Jim Dudley: Rearranging the deck chairs
March 13, 2017
Our health care payment model is not working. Current discussions are similar to rearranging the deck chairs on the Titanic. I think the chairs should be on the starboard side, you think they should be near the stern. Everyone forgets that the problem is the hole in the hull.
Congress argues over who pays for care, not the reality that the cost is too much. Not until all parties work together to cut costs will there be a solution. It is not just the pharmaceuticals, the greedy doctors, the insurance companies. It is all of those and we, the consumers.
Americans have an inflated view of what medicine can accomplish. Competition is not the answer — medicine is different. I can make patients very happy — give them antibiotics for a cold, a CT scan for a mild concussion narcotics for their sprained ankle.
I'll have all the patients I can handle. Good medical care often requires tough talks, and patients are often not happy. Speed and convenience are nice but, frequently, not necessary for good care and good outcomes. Yet, immense resources are spent to be competitive by being convenient and fast.
I see many arguments about the Constitution — medical care is not a "right." I will concede that, but I do believe, as a caring society, we have some obligation to help those who are less fortunate. I will acknowledge there are those who will take advantage (as they will in any given social situation). But I don't think I am one to judge which ill person deserves to have help and which one does not. Our current system allows politicians and insurance executives to do just that. People have noted "everyone can get care — all they have to do is go to the ER."
Unfortunately, that leads to huge numbers of bankruptcy — only in America. I really hope we are enough of a caring society to not allow that to happen on such a regular basis.
I readily admit to supporting a single payer system (not socialized medicine; there is a difference). It will not be perfect, but all other developed societies cannot be wrong. It does not matter what system, there will be disgruntled people — the doc was mean, the nurse was rough, the wait was long, etc. — but overall, people in France, England, Australia, New Zealand and other countries spend much less and are much happier with their care then in the U.S..
Can there be a combination system? Possibly. But as long as I only fight to make you pay, and you only fight to make me pay, none of us will come out of this happy.
We need a system to care for all Americans. Current legislative discussions don't debate how to provide medical care to Americans, but instead, "who can we deny coverage to" and "who can I make pay?"
I realize there are many who say "I'm healthy; I do not need insurance." But make no mistake — a percentage of those people will have a catastrophic illness or injury, and you and I will pay for them as they go to the ER for care and end up on Medicaid.
I certainly do not have the absolute answer but 535 congressmen and women (and thousands of staffers) are currently spending their time discussing ways to get someone else to pay, not how to solve the problem. We all need to step back and tell members of Congress to solve the cost problem and not fight to make the other guy pay.