NEOAVATARA

c/o Michael Ramirez, IBD

Before you can fix something, you need to know what is wrong.  And there are many things wrong with our health care system.

Democrats especially are struggling with the concept.  Ted Kennedy has an Op-Ed saying that his plan will fix what is wrong with the system…and misses some of the biggest problems there is.  For example, he points to choice:  choice is NOT a problem in this country.  In fact, if anything, we have too much choice.  He proposes a gateway system to get care; only problem is that system is failing miserably in the one place it has been tried, Kennedy’s home state of Massachusetts.

So what are the major problems with health care today?

1. Cost

This by far is the largest and most destructive part of our health care system.  Every method we have used to reign in costs has failed.  Why?  Because we are simply not willing to face facts:  we are asking for too much for the dollars availabe.

Rationing has been a major bogeyman in the political debate.  But there is not 1 country with national health care without some sort of rationing.  The worst of all worlds would be free health care to everyone, without any restrictions.  We could be bankrupt in a few decades.

Additionally, some liberals talk about Medicare and Medicaid, which have kept rate of increase around 2-3%, depending on whom you talk to.  O.K., but how have they achieved that? By rationing.  Look at recent decisions by the Centers for Medicare and Medicaid (CMS), which decide what to pay for and what not to.  They have severely limited spending on tests such as Coronary CT, Virtual Colonoscopy, etc.  They are already rationing; they just aren’t admitting it.

Fraud and abuse exist.  However, they are not what is breaking the back of the health care system.  In fact, as a percentage, the GAO estimates fraud is a much smaller percentage of health care spending today than it was two decades ago.   Kennedy also argues that the government will reduce red tape.  Can anyone, please, name me one government program that reduces red tape?  Who is he kidding?

2.  Prevention

This is one area that I agree totally with Democrats.  Nobody that I know of disagrees with this.  The American system is horrible at the preventative side of medicine.  We need to implement more programs that target diseases early, especially diabetes and hypertension, which some estimate cost us almost half of our medical dollars in this country.

Now, let us be clear:  I am all for increasing prevention medicine, but there is NO proof that even longterm such programs significantly decrease medical care costs.  The few studies that have been done have shown it actually increases costs.  That said, it is just common sense, regardless of cost.

3. Services

Frankly, our health care system of today cannot handle a national health care system.  Why?  Let us estimate that there are 45 million who don’t have health care today, plus 45 million more that are underinsured.  90 million people.  Now, if we cover everyone, that means that these people, instead of going to emergency rooms and urgent care systems, will come to private care physicians (which is as it should be).  Problem is that there are not enough primary care physicians in this country to handle an increase of 30% more patients.  In fact, in many parts of the country, doctors already have a waiting list. In Massachusetts, the one state with universal care, waits to see a doctor for anything are more than 6 months…and Massachusetts has one of the highest doctor/population ratios in the country.

4. Culture

Not many people talk about this.  And fewer really believe what I am saying about this is right.  But I a believe it as much as anything:

Culture, as much as anything, is destroying our health care system.

Why do I say that?  I have spoken about it before, but couple brief points of synopsis:

• Our legal system culture is the most expensive in the world, by far.  If we don’t have tort reform to go along with health care reform, little will change.
• The legal system has caused doctors to live in a culture of ‘defensive medicine’; meaning, sometimes they order tests and studies only because they are afraid of getting sued, not because it is necessarily medically relevant.  This wastes many times more money in this country than fraud and abuse.
• People in this country are not realistic about life and death.  We spend 1/3 of our health dollars in the final 3 months of people’s lives. Does that make any sense?  In most countries, people die at home peacefully; that is not the case in the United States.  We need to have a culture that respects life, and respects that death is just another step in the process of life.  Medicine is not magical.

There are actually dozens of other problems, though I think that most can fall into the four above categories.

However, for any new system to work in the long run, it must confront all of these factors, or be doomed to failure.  Remember that the next time presents a new bill, so you can analyze it properly.