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The Health Care Debate

Not long ago, a friend asked me what I, a health care professional, thought of the raging debate on health care reform. I’ve been silent on it both because I’m so busy that I usually avoid anything having to do with work on my days off and because so much was being said and shouted. Here is what I think on the issue.

It needs to happen. Health care reform needs to occur sooner rather than later because the current system is untenable and will end by bankrupting us all. Health care in this country is too expensive (the world’s most) and our population is mind-blowingly ill for the amount of money we spend on it (a statistic embarrassing among the first world countries). Now, people are ill in this country in spite of the health care system, not necessarily because of it. Amongst all the spending, there is a huge amount of waste, both on things that are not needed as well as plenty of penny-wise and pound-foolishness. The insurance model has turned it all into a business, along with the heartless pennypinching and backstabbing that comes with all business. A lot of health care standards practiced by medical professionals today are as much to protect against lawsuits as well as suiting the person who’s ill. These facts are undisputed. I didn’t make them up.

From all I’ve heard on CNN, The Daily Show, and the New York Times, it sounds like the reform is being plugged along backwards. A few things have to be gotten right before anything like “Health Care For All” can even become a reality on paper, nevermind a reality in reality. Firstly, the holes in the system that cause it to bleed money must be found and filled in. It’s too expensive, period. A large part that keeps costs up are lawsuits and the fear of lawsuits and the thought of lawsuits and the shadow of lawsuits that is in the back of every nurse, doctor, administrator, or student you have ever met or seen in a hospital or clinic or office. They may not admit it, but I’m telling you now WE ARE TERRIFIED OF LAWSUITS and most of what we do has the stain of the threat of litigation on it. Imagine the last time you wrote the wrong year on a piece of paper shortly after January 1. Now imagine that you did that while on your 16th hour, bleary with sleep, a in linoleum-covered room amid the din of pagers, phones, overhead call systems, monitors, and the sound of human wailing from the surgeon who’s late for a his flight. Now imagine that mistake could drag you to court, rob you of your license, your savings, your house, your car, your job your life. THAT is health care reality in the 21st century United States. Tort reform *must* happen. No one, NO ONE on this planet deserves to gain financially from an honest medical mistake. I don’t care if it made you paralyzed. No sob story should make anyone gain a dime. Furthermore, I don’t think cash settlements should be handed out at all. If it was an honest mistake, the plaintiff should be guaranteed care but anything over and above that needs to stop. Perhaps the money should be paid into a fund that will pay to guarantee that care but plaintiff should never get any money of any kind. Legal retainers should stay to keep the well-financed, powerful bar lobby happy. But that’s IT. No more crap lawsuits. Any health care reform that does not include deep tort reform is putting the cart before the horse.

Secondly, health care is too expensive. There needs to be a push for preventative care. Those who knowingly disobey medical advice should undergo the more extensive version of an AMA order. If you weigh 400lbs, you need to show you are making progress to take it off. If you flaunt your diabetes regimen, you need to feel the threat that something will be taken away from you. People, sadly, commonly respond only when they feel some kind of personal threat. I’m advocating something like high premiums, not a knee-capping by cousin Vinny.

Thirdly, we need to get away from the insurance model when it comes to health care. Insurance is a business. It’s a bet between you and the company. My homeowner’s insurance is basically me saying something will happen to my house, the insurance company is saying it will not. My money that I pay is my pound of flesh that I am willing to give up to secure the insurance company’s complicity should my bet fail. If all goes well, the insurance company pays nothing, gets to keep my money and continues to line its pockets. If something happens, they pay to fix my roof when a tree falls on it. The next year, we play again. The human body can’t be used for such a game. How can you make such a bet with something that we all KNOW will fail? That’s a guaranteed disaster.

The last thing is the siren song of reality, the thing Americans have the most trouble with. Man is mortal. And fragile. And death comes to us all.

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