The Health Reform Charade

As a strong believer that we really need true, honest health reform in this country, I am disgusted by what Democrats have done with the issue.  First, anyone that disagrees with Barack Obama or Nancy Pelosi clearly ‘hates America’.  Second, they are utilizing every classic 50 year old liberal policy to bring so-called ‘reform‘.

It is an outrage.

Conservatives, as well as liberals, need to compromise on some things on health care.   First, government clearly has a role. Second, that role should be limited as much as possible.

Unless we are willing to accept those above tenets, any further discussion is frankly a waste of oxygen.

Democrats have used their massive advantages in Congress to push extreme liberal agendas that ‘liberal thinkers’ have been pontificating for decades.  That was simply a mistake, for a multiple of reasons.  First, there is no proof that many of those concepts will work.  Second, the public is not as liberal as Congress or the White House.  Third, the bill is 1,300 pages at last count, and that much nonsense regulation is generally bad, and the majority of people know that.  Heck, when Representatives say that they can’t bother to read the bill, then poeple get worried.  That is part of the reason for the push back publically, and the plummeting poll numbers on health care.

The reality is this:  the current health care bill is much too big, too invasive, and contains too little reform to be effective.  The Congressional Budget Office, the only nonpartisan player in this game, basically agrees with these statements.  If you read the CBO report on the House health care bill, they are actually far more pessimistic than I am, which speaks volumes.

The sad part is that there is a general tenor in the country that we need health care reform.  Even polling of conservatives shows that.  But Democrats are wasting that ground swell of support.  Only 39% of Americans now support health care reform in the current form, down from over 50% earlier this year.  That is clearly a result of the shell game that Democrats have been playing.

Here is the heart of the problem:  the problems in Health care today are largely not macroeconomic problems, they are microeconomic.  I know, this goes against every expert’s belief.  I don’t care.

Yes, there are demographic problems with health care.  We have to provide more and more care for older patients, with less and less relative younger workers to pay for the elderly.  This is the reason Medicare (held up as the great liberal success) is going to go broke by 2017.  That is true.  However, that is only a small part of the problem.  The bigger part is that individuals in this society frankly are demanding too much of their health care system.  People want doctors to be perfect in diagnosing their problems in a field that perfection is impossible.  They want absolute answers to their questions; in medicine, anything can be answered, at a price.  The question is, is the answer worth the price?  In many cases, the answer to that question is no.

Let me give you an example.  Neck injuries have been extensively studied.  It has been shown thatafter an injury such as a motor vehicle accident, if the patient complains of no pain or tenderness the chances of serious, non-muscular or soft tissue injury is virtually zero (meaning, that the risk of fracture is virtually nil).  Yet, you will see numerous patients get CT and MRIs of their necks for those injuries, even without any symptoms of pain.  ER physicians know this, and generally would not order these tests otherwise.  So why does it happen?  First, patients demand these test, first of all because they don’t want to ‘take a risk’, even if that risk is virtually zero.  Why take a risk, when it costs the patient nothing to eliminate even the small risk that exists?  Second, ER physicians, like all physicians, have an extremely difficult time saying no, because what if this is the one patient out of a million that has a fracture without pain?  In that case, the ER physician would be sued…and could lose everything.

This is just a microcosm of the problem.  I can give you example after example that confirms my argument.  On the patient side, the patient has no incentive to skip an expensive test, because IT COSTS THEM NOTHING!  The ER physician has no incentive to say no, because saying no COULD COST HIM EVERYTHING.

These are the questions that Congress must answer if they are really interested in reform.  We must make patients more responsible for decisions, and make them pay for decisions that don’t meet the best practice standards of the medical community.  And we have to allow doctors to start saying no to their patients.  Without those two reforms, cost controls will never occur.

Moving money from here to there, increasing taxes, increasing mandates, that is all well and good.  But the heart of the matter is based on individuals.  Until Washington is willing to face that reality, we will not get useful health care reform in this country.

7 thoughts on “The Health Reform Charade

  • July 27, 2009 at 11:15 am
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    You are absolutely spot on! What a ludicrous representation of legislative attention when a Congressman says he won’t read the bill! It’s symbolic of our government, I fear. Second, when will elected representatives get it, instead of squabbling like a barnyard full of chickens? President Obama has done a great service by sticking this issue right into our faces. For that I say brvo!

    The problem is that our healthcare system is a model of waste, inefficiency and a haven for opportunistic practices and prodedures that bear no legitimate healthcare fruit. We are throwing an immense amount of healthcare resources down the toilet. We need to reshape of system and place caregiving on a spectrum of cost where each healthcare issue receives intervention at the appropriate time and place. Sore throats should be diagnosed and treated at the CVS Minute Clinic, and not at a more expensive setting that consumes a disproportionate amount of time and money. We need a national system of health information technology to reduce waste and duplications of cost. We need a primary care centrist system that moves care along the efficient spectrum of delivery. Read Christensen’s book “The Innovator’s Prescription”.

  • July 27, 2009 at 2:43 pm
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    I couldn’t agree more. People need to wake up and understand the full impact of this legislation and what it will mean to the current state of our health care. If it is considered bad today, we don’t know how good we have it. It would mean loss of all choices regarding the care we receive. And, health care will seem like much less of an issue when millions upon millions lose their jobs as a result of increased taxation and the government take over of private business.

  • July 27, 2009 at 6:56 pm
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    Folks –
    There is a key thread in this Gordian knot; I think I see it.
    To greatly reduce the health care problems, enact the following: “it shall no longer be illegal for any adult to own any substance whatsoever.” Remember, where 10+ years back it took vast education to know drug interactions, diseases and so on, much of that information can be gleaned by anyone in half an hour on the web (and the effectiveness of such searches is growing). Let people deal with routine matters themselves when they wish. (Incidentally forget about any narcotics being illegal, thus cutting the air off from the drug cartels.) Now, in addition to this you need some really severe penalties for misrepresenting what some substance is or will do (which takes care of all sorts of bad medecine, which must be labelled as not known to be safe and/or effective, as well as various purity concerns), and you need to have FDA et alia do research so that some “gold standard” for substances known to be safe or effective exists. However there would be massive competition for care against informed patients, and the health industry would need to show people why they do better than an informed layman. Surgeons can expect no trouble, but lots of current expensive pill pushing will go the way of the buggy whip, and the cost simply vanish. Note doing this basically costs the taxpayer nothing (saves money, really). So yes, this is kind of a weird idea, but think about the consequences and you’ll realize an awful lot of the health care problem just untangles itself if this is done.

  • July 27, 2009 at 7:47 pm
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    I agree with you 1000%!!! I don’t like how either party has dealt with the debate on reform. We all want reform of the health care system and insurance…but if the Republicans want to be heard they must speak up and let people know they want reform. Most people believe this notion that the Republicans want no reform whatsoever, and that’s the Republicans’ fault. And the Democrats? Well shoving this trash they are proposing down everyone’s throats and not being honest about what they are proposing is disgusting. Both sides are handling this terribly, so far.

  • July 28, 2009 at 5:48 pm
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    Is this true?

    “At a recent town-hall meeting in suburban Simpsonville, a man stood up and told Rep. Robert Inglis (R-S.C.) to “keep your government hands off my Medicare.”

    “I had to politely explain that, ‘Actually, sir, your health care is being provided by the government,’ ” Inglis recalled. “But he wasn’t having any of it.”

    One of the truly amazing and depressing things about the health reform debate is the persistence of fear-mongering over “socialized medicine” even though we already have a system in which the government pays substantially more medical bills (47% of the total) than the private insurance industry (35%).

    In a way, this is the flip side of the persistent belief that the free market can cure healthcare, even though there are no places where it actually has; people also believe that government-provided insurance can’t work, even though there are many places where it does — and one of those places is the United States of America.”

  • July 28, 2009 at 5:50 pm
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    I don’t believe pure free markets can cure health care. But I also don’t believe that pure government system can either. Medicare is broken as well…it will go broke by 2017, losing money yearly. The govt has not been doing any better than private insurance…that is the dirty little secret.

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