health care reform

It looks as if Health Care Reform will die a slow death. That is to be expected when powerful for profit forces with ample media access stand to lose their lucrative honey pot. Health Care will forever be a problem in America because both parties stand in the way of meaningful reform.

First one would need to take the lawyers out of the picture. We need to end the malpractice lawsuits and the punitive damages. These things accomplish nothing and they cost each and everyone of us a fortune. They cost us in more ways than one. We are denied simple things because people are afraid of being sued, and we pay through the nose for other equally simple things because the liability insurance is so high. We have to fill out tons of paperwork and stand in long lines before we can participate in everyday routine activities.

Unfortunately, the lawyers are a major force in the Democratic party so don't expect anything here. And if the Republicans want to take on the lawyers, they only do so to enlarge the already excessive profit margins of the major players.

Second, we need price controls on drugs, and we need competition for private health insurers. Better would be to get rid of private insurance but that is another matter. Both of these groups are ardent Republican supporters so here is another impossible roadblock towards reform.

The problem is simply this: health care is so full of conflicts of interest that even without a profit motive, it is hard to ensure fairness and equity. If you add in profits, everything goes to hell. If your doctor stands to gain from procedures, he will perform more of them. If the drug company stands to gain from selling pills, they will sell them to everyone regardless of need.

It costs us and it costs us in many ways. We pay for it over and over again, not just directly, but also indirectly. And we get very little value in return. No American Health Plan comes even close to what Europeans take for granted.

Even the wealthy with unlimited access suffer as the profit incentives force them into unnecessary tests and procedures. And the liability issues make it so their doctors and providers practice defensive care (i.e. another incentive to do even more tests). No test or procedure comes free of risk and in most cases the cost benefit is simply not there.

Now you say, but isn't our long life expectancy proof that we have great healthcare?

Unfortunately longevity is not a good measure of success. Longevity correlates well with wealth because good food, clean water, good sewers and an ability to stay away from dangerous (job) situations promote longevity. Anything that brings you closer to a doctor or hospital on the other hand is likely to reduce your quality of life or artificially extend the duration of it in ways that are unsuited for a dog, let alone a human. Every Terry Schiavo does wonders for longevity statistics.

Apart from party politics, one other bipartisan hurdle remains: the moralists. A key benefit of medicine is pain relief. And not surprisingly, pain is grossly under-treated in this country. Not because we don't have good drugs, but because a handful of moralists feel it is imperative to prevent drug addiction. Heaven forbid that a terminal cancer patient should become addicted to morphine! For that simple reason we all have to suffer. And suffer we will, because modern medicine will make sure we don't die a quick death. Euthanasia is out of the question, even if one's condition is hopeless and one's suffering unending. How's that for first do no harm?