Tuesday, July 21, 2009

Spinning health care

Health care is in the hands of politicians and pundits. That means you can’t trust anything you hear. The spin machine, left and right, is in high gear.

I don’t know how best to ensure the best health care for the largest number of people at an acceptable cost. I don’t know that anyone does.

But there are a few things I do know — and I’m sick of hearing these points spun by ideologues who would rather win an argument than get anything done.

• American health care is not very good overall. Yes, we have the best health care in the world — if you can access it; if you can afford it. But overall we spend more than other developed countries for poorer outcomes.

That has to change. How?

• Americans have to change our lifestyles. We’re too fat, our diets are poor and we don’t get enough exercise. We get drunk and high too much and end up in emergency rooms.

Those of us who don’t do all those things — who live active lifestyles and eat well and avoid the pitfalls of drugs and alcohol are subsidizing the rest.

• Medical intervention often comes late and in the most expensive stages of illness. Surgery rather than preventive medicine.

• We spend gobs of money extending people’s lives at the very end of them. When my mother was dying of cancer, she stopped chemotherapy that could have extended her life another six months or a year. Keeping a dying person alive is not the same thing as saving a life. We need to learn the difference.

The crisis in American health care is real — and it’s close to home, if not right on our doorstep or in the living room.

Every year, small businesses like those in Sisters struggle to insure their employees — if they can at all. Every year, they are faced with paying more for less.

It’s not hard to find people right here in Sisters who delay seeing a doctor because they don’t have coverage or their coverage is inadequate. Everyone knows someone who need medical help who has to fight to get it — if they get it at all. People in those straits often get sicker and their care costs more than if they had just been able to see the doctor when they first got sick — or had intervention before a problem turned into a nightmare.

One bugaboo that comes up in any discussion of a public health care option is “rationing” of health care.

We ration health care now. Anyone who has ever dealt with an HMO has experienced rationed health care. Anyone who has delayed seeing a doctor because they can’t afford it has rationed their own health care.

“Some bureaucrat” is managing your health care when your insurance company drops you or doesn’t cover what you thought was covered.

Any health care reform is going to be imperfect. The Obama administration’s current plan has significant flaws and it needs to be rethought. What is needed is a genuine, bipartisan, good faith effort to create a system that controls costs better, covers more people and encourages cultural shifts that empower people to take control of their own health through their lifestyle, and less through the pharmacy and the hospital.

That’s not likely to happen. There’s too much ideological baggage being dragged around in this discussion, too many people with a stake in political success or failure rather than in creation of good public policy.

My bet is that health care reform fails — again — and the status quo continues. And the continued status quo means things get worse.

Jim Cornelius, Editor


  1. Having the federal government run health care is the worst option available. They can't run VA hospitals now, so why give them the whole health care system? That's just crazy talk!

    A better idea is to cover all citizens below the poverty line and all children period and pay for it with cuts in other areas of the government (start with Congress' pay and airfare, slashing the bloated IRS might work too). Somebody smarter than me can find government waste. (How about removing earmarks?)

    There is always a win-win situation. Get kids and the poor access to doctors and leave the government out of my health care.

    Sounds like a win-win to me.

  2. Response to Easycure:

    Medicare is government run Health care and it seems to be pretty successful, since millions of seniors use it without a lot of complaints. So the Idea that government cant run a health care system is simply false.

    Also, to believe that this issue is only about the poor and children is keeping your head in the sand. Heath care costs are being driven up and up by a broken system that only rewards insurance companies who are making huge profits by selling over priced insurance and then spending all the energy and creativity in finding ways to deny claims to people who are sick. Even if you have insurance, if you get cancer and the cost of your treatments exceeds limits that the insurance companies set internally, they will drop you because you are too expensive. If you happen survive your cancer, no insurance company will ever pick you up again because you have a pre existing condition.

    To top that off, the way that providers are compensated on a fee for service basis encourages unnecessary and redundant tests and treatments that are focused on maximizing provider income not patient wellness. If this is not brought under control, even systems that are working well like Medicare will be bankrupted.

    Finally, the way our system works now we have the most expensive health care system in the world with some of the worst health outcomes of any industrialized country.

    The combination of all these factors is costing this country one sixth of our GPD each year and is bankrupting businesses, government and families all over the country, and it is not getting better. None of this has to do with poor people and children.