The abrupt and direct response to US Nationalized Health Care is that it will become a floundering mess of inefficiency and waste. One can argue, will nationalized health care in the US become more inefficient than what we have today and will it consume 20% or more of our nation's resources like what we experience today? My opinion is that if it doesn't consume 20% or more of our nation's resources, it soon will be designed to do so!
Two main problems exist with nationalized health care in the US: The supply side and the demand side. More clearly, in an environment where everyone is allowed and encouraged to seek medical attention as often as they want, the demand goes skyward. And since everyone is supposed to have equal access to health care considerations and resources, there certainly will never be enough to go around.
We get back to the major premise of socialism and why it distorts the reality of the free hand of an open market. With everyone wanting a service and theoretically enabled to have that resource, demand will always outstrip supply. (Insert image here of an old Soviet-ere Babuska slugging it out with another, similar woman over a package of toilet paper in a bare-shelved Moscow store).
One can argue all day about how successful Britain's or Canada's semi-socialist medical system is and they would be absolutely correct! Let's see if we could transfer that model to the US. Hmmm! I don't think so!
Why? Because US citizens are used to having the access of total availability of health care resources but at the already subsidized rate. If one thinks the present market has placed any restrictions upon consumer demand for health care resources, then please let's look at the reality of the marketplace.
There is no real "open-market" considerations where the actual payer makes decisions based upon price, availability and local resources. Most consumers are insulated from knowing the "true" cost of a procedure because insurance programs almost always pay the bill. The consumer only has to find a medical provider and the cost be damned! He or she really doesn't pay the bill anyway, so there is no understanding of the overall economic cost of specific services, resources or facilities.
So, what exists now is a "seemingly subsidized" consumer health care system in the US. Consumers buy the insurance program options when their employer's benefits renewal program presents repriced options, but nowhere does the consumer take direct responsibility of their own health care dollars as if no insurance existed.
As a nation, we are seeing more and more people without insurance for health care. The US Census Bureau has calculated that amount to be near 45 million up to 50 million people per year. The realities of a true consumer market for US health care actually only exists for a little less than one sixth the present population. These 45 to 50 million people have to make decisions as to how to spend their limited monetary resources on health care without the benefit of an insurance policy to smooth the way. WOULD A CONSUMER WITHOUT INSURANCE MAKE DIFFERENT DECISIONS ABOUT HEALTH CARE THAN ONE WITH?
The answer would have to be a resounding YES! Certain tests would have to be weighed with extreme scrutiny for cost-effectiveness. "Iffy" procedures and operations with low response and success rates would be immediately removed from the decision-tree. Greater importance would be placed upon how an individual makes choices for him or herself.
Specifically, individuals would have to take greater responsibility for diet, physical exercise, alcohol and tobacco consumption in order to preemptively remove the excessive and extremely high cost of obesity, diabetes, heart failure, arterial sclerosis, emphysema, various and sundry cancers and other life-style diseases.
Why is it then, when spending time with most Western Europeans or Canadians, they continue to exhibit such consumerism in health care even when there is socialized medicine in some form or another in their native countries? While US citizens are bellying up to the buffet table/trough on cruise ships, our German, Icelandic, Italian, French and Danish counterparts have modest portions. Why is smoking so unpopular in Europe, but still nearly 40% of Southern US adults still smoke? What is different where in countries health care is readily available the citizens show individual responsibility for its use? My premise is that such responsibility would not be exhibited by US citizens who would fight and claw for each very last piece of good or service to claim as their own, regardless if they needed it or not. Possibly, after years and years of being told they have to take on their own health care concerns, especially regarding life-style issues, Europeans have been conditioned to do so. And since post-WWII was the beginning time for such education, the remaining population really had to believe the government's statements of limited resources!
Yet, if we were to try that very same thing today to instantly limit the access medical resources, with the current level of over-abundance of medical resources just waiting to be called upon at our slightest whim, consumers would revolt.
And that is what we are going to see. As resources tighten-up further and further and people who had previously had access to too much in terms of medical resources suddenly have little or no options, there will be problems. What needs to happen is more "medical consumerism" where the vast population understands and realizes the true value of each and every medical procedure. From there, individuals can decide on how and on what to spend their 20% per annum charge. Additionally, everyone will have to acknowledge the fact that those with more income and wealth have more options.
At least, that is, until US citizens understand how to responsibly use nationalized health care.
Wednesday, June 20, 2007
Thursday, June 7, 2007
California Health Care & Big Business
Yesterday's LA Times published and article about how big business is jumping into the discussion about US Health Care and how Gov. Arnie is trying to get more people in the state of California covered under health insurance plans. This is another example that politics make strange bed-fellows. The article, in its entirety is at http://www.latimes.com/news/local/la-me-health7may07,0,4141456.story?coll=la-home-headlines
I applaud the 30 or so companies trying to make improvements to their employees lives by getting better insurance coverage, however, it also appears to be a little disingenuous considering how management typically and "normally" acts regarding overhead expenses, the largest being personnel and affiliated personnel expenses like benefits (insurance being the largest of that component).
The biggest way to improve health care in the US, is for each and every individual to take responsibility for their health. From being a wise and informed consumer of health care options to wise and aware consumer of food and lifestyles which keep one healthy and not endangered due to "fast living" or poor life decision-making. As a country, we have to teach our citizens such practices. (One can always tell the US citizens on international cruise ships -- they are the ones who habitually pig-out at the open buffet lines of food. Europeans show much greater restraint and moderate eating behavior).
The other part, is to make sure the medical/health care market place really is open. If we are allowed to make informed decisions based upon our wallets, I think we will do fine. Unfortunately, we as a nation don't see health care that way and think it is someone else's responsibility to pay. Wrong answer. I am healthy and don't want to pay for the hypochondriac. Let that person use most of their disposable income to chase phantom boo-boos. I don't want to pay for someone who enjoys their vacation time in medical waiting rooms. Not me!
But there is plenty of blame to go around for making the US a bunch of pill-popping wimps. Medical light-weights who are abdicating our ability to make our own decisions. Force it back to my wallet and I will be as cheap as I can be. Wait. I already do that with insurance! Then, I challenge the rest of my citizen cohort to do the same. Be brave. You can do it!
I applaud the 30 or so companies trying to make improvements to their employees lives by getting better insurance coverage, however, it also appears to be a little disingenuous considering how management typically and "normally" acts regarding overhead expenses, the largest being personnel and affiliated personnel expenses like benefits (insurance being the largest of that component).
The biggest way to improve health care in the US, is for each and every individual to take responsibility for their health. From being a wise and informed consumer of health care options to wise and aware consumer of food and lifestyles which keep one healthy and not endangered due to "fast living" or poor life decision-making. As a country, we have to teach our citizens such practices. (One can always tell the US citizens on international cruise ships -- they are the ones who habitually pig-out at the open buffet lines of food. Europeans show much greater restraint and moderate eating behavior).
The other part, is to make sure the medical/health care market place really is open. If we are allowed to make informed decisions based upon our wallets, I think we will do fine. Unfortunately, we as a nation don't see health care that way and think it is someone else's responsibility to pay. Wrong answer. I am healthy and don't want to pay for the hypochondriac. Let that person use most of their disposable income to chase phantom boo-boos. I don't want to pay for someone who enjoys their vacation time in medical waiting rooms. Not me!
But there is plenty of blame to go around for making the US a bunch of pill-popping wimps. Medical light-weights who are abdicating our ability to make our own decisions. Force it back to my wallet and I will be as cheap as I can be. Wait. I already do that with insurance! Then, I challenge the rest of my citizen cohort to do the same. Be brave. You can do it!
Patient Experiences - Mini Monopolies
I write this a day after I had a minor outpatient procedure. The procedure was conducted at the local hospital, which is the only facility within a 3o mile radius for such procedures. The intake process was demeaning and impersonal. The intake clerk expected me to provide all information without question or hesitation.
When I was to sign the contract between me and the hospital, she refused to comply to my request for my copy of the contract. I would be able to ask for a copy from medical records some other time. I was not allowed to get a copy of what I had just signed.
Wait! This is the sort of contempt back-office and billing areas of hospitals seem to normally exemplify to patients. I only requested a copy of a legal contract I was entering into with the hospital. I do believe that is part and parcel for US business; all parties are provided with the agreements to which they enter.
A secret agreement or one in which is hidden certainly is one that is not made in good faith. And that is what I postulate here - that the contempt and one-sidedness of US hospitalization (the back-office, admissions side) makes the validity of the contract questionable.
Please understand, I had absolutely wonderful care from the floor nurses. They were attentive and concerned about my feelings, concerns and desires. My biggest problem with the floor nurses was that they were a little hurried trying to do as many procedures as scheduled, so much so that they were not always aware of my little jokes or comments. They were being extremely professional, moving fast, but efficiently and always aware of how I, the patient, was feeling.
Wow! the situation was exactly the opposite of the intake/admissions person. She would have rather me drop dead than actually dig out the "Patient Rights" booklet when I asked where it was after I was to sign I had already received it. The booklet was in a bottom of a cabinet on the opposite side of her office area and she had to move her chair and rearrange locations of a few items just to be able to get to a copy. But, I was required to sign a formal document saying I had already received it, but there was no intention of having me get it. I forced her into complying with her own laws which I doubt had been done for a long. All this in regard to documentation stating she had provided mythical information.
Contempt doesn't appeal to me as a way to continue doing business with a company or entity. And yet, what choice do we have? My physician is in a town 11 miles away and the hospital is the only facility in a 30 mile radius. Do I or the people who live in my community really have an option? NO. We are in a localize monopoly. And the hospital knows it too. Every week they spend local advertising dollars to tell the community how wonderful they are. The hospital has several half-page newspaper ads touting their contribution to the good of the community. Why would or is that necessary if it were really the case? Truthfully, because it isn't. The emperor is all to aware he (or she, as is the CEO) has no clothes. The hospital is not all that great. It overcharges by a factor of 400% on procedures and more on pharmacy and oncology. The hospital is stated to be a "Christian-based and not-for-profit", but has employed about every technique available to make it a huge "reserve" generator. Recently, the hospital added more new construction, new heli-pad and business relations with other, larger hospitals to feed patients. And above all, nastier, meaner and more contempt-filled back-office workers.
If other hospitals were available, I would certainly like to check them out. And basic consumerism is denied. At great expense to the consumer.
When I was to sign the contract between me and the hospital, she refused to comply to my request for my copy of the contract. I would be able to ask for a copy from medical records some other time. I was not allowed to get a copy of what I had just signed.
Wait! This is the sort of contempt back-office and billing areas of hospitals seem to normally exemplify to patients. I only requested a copy of a legal contract I was entering into with the hospital. I do believe that is part and parcel for US business; all parties are provided with the agreements to which they enter.
A secret agreement or one in which is hidden certainly is one that is not made in good faith. And that is what I postulate here - that the contempt and one-sidedness of US hospitalization (the back-office, admissions side) makes the validity of the contract questionable.
Please understand, I had absolutely wonderful care from the floor nurses. They were attentive and concerned about my feelings, concerns and desires. My biggest problem with the floor nurses was that they were a little hurried trying to do as many procedures as scheduled, so much so that they were not always aware of my little jokes or comments. They were being extremely professional, moving fast, but efficiently and always aware of how I, the patient, was feeling.
Wow! the situation was exactly the opposite of the intake/admissions person. She would have rather me drop dead than actually dig out the "Patient Rights" booklet when I asked where it was after I was to sign I had already received it. The booklet was in a bottom of a cabinet on the opposite side of her office area and she had to move her chair and rearrange locations of a few items just to be able to get to a copy. But, I was required to sign a formal document saying I had already received it, but there was no intention of having me get it. I forced her into complying with her own laws which I doubt had been done for a long. All this in regard to documentation stating she had provided mythical information.
Contempt doesn't appeal to me as a way to continue doing business with a company or entity. And yet, what choice do we have? My physician is in a town 11 miles away and the hospital is the only facility in a 30 mile radius. Do I or the people who live in my community really have an option? NO. We are in a localize monopoly. And the hospital knows it too. Every week they spend local advertising dollars to tell the community how wonderful they are. The hospital has several half-page newspaper ads touting their contribution to the good of the community. Why would or is that necessary if it were really the case? Truthfully, because it isn't. The emperor is all to aware he (or she, as is the CEO) has no clothes. The hospital is not all that great. It overcharges by a factor of 400% on procedures and more on pharmacy and oncology. The hospital is stated to be a "Christian-based and not-for-profit", but has employed about every technique available to make it a huge "reserve" generator. Recently, the hospital added more new construction, new heli-pad and business relations with other, larger hospitals to feed patients. And above all, nastier, meaner and more contempt-filled back-office workers.
If other hospitals were available, I would certainly like to check them out. And basic consumerism is denied. At great expense to the consumer.
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