The Problem

The health care debate is heating up. I’m entering the fray in an attempt to analyze health care from the inside out; there are too many on the outside looking in that don’t know their axillas from their umbilicuses, so I thought I’d throw in some views from my vantage point.

I’m also writing this because I’m mad. Not angry—mad. You have to be crazy to post on the internet, because it exists out there in the ether in perpetuity to incriminate humiliate and aggravate.

OK, I guess I’m mad.

I’m also angry. But this doesn’t distinguish me from the millions of other mad, angry bloggers out there. So if you’re reading this, it’s because I’ve encouraged it through threat of bodily harm, or you’ve heard I’ve got something to say that is so important or awe-inspiringly stupid, ignorant or insulting that you had to see it for yourself.

Either way, welcome.

First, I’m a practicing physician. I’ve had (and hope to continue having after this post) a respectably flourishing practice as a noninvasive cardiologist. I’m 57, old enough to have seen a lot, young enough to … well, let’s say I’m still capable of walking upright and pushing in-line skates fast enough to allow me to access the health-care system I’m about to dissect. I tire more easily but don’t dodder. I anger more easily but am more adept at internalizing it. This is good for business and the world at large, but not so great for my physiology. But I digress.

 So, what’s wrong with health care? And who cares what I think, anyway?

I’ve had the benefit of practicing medicine in both the managed care and private sector arenas. I believe I have a more balanced view than many of my colleagues who have only been in one camp or the other. I have no agenda, other than trying to present a more global viewpoint that will hopefully structure and clarify this sick institution in your mind, and in my own. And make no mistake about it, it is sick. Or, more metaphorically, a sickbed.

 The health care debacle is a queen-sized sickbed—on its way to becoming a king. And we’re trying to cover it with a twin-sized bed sheet. Every time you get two or three corners covered another pops off. And the sheet’s been laundered so many times it’s shrinking. The only way out is to shrink the bed; to be blunt, there ain’t no new sheet.

I’m sure this is no revelation to you; every year the cost of medical insurance skyrockets and the benefits plummet. You hear that Medicare will be bankrupt in 2017. I don’t think we have that much time. In fact, I believe the institution is a heartbeat away from the ICU.

 Let’s cut to the chase: who’s to blame (assigning blame is a great American pastime—one we’ve honed to a razor’s edge). That’s easy: everyone. No, this is not a cop-out; I’ll get specific. The culprits are, in no particular order: Big Government, the trial lawyers, the insurers, the more than 300,000 American doctors … and, yes, the poor, beleaguered patient, who didn’t ask to be sick. And they’ve been aided and abetted, to some extent, by Big Pharma and the medical device industry

In subsequent entries I plan on taking on all of these groups, until perhaps no one in this wonderful land of ours will be willing to be seen in the same room with me. However, I’m optimistic; I’m not the only curmudgeon in this world. Our ranks are growing every day.

 

NEXT: The Trial Lawyers

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3 Responses to “The Problem”

  1. Kelly Says:

    Hi David,

    This is great. Looking forward to more postings.

  2. monica tarzier Says:

    Glad to hear that you’re entering the fray, David! I know of no one who can claim qualifications superior to yours.

    I agree that everyone is to blame for our health crisis. Which, of course, means that no one is to blame. I believe we’ve all participated, quite innocently, in the problems we face. Here are a few errors in thinking that I see, offhand:

    1) We hold it as gospel our right to live forever, at all costs, by whatever heroic means science may offer. The medical establishment supports this view, even when the patient himself is tired of fighting and has already lived a natural lifespan.

    2) “Health insurance” became a synonym for “health care”, and we hold someone else (other than the individual) responsible for expenses incurred in the maintenance of the body. Think about it– we pay State Farm to insure our vehicles, but we don’t expect them to cover new tires, oil changes, or replacement wipers. Why isn’t health insurance reserved for catastrophic events, much as we buy auto insurance for major damage? Why don’t we pay out of pocket for checkups and save insurance for brain surgery?

    3) You mention trial lawyers. Now there’s a can of worms! A good start would be to limit awards to expenses incurred, and to outlaw dollar awards for pain and suffering. After all, how does one determine the worth of one’s pain? I can guarantee that my pain is worth way more than anybody else’s.

    The September issue of Atlantic has an excellent article by David Goldhill–“How American Health Care Killed My Father.” I appreciated the clarity with which he examines the process flaws of health care, especially the disconnect between payer and recipient.

  3. Your Youngest Says:

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