apply the "informed" aspect of "consent." It is now called "choice." That is not to say that patients should not be as informed as possible regarding details and options for treatment..
In my day, we recognized degrees of dependence on the competence and ethics of care providers. In addition to various accreditation institutions, we had peer review and something we called the Hippocratic Tradition. In our current market driven health care the huge conflicts of interest have devastated these institutions. Though never totally sufficient, the stronger those processes are the better.
But alas, in spite of the fact that poll after poll indicates three fourths of the people want government managed single payer insurance the Washington elite appear determined to ignore their will. Indeed, and I think strangely, the Obama administration is discouraging grassroots petitioning of the Congress.
© July 2009
