This article cuts to the chase. Do we want bureaucrats or doctors and patients determining health care? Should health care be determined by political decisions?
As she points out what can be given can also be taken away. How would it be to be going though a treatment program and suddenly have some government flunky decide it was not needed? That could happen.
Health Care: Missing the Forest for the Trees
By Jane Orient
View all 4 articles by Jane Orient
Published 11/21/09
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Various groups, on both sides of the issues, are squabbling over details: abortion, a "public option," treatment of illegal aliens, size of penalties, distribution of subsidies, calculation of doctors' pay, etc. Items are moved in or out of the bill as needed to capture just the right number of votes with the least electoral damage.
None of it really matters. The rules will be written later -- after they "get it done" and "something" passes and the next election is over.
Americans need to take the view from 35,000 feet. That's the view of the controllers, the global budgeters, and the folks who drop bombs without having to see the faces of the victims.
The problem is the forest. Cutting down a tree here and there isn't enough. The question is whether we want to put the federal government in control of American medicine. And about the related question of what medicine should be.
Traditionally, medicine is practiced by physicians, one patient at a time. The outcome is assessed by that patient. The right decision is the one chosen by the patient, in consultation with the physician, based on what is optimum for that patient, considering all aspects of his circumstances. The standard of care is the Oath of Hippocrates: providing treatment for the good of each patient according to the best of the doctor's ability and judgment.
In the "reformed" delivery system, healthcare is practiced from on high by committees of "experts" pulling the strings of marionette physicians (rankings, payment rates, other incentives and disincentives) who are judged on how well they achieve population-based outcomes. Patients are like sheep in the flock, categorized by race, income level, quality-adjusted remaining years (QARYs), compliance, functional ability, diversity score, or whatever metrics the rulers adopt. Any individual can be sacrificed for the good of the whole.
All information is to be coded and fed into a huge database, so that the herd's behavior and health can be monitored on a "granular" (minutely detailed) level. Non-reporting is punishable by fines or exclusion or worse.
One of the most common words in the House healthcare reform bill is "eligible." Obviously if you have to be eligible, you can also be ineligible -- and probably are, until proved otherwise. If subsidies can be given, they can be denied, or taken away. If the price-fixers can raise the doctor's pay, they can also cut it. If a committee can mandate coverage and level of payment for a service, it can refuse coverage or set the allowable charge below cost. If it has to certify need, it can declare that there is no need.
There is no need to report something to an official, unless the official has the power to act on the report: by allowing, disallowing, punishing, or making additional demands.
There is no need for a 2,000-page bill unless it is enabling government control over formerly private matters.
There is no need for a "place at the table" unless the czars can serve you a share of the collective goods -- or carve you up.
There is no need to read the bill -- unless it will affect your life. And a bill that creates winners and losers on every page, and that concerns everyone who is born, lives, and dies, will affect your life.
Some Americans may gain something from the bill, at least temporarily. But all lose freedom.
The only long-term winners are the elite who plan to control the show, together with the big special interest groups who will divide up the trillions of dollars of cash flow. They're the ones who are writing the bill -- not your congressman. Remember, he hasn't even read it.
The very worst thing about the bill is that it pits various groups of Americans against each other. What should we do? It's now as though we are on different sides of a giant forest fire, each praying for the wind to shift.
The American thing to do in a disaster is to forget our differences.
Let's all come together -- and pray for rain.
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Comments: 37
-- bad move
-- they need to do one thing at a time, starting with insurance reform
-- people pay hundreds of dollars in premiums, but nothing ever seems to be covered by their insurance
~~~
Yes, that was one of the things mentioned in the bill proposed by Republicans - the one that was only about 300 pages and was about reform, not government take over.
If the whole of government elected officials and appointees were mandated to carry it also, I'm sure the law-makers would make it a better bill.
It's obvious. Look!
Understand the nature of the problem in order to find a solution. The problem is that big money means big influence which can be used to gain still more money. (The return on investments for lobbyists is huge.) Thus builds up influence to the point that the powerful destroy the very system they are exploiting. You can see this over and over in American history. Every panic/collapse of parts of the economy was brought about by too much exploitation of some resource, usually financial.
The very nature of our money causes these problems. Isn't it obvious? Isn't even a cursory survey of history enough to show that every means used to avoid or fight such problems has failed? To say that government should not do certain things is like saying that a patient should not let those germs kill him. How can the trick be done? How can any government avoid the same problems? No matter what is tried, it always fails sooner or later. The seeds of destruction are inherent in the nature of the money.
I don't want the government deciding my health decisions. I've seen how that works for friends and family who have had Medicare, Medicaid and VA benefits, and for a brief period for myself. No thanks.
And...we're seeing a glimpse of what will happen with that new decision by the Obama task force that decided the women don't need mammograms until they're 50. Our newspaper today explained that having women over 40 do mammograms means saving one life for every 1900 screenings. By waiting until 50, it's one life saved in every 1900. The government doesn't think there is a big enough difference to warrant the expense.
And so it will be with all such decisions. They will be the ones to weigh the cost/benefit factor. Not you or your doctor.
When I had a short period of a county health plan years ago, I watched as the doctor poured over a list of prescriptions that the government thought were the ones he should use. He had 3 he was looking for and none were on the list. Thankfully, the doctor cared enough to send me to a social worker who found a program through the drug company to get the prescription free for 6 months. But the government certainly didn't care.
I've never had that experience with an insurance company. You can argue with an insurance company - your doctor or you can. But with government programs, the decisions are made by committee and written in stone.
Riding on the House bill are several issues not even related to health or the bill. i.e. the extension of the rebate program for new home buyers.
That's been happening all along except that it's insurance compnies who have been telling our doctors whay they can and can't do (with our lives). As for pharmaceutical companies, the word is ugh! Here's a glimpse at what they've been up , while we haven't had the public option : http://www.gather.com/viewArticle.action?articleId=281474977488541
What could be a more convincing claim ? Yet policyholders spent years and thousands of dollars fighting the insurance companies to get their money.
I'd rather have a $/hour government worker handling my health and medical, than someone (insurance co., pharma co., hospitals, doctors, etc) who has a monied interest in what care I get.
If the company refuses to pay (as happens too often), the policyholder is stuck having to take the company to court. Time, energy, big bucks, nuisance. Most insurance companies can afford to go to litigation. Most Americans can't. The companies know that.
This is why I not only advocate national health insurance, I support national legal insurance (public option/strictly vetted). I even think there ought to be national health care for our pets (cats, dogs, birds). Veterinarian care is expensive.
If taxes are raised on the very, very rich (last I heard the healthcare bill hikes taxes on $500,000/yr), I don't see a problem.
(Check out : "...and Justice For ALL ? Hmmmmm" by Robert F. protectionist, April 14, 2009, http://www.gather.com/viewPostsByMember.action?memberId=93809&num=-20¤tPage=4&start=80
I can't say I don't support national health insurance but what they have right now to discuss is not it. HR 676 was and is a better bill even if it can be labled a totally socialist program.
On vets. tell me about it. My dog broke a leg when a pickup swvered to try to run over her. So far it has cost me $500 and vets here are a lot cheaper than in the cities or metropolitan areas.
Insurance and it's many, many, many details is an ambiguous thing. How many people buying a car insurance policy, for instance, READ EVERY WORD before they sign those signatures and put all those initials in there ? C'mon really. How many ?
Everyone I know is happy just to know what coverages they're getting, the deductibles, and the costs, and to get out of the office as quick as possible.
In every case, 90% of those long, small print contracts go unread.