Wednesday, July 01, 2009

Health Care

I like this article. Yet another reason to move to Canada - their health system actually makes sense.

Debunking Canadian health care myths

I'm lucky, I actually have good health care. Our doctor has never had to adjust what she wanted to do because insurance wouldn't cover it. Not true for many people. And that's not right. I do have issues with my son's need for mental health - insurance companies are more reluctant to pay for that. And the doctor is so conditioned by insurance and it's limitations that even though we are willing to pay for it out of pocket if it will help our son be happy, healthy and safe, the doctor didn't send us to do the testing.

It has always struck me as fundamentally wrong that money gets brought up AT ALL when you are trying to deal with health issues. As if the health issues weren't bad enough. It's just not right. One of the things that struck me was a clip of Nixon talking to an aide about HMO's (saw it in the movie Sicko). He liked the idea that people could make money off of healthcare and that is why he supported it. Now we are stuck with it - a system driven by money and profit instead of taking care of people.

Another statement that always struck me is a something Dick Devos said during his run for governor. He said it is the responsibility of employers to provide health insurance. That is not right. It is true with the current system, but it's an indication of how the system is flawed. Employers should not be in the business of providing healthcare. It becomes a cost to them. And what do responsible, effective companies do? Try to minimize cost. By making healthcare the responsibility of employers, you are building a system that encourages minimum and poor healthcare. In addition, it directly drives up the cost of goods, which will lead to higher prices, lower profits, or both. Which leads to cutting costs in other areas, which leads to lower quality and less innovation. Which leads to bankruptcies and layoffs and going out of business. Automotive industry is the glaring example. Of course, not all of any company's woes can be blamed on healthcare, but it certainly doesn't help and can play a significant role.

The current system favors profit over health every step of the way. You go to a medical center, which is most likely run by a corporation that is trying to make a profit. The care will be paid for by a health insurance company (assuming you have insurance), which will try to control costs by paying as little as possible. The medical facility gets paid for services rendered, not the outcome, so they end up focusing on what services they can get the insurance company to pay for instead of taking care of the patient. The insurance company was picked by the employer, who will pick the most cost effective option, not necessarily the best option for the patient. Prescription drug companies are inserting themselves into the process as well, trying to sell their products.

Canada and Europe have systems that work. We have a system that even the clueless conservative will admit does not work. Ultimately, the fix will have to involve taking money out of the equation and provide incentives that are based on quality of care and positive outcomes instead of profits. In the meantime, we have to take whatever steps we can to get healthcare out of the control of insurance companies and other profit driven industries and in to the hands of Doctors and patients.

Future installment: Why I think all advertising for prescription drugs should be banned.


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