In my opinion the true issues regarding the costs associated with health care in the USA are not being addressed. As is usual in these politically charged debates, the true issues are not being addressed. Issues that fit ideological biases, or which seem to be populist are pursued without really taking the time to dig down to the root issues. It is almost like the old joke about "don't confuse me with the facts".
The crux of the current debate about health care seems to be about the large number of people in the USA who do not have health insurance. Some might argue that the uninsured to not have access to health care. Obviously everyone have access to primary health care. The emergency rooms treat anyone who walks in. The issue is not whether you can get treatment, but whether you can pay for it.
Unfortunately, emergency rooms are being abused by many people who do not have legitimate emergencies. Often, the patients in the ER are there for routine treatment because they do not have a insurance or are illegal aliens etc. In many situations, the ER has become a health care clinic.
An anecdote: A friend who is a nurse at a local ER told me of a situation where a patient used the emergency services (ambulance etc), to have a pregnancy test done. The person did not have the money to get a pregnancy test done elsewhere, but since she declared an emergency, the ambulance was used and the test was done. The cost for this incident was probably around $2000. This kind of abuse or the ER (in my view) is not an isolated case. People will find loopholes in every system.
Often hospitals treat uninsured patients in the ER at a loss. The loss is usually borne out by paying patients. As I mentioned in a previous post - altruism and the profit motive do not make good bedfellows.
The solution to the problem of uninsured patients is not giving everyone insurance and creating a huge (and expensive) bureaucracy to administer the insurance system.
A starting point for thinking about a solution must involve providing affordable primary health care (free in some cases) to those who cannot afford their own insurance. Primary health care should be easily available. People should not have to abuse the emergency system to get primary health care.
In a next post I will write about the cost of training doctors. After 11 years of medical training, the student loans could reach $300,000 in some cases.
Monday, August 03, 2009
Friday, July 24, 2009
universal health care?
The debate keeps raging about universal health care in the USA.
The problem with the debate is how the questions are framed.
No right thinking person would assert that anyone should be kept from primary health care. Obviously nobody should be turned away from an emergency room because of the inability to pay.
In the USA at least, there is no shortage of emergency rooms and primary health care facilities. One could not honestly say that most of the population is not within easy reach of primary emergency treatment.
However, the ability to pay for treatment has become the crux of the issue (in my understanding).
People who do not have health insurance in the USA faces some real financial issues if they need any kind of definitive health care. Any serious medical care will cost more than the average person could afford.
Let's say for example that you step on a rusty nail and go to the ER for treatment. According to the figures released by a Consumer Health Organization the average cost for the treatment will be $1081. If I did not have health insurance, I would most likely NOT go to the emergency room for treatment. I would probably have elected to treat the issue at home until I probably developed a serious infection and then would have had some really serious financial issues. For the average person, spending $1000 on an unplanned issue is a huge problem.
In my opinion, the issue of universal health care is more complex than making sure everyone has access to affordable insurance.
In the USA, health care is a huge business. As long as health care is a profit driven business there will be no end to the ever escalating costs. It is a self fulfilling prophecy in a way. Costs will increase in relation to the need to show a profit. Altruism and the profit motive do not make good bedfellows.
The problem with the debate is how the questions are framed.
No right thinking person would assert that anyone should be kept from primary health care. Obviously nobody should be turned away from an emergency room because of the inability to pay.
In the USA at least, there is no shortage of emergency rooms and primary health care facilities. One could not honestly say that most of the population is not within easy reach of primary emergency treatment.
However, the ability to pay for treatment has become the crux of the issue (in my understanding).
People who do not have health insurance in the USA faces some real financial issues if they need any kind of definitive health care. Any serious medical care will cost more than the average person could afford.
Let's say for example that you step on a rusty nail and go to the ER for treatment. According to the figures released by a Consumer Health Organization the average cost for the treatment will be $1081. If I did not have health insurance, I would most likely NOT go to the emergency room for treatment. I would probably have elected to treat the issue at home until I probably developed a serious infection and then would have had some really serious financial issues. For the average person, spending $1000 on an unplanned issue is a huge problem.
In my opinion, the issue of universal health care is more complex than making sure everyone has access to affordable insurance.
In the USA, health care is a huge business. As long as health care is a profit driven business there will be no end to the ever escalating costs. It is a self fulfilling prophecy in a way. Costs will increase in relation to the need to show a profit. Altruism and the profit motive do not make good bedfellows.
Sunday, July 12, 2009
Off Topic - movie review
Last night I watched a movie called Breach.
The movie is based on the true story of the Robert Hanson who according to the movie was the highest placed Russian spy ever in the history of the USA.
I had a vague memory of the Hanson affair from the press reports at the time. All I could remember was that he was a rather intense person with a penchant for a stripper who he supported. I also remember that he tried to lecture the Russians about OODA loops.
The movie portrayed Hanson as a driven man who eluded capture and exposure for many years. The movie portrays him as one of the best to elude detection. Perhaps his quirky personality and intense interest in religion and family kept him off the RADAR.
The movie is not a blockbuster but was interesting to watch and to know that a lot of what was portrayed in the movie actually happened.
It seems that Hanson was part driven to prove that he was smarter than his colleagues and part a flawed man with an inner conflict to prove that he was right.
The movie is based on the true story of the Robert Hanson who according to the movie was the highest placed Russian spy ever in the history of the USA.
I had a vague memory of the Hanson affair from the press reports at the time. All I could remember was that he was a rather intense person with a penchant for a stripper who he supported. I also remember that he tried to lecture the Russians about OODA loops.
The movie portrayed Hanson as a driven man who eluded capture and exposure for many years. The movie portrays him as one of the best to elude detection. Perhaps his quirky personality and intense interest in religion and family kept him off the RADAR.
The movie is not a blockbuster but was interesting to watch and to know that a lot of what was portrayed in the movie actually happened.
It seems that Hanson was part driven to prove that he was smarter than his colleagues and part a flawed man with an inner conflict to prove that he was right.
Sunday, February 15, 2009
51 Weeks
Last week I spent a glorious week of diving and enjoying life. The week consisted of diving eating and sleeping (in that order). Everything was right with the world.
I was not ready for the return to the real world.
It has been a week back at work and I still cannot get back into the regular routine. I feel an emptiness and find my mind drifting back to the carefree days diving and laying in the sun during the surface intervals.
The diagnosis: a bad case of post-vacations blues.
Usually I find it easy to get back into work and the routine of life. For some reason, on this vacation, I almost feel like I left a part of my heart in the ocean. I know this will sound odd - but I feel a similar emptiness to when I got dumped by my previous girl friend.
A thought occurred to me today. Taking one week off to do what I live for seems like I have to endure 51 weeks of tedium for one week of bliss. Not only that, but I spend about 200 hours a year doing a part-time job just to pay for my SCUBA trips. Every minute of that is worth it for the sublime bliss of descending over the wall in the crystal clear water Roatan.
Only 50 weeks to go...
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