Friday, August 21, 2009

American Health Care


Uncle Dave chewed into his leg with a logging-grade chain-saw just above the knee. As legs have dramatically less resilience than the average tree, this usually results in an artificial leg. But Dave was very experienced with chain-saws and, above all, lucky, fortunate, blessed, charmed, and Lucky. Instead of dismantling himself, he only cut a few centimeters into his quadricep. Pulling the saw from the gash, Dave turned to his son and said, go warm up the plane. We'll be flying to Saskatoon.


There is big debate about health care in North America. Does the US have the best health care in the world? Or is Canada's better? The United States has, without peer, the best medical technology in the world. And Canada has lines for medical service; in the US, health care is provided by the efficiency of capitalism, in Canada, and the rest of the "developed world", most of it is provided by government. Despite how one sided the issue appears, the issue is split because different people believe different sources of information, as is usually the case. Both sides find it hard to imagine why or how the other side actually believes the morons they are listing to and the sources are not making it easier to trust them. Democrats are constantly pointing their crooked fingers at Sarah Palin; she's against health care but she's a blithering idiot, say the talking donkey heads, so if you're smart you will think the opposite. The Republicans are saying that Obama is creating a socialist health care policy which includes articles about "end-of-life services" which, they recite with fear, could lead to "end-of-life orders" because the elderly are a financial burden!


In today's "information age", it is amazing how many things can be taken out of context when the context is so easy to find. The internet is omniscient. Unfortunately, it is also a pathological liar with poor language skills. "You may ask me as many questions as you like, but I always lie" it lies. But with a little work, you can find anything. Palin's comments are readable to anyone with a Facebook account. It's probably been copied and pasted into an even more public realm. Most of the article is actually rather rational. She fears what could happen with government-run health care and that it could lead to unethical financial book-keeping. Similarly, Obama's health care plan is also not a socialist health care solution with Death Panels! That was Kucinich. The bill can be found on-line,with everything else, but it's written in Leagalese .


The bill being proposed right now is already a compromise from social medicine. It is nothing more than a government insurance option. Insurance companies will still be in business, the government will just offer a competitive alternative. If it turns out to be so much better than the current options that they can't compete, then that's better for the customer. We wont be preyed on by the government like the fears of "socialism" suggest. There is nothing behind the "Death Panels" hysteria besides a small bit (starting on page 425) about end of life counseling. It is for people who want it, want information, not to be told what to do. If you want a good perspective on why this is necessary, visit a nursing home. It is supposed to improve the quality of life for the terminally ill.


Creating a competitive alternative to insurance with a budget the size of the government's does seem, at first, to be unfair. But in reality, the business is a "natural monopoly" like the post-office or the rail-road. The governmentally supported USPS does have stiff competition from UPS, FedEx, DHL. Many people point out fallacies in this argument. Postal services are not like medical services. Sure. And USPS is failing to the private providers. I will admit a bigger difference: unlike rail-roads and the post-office, health insurance is an inherently unprofitable business. Not if you are actually providing care. There's too much risk to expect any profit and these companies have made multiple trillions of dollars. This suggest to me that they have not been acting any more ethically than our banks, which is a whole new issue. If your customer has a "pre-existing condition", then they'll just be a sink on your money. The fact remains that other countries have their care supplied by the government and are healthier than we are. If we insist on calling ourselves the "greatest country on earth", then shouldn't our government be able to out-do the British and the French and the Canadians? They may have a few lines, but the people I have talked to, like Dave, attest that this isn't a problem when you need it. Perhaps the reason we don't have lines is not because we're efficient capitalist, but because there is no one going to the doctor. Instead, we refuse to take off of work even if we have tuberculosis and pink eye.


We should start considering health care as a right. Nor more or less basic than equitable treatment and universal suffrage. It shouldn't be a privilege exclusive to the filthy rich or we will be in danger of being more like victorian Britain than a modern world power. If you don't have money, we don't really want to help you, so we just stabilize your vitals without actually fixing the problem. Yet somehow the US spends more on health care than "socialist" Canada. Perhaps it is time that we ask our country what it can do for us. That is, after all, what it is there for. A country, in essence, is no different than a company, or a party, or a union, or a club: it is a group of people brought together by similar ideas or interests in order to achieve a common goal. Traditionally, government-level groups are organized around safety or cultural identity. Everyone in this group should feel as obligated as a family member to help out those less fortunate.


Clare was a thin, frail woman who had hip problems. Not uncommon in the USA. She would return to the doctors almost yearly to get her hip worked on. But, because it was too expensive and, of course, not covered, she was only ever stabilized. Fed up, she moved back to Europe where she was born and got her hip permanently fixed. Now, she is never coming back. Dave has retired, because it did not bankrupt him to go to the hospital in Saskatchewan. He was administered to immediately, there was no waiting line, was administered to immediately. His wife Mary, who was born in North Dakota, says that health care is the biggest reason she would never live in the United States; she's not an official citizen (though she does pay taxes) and she gets better health care in that foreign country.

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