Thursday, June 23, 2011

Paging Dr. Shaver ... health care needs you!

First, I want to say thanks for handing over the reins of The Marshall Society to me for this post. I’m writing about health care in the U.S.—partly because your fearless leader suggested the topic to me and partly because I’m passionate about health care.

Health care is broken. Most Americans aren’t health care experts. In fact, many of us seem to only consider health care policy when it’s a hot topic. We don’t know what we need.

Health care is highly fragmented. For years and years, our health care system has been treated like an equation. We add a little here, subtract a little here and see what works. The problem is, quite a few of the programs initiated over time don’t mesh well with each other. Health care is not some neat puzzle. Most of the pieces we’re working with don’t even fit together properly.

The 2010 Health Care Act (It has a longer title, I’ll call it 2010 HCA) tried to make some pieces fit.

I love what the legislation tried to do, but the law isn’t really about health care as much as it is about insurance and the relationship between insurance, patients and providers. You can Google your little hearts out to see the specific provisions, but for fear of losing your attention, I’ll ask you to take my word for it for now.  If 2010 HCA won’t work, we must find another solution.

First, I suggest eliminating the thought that health care can be “fixed” with one overarching piece of legislation. We’re back at health care being fragmented. There are simply too many unrelated parts to fix with one law, even one that’s more than 2,000 pages like the 2010 HCA.

Second, we reside in a political environment toxic for health care policy. Words like “Obamacare,” “Obamneycare,” “socialized medicine” and “universal healthcare” are absolutely irresponsible and give everyone the wrong impression.

No one political party or ideology is causing the problem. The polarization of political people is. We’re in a society where moderation is seen as fence-sitting nonsense rather than as an attempt to find the best solution, regardless of whose idea it is. Unfortunately, I don’t see polarization helping. We’re politicizing people’s lives and people’s well-being.

Third, people deserve proper health care. This seems simple enough, but it brings about a third problem. What exactly is proper health care? What counts?

I’m skipping this issue entirely because I’m not a medical doctor. I have no right to determine whether a procedure or treatment is necessary. For that matter, neither do a bunch of lawyers sitting in a room writing health care laws…. We do need an answer to this question. Best wishes to those trying to find it.

Say we figure out what kind of health care is necessary. How can we make it affordable? I’ve never heard a decent argument for refusing necessary health care to someone who needs it because they cannot afford it.

Health care is too expensive, though.

We can blame the insurance companies (I personally do), we can blame the doctors who abuse and overprescribe treatments because of their own financial rewards (I blame them, too) or we can blame the government, federal or local, for not fixing this by now (I’m actually a bit on this side, as well).

Insurance companies are a problem. I really don’t like big insurance. They’re in the business to make money (I know, I know…). The problem is they’re making money by exploiting health needs. It’s practically medical spending inflation. Also, cost-sharing, which includes co-payments, co-insurance and deductibles, actually prevents people from getting the care they need.1

Some doctors do overuse equipment, procedures and treatments because they make more money that way. They add cost, but not value. If you go in for a check-up and complain about a headache, they may push you right over to their conveniently located CT scan down the hall. Yay, more money!

What about the government? Well, I agree with Thomas Carlyle: “Government can do much, but it can in no wise do all.”

I really don’t think the government tries to screw up the lives of its citizens. Sometimes, it falls short. Health care is one of those times.

Those are some of the problems, so what about solutions?

Here are my ideas:

1. This 2012 Presidential election will focus on health care, among other things. We can listen. Health care is going to be politicized and abused as a policy concept. The more propaganda we ignore, the more we’ll actually know.

2. I’ll stay political for this point. Democrats and Republicans can lay off each other. This won’t happen. I know it won’t happen. It would be nice, though, and it would help. Any depolarization would help…

3. The policymakers can focus on primary and preventive care. Proper primary care can deter illness and disease in some cases.

4. We can take a little responsibility for our own health.

Here are some numbers:

Approximately 20%, or around 46 million, of adults in the U.S. smoke cigarettes.2

No state has an obesity rate under 15% (as of 2009) and only Colorado has an obesity rate under 20% (18.6%). West Virginia’s obesity rate in 2009 was 31.1%.3

The leading medical issues in the U.S. are:

Heart disease

Cancer

Diabetes

*In fact, these account for around 70% of deaths in the U.S.1

What factors make those medical issues more likely? Smoking, Obesity, Lack of Exercise and Genetics

We can’t do much about genetics, but we can do more about the other three. If we would just take care of ourselves, we would save millions of dollars, annually, on health care. This is the simplest small “fix.”

As messed up as the U.S. health care system is, I’m optimistic. We’re living in exciting times where scientific innovation inches closer and closer to eradicating some of the worst ailments. Also, despite the problems our nation faces today, if I had to put such a difficult puzzle in front of any nation, I’d choose us. I believe in us. It may take us a while, we may make some poor decisions, but we’ll get there.

For now, thanks for reading. If you want to hear more from me, I’m @ErinLShaver.

Best wishes,

Erin

Endnotes

1http://www.healthcare.gov/law/provisions/preventive/moreinfo.html

2http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm

3http://www.cdc.gov/obesity/data/trends.html

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