Tuesday, July 28, 2009

AB.Com Open Discussion - The Great HealthCare Debate.

I've deliberated for some time on how to view this whole debate over healthcare. I think it's fair to say that something must be done. Outside the issue of the uninsured, there's the problem with those who are under insured, the fact that even with the stimulus package's assistance, health benefits for the recently laid-off are still too expensive. It's a complex issue with a lot of complex solutions proposed. It all makes me feel extremely blessed that I have quality healthcare.

Again, I don't have the solution, but there are some things I have to say on the matter.

We DON'T Have The Best Healthcare In The World! - Opponents of Healthcare reform argue that there's no need to overhaul our system because the US already has "the best healthcare in the world". Really? A few years ago, the World Health Organization made the first major effort to rank the health systems of 191 nations. France was first, followed by Italy. The United States finished 37th. In another ranking of advanced nations, we ranked dead last on almost all measures of equity because we have the greatest disparity in the quality of care given to richer and poorer citizens. Americans with below-average incomes are much less likely than their counterparts in other industrialized nations to see a doctor when sick, to fill prescriptions or to get needed tests and follow-up care. We rank near the bottom in infant mortality rates, average life expectancy, and near the bottom in kidney and liver transplants. So what are we #1 in? Obesity, of course.

HealthCare Providers Are Notoriously Wasteful - As a guy who's done consulting for dozens of healthcare providers, inefficiency and waste have been two hallmarks of every customer I've visited. These companies make money hand over fist, over duplicate efforts, and often have little internal accountability. They have no inclination to improve their lousy internal processes because, hell, they're making money. Why would they bother? I don't know how to change this, but perhaps some public option will encourage these companies to change the way they do business. As-is, there is no motivation.

Rationing and Long Waits - Uh, scuse' me, but doesn't this already happen today? Making an appointment for my routine annual physical results in a 2-3 week wait, simply because they're already "busy". Anyone who's had a child knows most hospitals start pushing the Mom to go home the moment the baby drops because beds are a valuable commodity. My sons sometimes are told to wait days (I said "told to", my wife usually just walks them in and demands that they be seen) before their pediatrician can see them for a fever. And I have great healthcare. It's not like our current system is perfect in this regard.

Don't Let The Gubb'ment Run Healthcare - One thing that continually pisses me off is when politicians keep arguing against a public option because they swear that you don't want the gubb'ment ruining something so crucial given their track record of incompetence. Uh, you mean the exact same track record of incompetence that you guys were elected to fix? F'real? Yeah, the gubb'ment isn't perfect, but why throw every public servant (10% of the US workforce) under the bus to make a pointless political point? And BTW, the gubb'ment is pretty good at some things. They mail packages cheaply and on-time. They protect us from terrorists. They collect our taxes, pickup our trash, and attempt to educate our kids. They often do these jobs for far less than they're get in the private sector. But yeah, throw em' under the bus anyway. And as for the private sector being so perfect, I have yet one word: Enron.

Don't Believe The Hype - For every disaster story of failed universal healthcare in other countries (ie: The UK, Canada), I am sure there are dozens of great experiences simply not being shared. If you're in a country that's already got some form of gov't run HC, please chime in below.

Where Are The Uninsured Opinions? - My biggest problem in this debate seems to be that the main folks (ie: me) doing all the jawing about what's wrong with healthcare all seem to have one thing in common: they're insured. Any cable news pundit, politrician, or talkshow host poppin' sh*t is entitled to their opinion, but I'd really like to hear more from those either out of work, or unable to otherwise afford insurance.

The Illegal Issue - One easy way to keep costs of any program under control is to simply not allow non-citizens to receive benefits. This doesn't just include illegal aliens, but also those here to work on H1B visas, exchange students, etc. I don't know how much this cuts into that fluctuating number of ~50M uninsured, but it's gotta help somewhere. Would anyone really have a problem with this?

Again, these are just my thoughts, not necessarily solutions. What are yours?

Question: What are your feelings on the HealthCare Crisis? You got any magic bullets to fix the situation? Any horror stories?

World’s Best Medical Care? [NYTimes]

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