Wednesday, November 3

The Elephant in the Health Care Issue

The "elephant in the room" which all parties are still ignoring with respect to health care is rationing.

Everyone (on both sides of the aisle) complain about:
  • insurance. Costs and coverage.
  • tort reform, be it good or bad
  • costs of pharmaceuticals
  • doctors, be there a glut or too few
  • Hospitals and doctors struggling to treat uninsured patients, prompted by the Hippocratic oath.
Some claim coverage is a right, but I disagree. Find it for me in the Constitution! For the most part, the Constitution delimits the rights and describes the mechanisms which make up our government. A Bill of Rights, attempts to preserve for us some rights the government is not to take from us. Nowhere is mentioned a "right" to a doctors care or medicines. But that is not the point.

The big problem, either apparent or lurking below the surface, is the following:
We can deliver far more treatment to virtually every patient than we can ever afford.
We can do for almost every critical patient more than is done. The reason we don't it that we it would beggar us as a nation. Everything in medical care costs more than we expect, not just because those who can pay are subsidizing those who can't but because with every technological advance, more and more is possible. Our bio/medical industry is discovering getting more and more capable. That isn't to say, cheaper. We can do more. It isn't cheaper, much the reverse. We sent a man to the moon. We couldn't send all men to the moon.

Rationing should be addressed, in a democratic fashion. By policy, not by ducking the issue. By avoiding the issue and addressing symptoms, politicians merely make it harder to come up with solutions when they finally get around to it. This should be solved not by forcing those in health care to just get by and struggle with the increasing weight of these issues.

This is the real problem, no other. The biggest problem with our election driven system of government in the light of issues like this is that it takes real courage for an official to propose anything to the electorate that smacks of bad news. But, hell, I'm a blogger. I don't have a constituency to which I'm beholden. Heck, as a beginning blogger, I barely have any readers. If you're reading this, thanks by the way. I don't have to hide when trumpeting problems in our society.

So, beyond pointing out the problem, I will propose a solution. It is not a "real" solution in that it is too simple, but perhaps it is a start. You are truly entitled to the insurance/medical care which you can afford. I can see no better way to ration health care, than ability to pay. No redistribution of wealth other than that is justifiable. As a humanitarian (dare I say Christian) nation, we feel however that the poor and those who can't afford anything do not deserve nothing. Taxation however, removes any choice from your charity. Thus I feel that "free" health care should be available but should be "regulated" in such a way both to minimize red tape, and more importantly to limit coverage. That is, it should be decided democratic fashion how much we will pay for the "free" health care for our citizens. We should not put the burden on the doctors or the health care providers to decide on a case by case basis (and on their "nickel") who this is to be done. Some sort of cap needs be placed on spending for any one person/problem. Our current system of entitlementitus, tends to promise far more than it can afford to give. By continuing to do this, warps the health care system into the strange state we find it today.

We need to start calling it rationing and need to start discussing how to do it right.