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Health Reform

Health Care (“Healtho”)

Between the idea and the act lies the wasteland.   Between the theory of the best health care system and it’s reality lay politics. Obama and the progressives have only passed what they could get through Congress.  Obamacare may be worse than what we have.  It may drive the country quicker towards bankruptcy.

As Bill Clinton says, “let’s do the math.”  President Obama says that we can expand health care to 40 million Americans, expand Medicaid, keep Medicare providing the same services, keep the tort system the same, lower taxes on the middle class, and save money.   Let’s do some Obama math:  2 + 2 = 3.

The only argument for Obamacare is that it is better than our current health system, which we can call “Sicko.”

The main problem with Sicko and Obamacare is that it is based on free enterprise and health care is not conducive to the realities of free enterprise. With Sicko and Obamacare, a person gets sick or is in the process of dying and he/she is surrounded by licensed professionals trying to make as much money as they can for themselves. And outside of this circle is a circle of vultures — called lawyers — waiting for a mistake to happen so the patient can sue Sicko, the patient can get rich, and the lawyer can get a 30% cut of the payout.

The reality is that a doctor is makes income from the amount of procedures he performs, the sophistication of the procedures, and the number of patients he sees. Because of this decision making process, he cannot make the best decision for the health of the patient. He will usually make a decision based on these three variables: 1) the health of the patient; 2) the amount of income he will make from the decision; and 3) the probability of a suit, which will raise his insurance costs.

The result of these realities is the characteristics of Sicko: 1) More patients are seen than needed to be seen; 2) More expensive procedures are done than needed to be done; 3) the unneeded procedures often hurt the patient more than they help him; 4) the money used for useless procedures is taken from people who really need medical care; 5) harmful and expensive procedures and tests are done for the sole purpose of avoiding expensive lawsuits; and, finally 6) Sicko costs more and does less for the health of the society than any other major health systems in developed countries.

A Proposed Health System (“Healtho”)

It is acknowledged that Wello probably could never be passed in the U.S. Congress for various reasons. These reasons include:

1) The public’s almost religious belief that the free-enterprise system is reality’s only economic system and that it can solve any problem. That is, individual’s pursuit of economic self-interest and “the unseen hand” will create the best solution to any problem.

2) The pollution of Congress’ and the President’s mind with lobbyists. Virtually every political election is heavily polluted with big contributions from big lobbyists. This includes the tort lawyers who have the democratic party in their pocket.  The result is that individuals lobbyist’s interests get synthesized in the politician’s mind with the only authentic goal of the authentic political leader: to create policies which is good for all groups in the long run.

The best possible Healtho — one which RG Martin proposes — will have these characteristics.

1) Healtho will be paid for largely by value-added tax on unhealthy foods and unhealthy products. That is the following foods wouid be heavily taxes: all meats, all foods with additives, all fats, all sugars, and so on. The following products would be heavily taxed: cars without electric or hybrid motors, oil, and harmful chemicals. Healthy foods, especially raw fruits and vegetables, would be subsidized.

2) Healtho would be basically socialized medicine. Most doctors would be eventually be on salary and their salaries would be paid by the government. Their medical decisions would not be based on their profit or income but what was best for the patient. Only the highest quality of student and prospective doctor would be admitted into medical school, and one of the qualifications would be their dedication to the health of the people of the society. Once admitted, their tuition would be paid and they would be paid between $20,000 and $30,000 for attending school and going through training.

After their training, they would get salaries starting at around $100,000 a year. With this generous system, medical schools would attract the not only the best and the brightest, but also those persons who are dedicated to the health of the nation and not to their personal financial wealth.  Primary doctors would be paid the most and specialists less so. Doctors could be ordered to go to needed geographical areas for a period of time. There could be a draft or lottery system. The doctors would be evaluated every year by their patients and by health economists. Their salaries would increase on the basis of these evaluations. Whether they worked in their own practice or for a big clinic and how the technology would be supplied would be worked out in a flexible and reasonable way.

The government would pay for all costs of basic health care, leaving the businessmen and the individuals free of the costs. Basic and cost-efficient health care would be provided for. Unneeded, untested and cost-inefficient care could be provided by private pay to private doctors. The government would be responsible for basic health care and the individual would be responsible for all other health procedures. It must be realized that if all health procedures and medicine that are available were given to people who demand them, the economy would be bankrupt in a short time. Also there is no realistic way everyone could — or should — receive the same health care. People will more money could always get cost-inefficient health care.

3) There would almost be an elimination of malpractice suits. Medical malpractice lawyers would be out of business. If a medical mistake was made, or if there was a malpractice incident, the victim would be taken care of his entire life and the doctor punished in some way — perhaps even revoking her license, but the patient and her lawyer would not get rich.

4) There would be assertive public policies to increase healthy lifestyles. The general idea would be that if a person lived an unhealthy lifestyle, for instance abusing food, alcohol, nicotine or other drugs, he would have to pay for some of the costs for his consequential health care. He couldn’t expect the public to pay for his unhealthy choices.

5)  The public would have to accept the reality of eventual death and the inability of the economy to support all the costly technological procedures that make it possible to extend one’s life a few more months at the end of one’s life.  If a person wanted to extend their life for a few more months at a high cost, they could buy insurance to cover the costs, pay for the costs out of their own pocket, or have their extended family pay for the costs.

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