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Reflections on health-care reform

Ever since I returned from ‘Healthcare Reform:  Putting Patients First,’ sponsored by Dr. Val at getbetterhealth.com, I’ve been energized.  I mean, the minds that were present!  Not only did I get to hear their ideas, I was privileged to sit and talk with them.  My thanks to everyone who allowed me into the inner circle of great bloggers; I have much to learn.  Not the least of which is how to give myself an Avatar on Twitter!

But since I’ve been back, I’ve been thinking.  Going to the ER to work, still pondering the entire healthcare reform issue, my mind has been fairly racing.  And I have some ideas that need to get out.

1:  Health-care in America isn’t perfect.  I’ll admit that.  I’ve worked in it long enough to know the ugly truth.  We do somethings badly, and we need to do better.  There are people with chronic diseases who need attention, medications and hope.  There are those bankrupted by disease who need our mercy.

2:  Health-care in America is awesome!  The lady who came to me with 2 weeks of vague abdominal pain, treated as a UTI, was in pain and afraid.  I ordered a renal-stone CT.  She had a 4mm stone a the insertion of the ureter into the bladder.  How long should she have waited?  What would have been the ‘cost-effective’ way to diagnose her?  Sure, it will probably pass on its own.  But how many times would she have been back?  How many false diagnoses given, in order to avoid the cost of a CT?

And the man with the suicidal thoughts.  Homeless, divorced, living in a tent, drinking his pain away.  I don’t have a psychiatrist; but I have tele-psych!  A psychiatrist spoke to him over the web, face to face.  We had a plan.

My friend Patrick with the injured knee.  An active, healthy guy.  I was able to order his MRI easily.  He has an ACL tear, a meniscal injury, and needs it repaired to continue being active.  Sure, we could save some money.  And he might not ever walk or play sports again.

Is it expensive?  You bet.  Can we reduce costs?  Absolutely.  But we need to be cautious.  Because the tendency I see is to reduce costs…for other people.  Americans love to cut costs for ‘those folks,’ but always want the best for themselves when the accident or disease is personal.

3:  Is healthcare a right?  Careful with that one, too.  A mentor of mine said that the constitutional guarantees of ‘life, liberty and pursuit of happiness,’ are hollow without a right to healthcare.  But one might say the same about food.  Or shelter.  Or transportation.  Or income.  At which point, no one has to produce, or be accountable, for everyone is given everything.  But by whom?

Kim McAlister of Emergiblog ( http://www.emergiblog.com/) said it nicely.  To paraphrase, she said, ‘I don’t think it’s a right, but I think it’s just.’  Beautifully stated.  I agree.  Ladies and gentleman, it can’t be a right, because then someone has to provide it for free on demand.  Rights can only be non-tangibles; non-interference, as it were.  I think I would say that health-care is something we ought to give to others when they need it; but that they ought to pay for whenever they can.

This seems, at first, a sticky wicket for a Christian physician like me.  But it really isn’t.  I’ll give away my care when I perceive that it is needed.  But I don’t feel guilty about being paid for my work, if I do it well.

What would Jesus do?  (As the bracelet says.)  Well, Jesus healed the sick.  He sympathized with their suffering, their bleeding, their hunger, their pain, their paralysis.  He even sympathized with  grief and brougth life where death had visited.  But healing the sick wasn’t his primary mission.  It was transformation and new life.  It was spiritual, far more than physical.

Do you want the sick treated compassionately?  Christianity can help with that.  Christians, on fire for Jesus, have gone around the country and around the world, to the worst possible places, to (get this) GIVE care away.  But never out of government fiat; out of love for their Master. We banish faith from medicine to our grave peril.

Want to fix healthcare?  Baptize it.  Transform insurance executives, congressmen, presidents, doctors, nurses and all the rest so that they see their work from a transcendent perspective.  You’ll have more compassion for the poor and sick than you ever imagined possible.

4:  Socialism sucks.  Read your history.  Governments that take over things that they can’t manage always mess them up.  Oddly, everyone asks Christians to apologize for all of their misdeeds in history.  Has anyone ever asked Socialists to do the same?  For the 100, 000, o00 who died in the 20th century as governments tried to fix humanity with government solutions?  What makes anyone think that America can do socialism better than anyone else?

Socialism, in medicine or elsewhere, is always billed as a compassionate attempt to help people, to heal the misery of the masses.  Poppycock.  Socialism is an ideology that is all about the collective; and which, in its collective disregard for the individual, always offers the individual up to death for the ‘hive.’  Death by famine, death by revolution, death by war, death by disease; death for country, death (now) for the good of the earth, death for cost-savings.

Socialism, as I said, presumes too much.  Take, for example, Lycenkoism.  The Soviet government, convinced it knew best in all things, took over agriculture.  The results…well, if you’re a thinking person, you’ll have an idea.  Go ahead, read about it.  I’ll wait.

http://www.newworldencyclopedia.org/entry/Trofim_Lysenko

Suffice it to say, Soviet agriculture failed, people starved, it failed again, scientists died and more people starved.  GO GOVERNMENT!!

Government cannot fix health-care.  Government could do something:

5:  Offer a back up to the poor; they need it!   For instance using the Public Health Service in an expanded form as a funded safety net (unlike the unfunded one of EMTALA).  Then, let the market work.  Those who say it has worked don’t get the facts.  The market has been tangled up with government since Medicare was initiated.

Plastic surgery, Lasik and other procedures are progressively cheaper because they are market-driven.  Compeition drives prices down.  My physician, Dr. Jaymie Meyers, takes no insurance.  He’s always available; appointments the same day, any day.  His labs are cheaper.  And he’s happy, as are his patients.

6:  Why are we surprised that insurance companies want to turn a profit?  They are BUSINESSES.  They aren’t misguided charitable organizations.  They have faults, but they provide valuable services to millions.  Now, let people join pools across state lines and let people deduct their own insurance payments from their taxes…that will help the insurance problem for everyone.

7:  Why does ANYONE believe that government is inherently  more moral or ethical than business or physicians?  Read your history!  Read about the syphillis experiments in the 1930’s.  Read about Watergate.  Read about Ted Kennedy.  Read about any period of history and see that governments are made up of individuals, who are fallen and sinful and make mistakes.

8:  Why does ANYONE believe that individuals are pure, holy and motivated by only the best purposes, whereas society, government and business are of uncertain morality?  If society, medicine,  government or businesses are evil, it’s because they are made up of fallen humans; doctors, patients and all the rest.  Fallen humans who will use anything they receive for free, will abuse it, and will ultimately trample it to pieces; if they don’t have to pay for it themselves, or don’t have some ownership of their efforts and rewards.

9:  The elephant in the room:  people won’t value free health-care.  The most needy, the poorest, those with diseases currenlty too expensive for them, they may.  But the rest will use it, and use it, and use it more; just like they do now in emergency departments.  Witness the man who came to us with his injured son and said, ‘why should I give him Tylenol at home when I can come here and get it for free?’  Ask anyone who has ever worked in the ER of a military base and been thus abused.  Humans, glorious as they are, are also evil.  Sorry.  That’s my evidence based viewpoint; I’ve seen the evidence.  I love them, God loves them, but they’re broken and wicked.  Don’t believe it?  Hang out for a weekend with a police officer or ER doctor.

10:  Finally, in an era of evidence-based medicine, there’s good evidence the health-care reform act is too expensive, and  good evidence from history and around the world that the bill will break the bank.  (Ask the Congressional Budget Office.)  And in a time when many call for transparency of motives and costs, there’s no transparency in an ever-evolving bill of 1200 pages that no one has read and that heralds unknown future costs.

11:  As an additional motivation, the carbon footprint of the paperwork this bill will generate may well be the end of life on earth.

I have to go to work now; and deal with health-care face to face.

God bless you!  Sorry to run on so long.

Edwin

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6 Comments

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