Random is the word I would use to describe
So.
It has been DISTURBINGLY quiet here the last two weeks. On the one hand, it's nice being done in the afternoon. On the other, I get so worried about the business and job market, that i get kinda twitchy having all this free time. Can't win, eh?
~
I've been thinking a lot about health care, in light of the recent travesty-disguised-as-debate, but also because I am in a parallel field to human medicine, just purchased my first real own-it-yourself-and-not-just-because-school-requires-it health insurance, and am disgusted with the direction that our national health and health care is going as well as most of the media coverage of the 'debate'.
I just read this article, How American Health Care Killed My Father, (Published Sept 2009 in The Atlantic) and it rather blew me away. In a good way because he pointed his experience out as no more than that, did not place blame on the typical players, and gave extremely interesting examples of how we could fix the status quo. If only our elected officials could see past the health care lobbies and do it, we stand at a moment where real change is possible.
Like every grieving family member, I looked for someone to blame for my father’s death. But my dad’s doctors weren’t incompetent-on the contrary, his hospital physicians were smart, thoughtful, and hard-working. Nor is he dead because of indifferent nursing-without exception, his nurses were dedicated and compassionate. Nor from financial limitations-he was a Medicare patient, and the issue of expense was never once raised. There were no greedy pharmaceutical companies, evil health insurers, or other popular villains in his particular tragedy.
Indeed, I suspect that our collective search for villains-for someone to blame-has distracted us and our political leaders from addressing the fundamental causes of our nation’s health-care crisis. All of the actors in health care-from doctors to insurers to pharmaceutical companies-work in a heavily regulated, massively subsidized industry full of structural distortions. They all want to serve patients well. But they also all behave rationally in response to the economic incentives those distortions create. Accidentally, but relentlessly, America has built a health-care system with incentives that inexorably generate terrible and perverse results. Incentives that emphasize health care over any other aspect of health and well-being. That emphasize treatment over prevention. That disguise true costs. That favor complexity, and discourage transparent competition based on price or quality. That result in a generational pyramid scheme rather than sustainable financing. And that-most important-remove consumers from our irreplaceable role as the ultimate ensurer of value.
...
I’m a Democrat, and have long been concerned about America’s lack of a health safety net. But based on my own work experience, I also believe that unless we fix the problems at the foundation of our health system-largely problems of incentives-our reforms won’t do much good, and may do harm. To achieve maximum coverage at acceptable cost with acceptable quality, health care will need to become subject to the same forces that have boosted efficiency and value throughout the economy.
In fact, the suggestions he makes at the end of the piece are exactly the health care regime I provide for my dog-- who is much more efficiently and completely covered than most humans I know. Veterinary clinics exist in the free market. They will quote prices, sell you care packages, and let you make an informed decision on the price and quality of routine care you pay for out of pocket. He has insurance to cover catastrophic events; hit by car, GDV, cancer, etc. And I save to cover the larger routine bills, like dental cleanings under general anesthesia (the equivalent of his health savings account).
And, while I don't necessarily believe that health care should be wholly a free market commodity, it works for veterinary medicine where we provide care for the companions who live in 63% of American households-- 88 million cats, 74 million dogs, 13 million horses, no small number of patients. It's an interesting scale model of the system he suggests.
It also shows the pitfalls of such a system, when people *can't* afford enough care for their loved ones. These are also topics he touches upon but would need to be examined further.
I dunno. It made me think. Feel free to discuss. That's enough deep thought for me for the night.
I'm going to have another glass of wine and watch some Leverage (Yes, I started it, damn Netflix and 'watch instantly' options), Castle (because deep down, we all ♥ Nathon Fillion), or Star Trek ToS (because, goddamnit, I want to see the movie again but it's not out on DVD).
Happy long weekend!
It has been DISTURBINGLY quiet here the last two weeks. On the one hand, it's nice being done in the afternoon. On the other, I get so worried about the business and job market, that i get kinda twitchy having all this free time. Can't win, eh?
~
I've been thinking a lot about health care, in light of the recent travesty-disguised-as-debate, but also because I am in a parallel field to human medicine, just purchased my first real own-it-yourself-and-not-just-because-school-requires-it health insurance, and am disgusted with the direction that our national health and health care is going as well as most of the media coverage of the 'debate'.
I just read this article, How American Health Care Killed My Father, (Published Sept 2009 in The Atlantic) and it rather blew me away. In a good way because he pointed his experience out as no more than that, did not place blame on the typical players, and gave extremely interesting examples of how we could fix the status quo. If only our elected officials could see past the health care lobbies and do it, we stand at a moment where real change is possible.
Like every grieving family member, I looked for someone to blame for my father’s death. But my dad’s doctors weren’t incompetent-on the contrary, his hospital physicians were smart, thoughtful, and hard-working. Nor is he dead because of indifferent nursing-without exception, his nurses were dedicated and compassionate. Nor from financial limitations-he was a Medicare patient, and the issue of expense was never once raised. There were no greedy pharmaceutical companies, evil health insurers, or other popular villains in his particular tragedy.
Indeed, I suspect that our collective search for villains-for someone to blame-has distracted us and our political leaders from addressing the fundamental causes of our nation’s health-care crisis. All of the actors in health care-from doctors to insurers to pharmaceutical companies-work in a heavily regulated, massively subsidized industry full of structural distortions. They all want to serve patients well. But they also all behave rationally in response to the economic incentives those distortions create. Accidentally, but relentlessly, America has built a health-care system with incentives that inexorably generate terrible and perverse results. Incentives that emphasize health care over any other aspect of health and well-being. That emphasize treatment over prevention. That disguise true costs. That favor complexity, and discourage transparent competition based on price or quality. That result in a generational pyramid scheme rather than sustainable financing. And that-most important-remove consumers from our irreplaceable role as the ultimate ensurer of value.
...
I’m a Democrat, and have long been concerned about America’s lack of a health safety net. But based on my own work experience, I also believe that unless we fix the problems at the foundation of our health system-largely problems of incentives-our reforms won’t do much good, and may do harm. To achieve maximum coverage at acceptable cost with acceptable quality, health care will need to become subject to the same forces that have boosted efficiency and value throughout the economy.
In fact, the suggestions he makes at the end of the piece are exactly the health care regime I provide for my dog-- who is much more efficiently and completely covered than most humans I know. Veterinary clinics exist in the free market. They will quote prices, sell you care packages, and let you make an informed decision on the price and quality of routine care you pay for out of pocket. He has insurance to cover catastrophic events; hit by car, GDV, cancer, etc. And I save to cover the larger routine bills, like dental cleanings under general anesthesia (the equivalent of his health savings account).
And, while I don't necessarily believe that health care should be wholly a free market commodity, it works for veterinary medicine where we provide care for the companions who live in 63% of American households-- 88 million cats, 74 million dogs, 13 million horses, no small number of patients. It's an interesting scale model of the system he suggests.
It also shows the pitfalls of such a system, when people *can't* afford enough care for their loved ones. These are also topics he touches upon but would need to be examined further.
I dunno. It made me think. Feel free to discuss. That's enough deep thought for me for the night.
I'm going to have another glass of wine and watch some Leverage (Yes, I started it, damn Netflix and 'watch instantly' options), Castle (because deep down, we all ♥ Nathon Fillion), or Star Trek ToS (because, goddamnit, I want to see the movie again but it's not out on DVD).
Happy long weekend!