"Vice is a monster of such frightful mein,
As to be hated, needs to be seen;
Yet seen too oft, familiar with her face,
We first endure, then pity, then embrace."
~Alexander Pope "Essay on Man"
In my last post I briefly commented on the apathy of people towards their own healthcare and now I want to brush on a continually growing moral apathy of America.
Yesterday I was thinking about my favorite movie of all time (yes, I know I've posted about it before - It's A Wonderful Life), and this time I was looking at it from a social perspective and found some eerie parallels. I recommend watching it again, even though Christmas is still 8 months away. You'll see where I'm coming from. Look at the background: Economic crisis (a bank run during the Great Depression), greed, power, and an effort to take over businesses (Potter takes over bank and wants to take over the Savings and Loan), and the transformation of Bedford Falls into Pottersville, where the Emporium, Movie House, and other buildings become sleezy motels and exotic dance clubs. Citizens are unhappy everywhere.
Right now I'm finding a couple of recent topics a bit disturbing that makes me wonder if our country is going the way of Pottersville. Some may consider me a "prude" or an old "fuddy-duddy" twenty-something. Maybe I am.
The first has to do with the legalization of "sexting." This is a new term that describes people taking nude or other inappropiate pictures of themselves or others on camera phones and then sending or texting these pictures to their peers. Some people estimate that 20-25% of teenagers have engaged in this - either sending or receiving. When minors are involved, this is considered technically as child pornography, which in many states carries stiff penalties such as prison terms and being labeled as a "sex offender." Many promoters of the legalization of sexting argue that children should not be subject to such stiff penalties and that it's just another form of lame adolescent behavior such as mooning or flashing. Many do warn that, yes, these pictures of them will be out in cyberspace forever and can impact them years from now, but they don't stress any form of strong punishment other than conversation and taking away their cell phone. To me, child porn is child porn, and teenagers need to realize this and some sort of legal prosecution should be in order.
My next worry is the legalization of marijuana. Some proponents stress that marijuana crimes are not serious and plug up the justice system's courtrooms, lawyers, and jails. Others think of legalization as a solution to easing the tensions and violence between drug cartels, smugglers, border patrol units, and other law enforcement. One California representative offered the suggestion that California would prosper economically off of the legalization and taxation of marijuana growers. Hmmmm.... Marijuana is practically harmless, right?
According to my Current Pediatric Diagnosis and Treatment, low intoxication levels can lead to impaired thinking - sure, we could use more of that. Would you really like to see the driver next to you on the freeway smoking a joint? Chronic use can also lead to infertility (could be touted as an alternative form of birth control!) as well as apathy (after substitute teaching high school, I really fear an increase in this) and amotivational syndrome. Amotivational syndrome is characterized as "decreased attention to environmental stimuli and impaired goal-directed thinking and behavior" which is due to "destruction of hippocampal and basal ganglia nuclei." I think that anything that causes destruction of any part of my body would be cause for concern. Doesn't it seem that all that money spent of childhood Ritalin is going to waste? Not to mention the studies of marijuana as a "gateway drug" and the effects of toxic intoxication (i.e. psychosis...). Other studies have shown that the marijuana stashed under your teenager's bed is not the same kind their dad smoked at Woodstock. One analysis in the late 1990's proved a 3-5 fold increase in the concentration of THC since 1970's and 1980s. Not to mention the possibility of "hybrid" drugs (smuggling hard drugs like cocaine and meth with marijuana).
I fear that we're only a few months to a few years off from public service announcements urging us to "smoke responsibly." Sigh...
2 questions I have are these: Are we teaching the future leaders of this country that when confronted with problems and social issues, we throw our up hands, shrug our shoulders, turn our heads, surrender, and let them infiltrate our society? Do we just legalize all vices just to make "life easier," "save money," and not "tie up our justice system"?
Showing posts with label politics. Show all posts
Showing posts with label politics. Show all posts
Monday, April 20, 2009
Thursday, January 22, 2009
Kudos to Kutcher
I am not usually one who follows the lives Hollywood celebrities or pay attention to what they have to say about politics. Most of the time it seems obnoxious to me to hear their rants because they're usually one-sided and sound condescending to those "non-famous" people who don't agree with their opinions. Last night I was listening to the radio and Billy Bush brought up Ashton Kutcher's latest blog on his MySpace. Commenting on his experience at the inauguration, Kutcher mentioned this:
"I was less impressed by the boo's as the republican representative took the stage. I found it to be offensive and separating. I was also appalled by the people who didn't stand when former President, then President G W Bush appeared. I urged the people around me to rise. Regardless of whether or not you agree with, or like the man, he at that time was still our president and he gave 8 years of his life to serve you. The cook might not be making what you like but be grateful for the fact that he's serving you at all. How many people can say that they've dedicated 8 years of their life to the greater good of man kind, made the toughest decisions known to man... Part of being an American is standing by the process and respecting our commander. Don't be an Obama patriot, be a patriot. Let bipartisanship die and represent this country united!"
The country has just witnessed the transition of power from one President to another. Although there were some things I did not agree with about Bush, I believe he had worked extremely hard these past 8 years and tried to keep the best interest of the country in mind. He has had to handle crises, changes, and criticism from millions of people worldwide. It is no doubt the toughest job in the world.
While I was on my mission in Argentina, the Iraq war broke out and brought with it much criticism towards George Bush and Americans. The anti-war sentiment was evident (especially at the medical school) and strong enough that I had to avoid part of my assigned area that contained the US embassy. As a missionary, I did not have access to newspapers, radio, or television, so I did not have much info on what was happening or swayed any direction by commentary from the political pundits. I did, however, have faith. When asked by people on the street how I felt about Bush, my response was simple and expressed in four words: "I pray for him."
And that is how I feel about our next president. There are things that I do not agree with about issues that he has proposed, but I do want him to succeed as a president. If he succeeds, then our country succeeds. I do want to support him and the rest of the leaders of this country. I don't think our country can progress with this sharp divide of bipartisanship that has crippled it in recent years. I do hope that Obama will do what is best for this country and serve it well. And I will strive to respect him for it.
"I was less impressed by the boo's as the republican representative took the stage. I found it to be offensive and separating. I was also appalled by the people who didn't stand when former President, then President G W Bush appeared. I urged the people around me to rise. Regardless of whether or not you agree with, or like the man, he at that time was still our president and he gave 8 years of his life to serve you. The cook might not be making what you like but be grateful for the fact that he's serving you at all. How many people can say that they've dedicated 8 years of their life to the greater good of man kind, made the toughest decisions known to man... Part of being an American is standing by the process and respecting our commander. Don't be an Obama patriot, be a patriot. Let bipartisanship die and represent this country united!"
The country has just witnessed the transition of power from one President to another. Although there were some things I did not agree with about Bush, I believe he had worked extremely hard these past 8 years and tried to keep the best interest of the country in mind. He has had to handle crises, changes, and criticism from millions of people worldwide. It is no doubt the toughest job in the world.
While I was on my mission in Argentina, the Iraq war broke out and brought with it much criticism towards George Bush and Americans. The anti-war sentiment was evident (especially at the medical school) and strong enough that I had to avoid part of my assigned area that contained the US embassy. As a missionary, I did not have access to newspapers, radio, or television, so I did not have much info on what was happening or swayed any direction by commentary from the political pundits. I did, however, have faith. When asked by people on the street how I felt about Bush, my response was simple and expressed in four words: "I pray for him."
And that is how I feel about our next president. There are things that I do not agree with about issues that he has proposed, but I do want him to succeed as a president. If he succeeds, then our country succeeds. I do want to support him and the rest of the leaders of this country. I don't think our country can progress with this sharp divide of bipartisanship that has crippled it in recent years. I do hope that Obama will do what is best for this country and serve it well. And I will strive to respect him for it.
Monday, November 3, 2008
The Matters of Rights, the Constitution, Discrimination, and Marriage
"May I humbly urge you to learn about the Constitution, the Declaration of Independence, and other basic documents of our great country so that you can sustain it and the free institutions set up under it...Before we can intelligently sustain the principles of this divinely inspired document, we need to understand it and the philosophy that underlies it. We will then be in a position to determine encroachments on our liberty when well-intentioned, but unenlightened politicians attempt to circumvent those principles. The greatest watchdog of our freedom is an informed electorate." Ezra Taft Benson
This election season, much is being said in support of rights. From the rights of animals, to the rights of the unborn, rights of teenage mothers, and the rights of same-gender relationships. I have decided to take up Benson's challenge and review the Constitution and ponder about the meaning of rights. Much of this blog will focus on the same gender marriage debate that is happening in California, Arizona, and Florida.
Point#1 Protection of Voting/Democratic/Republican Rights
The United States shall guarantee to every State in this Union a Republican Form of Government... Article IV, Section 4 Clause 1
In regards to California's Prop 8, regardless of marriage, it is the right of the citizens to have their government respect the voice of the majority. The Founding Fathers did not intend to have the states run by a monarchy or a mobocracy, but they sought to preserve republican values to maintain the stability and liberty of the states. One of the issues behind California's Proposition 8 , regardless of one's opinion on the definition of marriage, was the abuse of power of 4 judges who overturned the will of 61% of Californian voters to legalize gay marriage. While some people may support this action, what is there to stop these judges from overturning the state's decision on another matter in the future.
Point #2 Constitutional Amendments in Other States
The controversy over same sex marriage is not new. This is an important issue to all Americans, and Americans have made their voices heard on the matter. Currently, defense of marriage amendments have been adopted into the state constitutions of 27 different states. Of these, eight make only same-sex marriage unconstitutional, seventeen make both same-sex marriage and civil unions unconstitutional and two states have their own unique laws. Hawaii grants legislature authority to ban same-sex marriages and Virginia prevents the state from recognizing private contracts of unions that "approximate" marriage. These amendments passed in their states with an affirmative vote ranging between 52% (South Dakota) to 86% (Mississippi) with an average of the combined states being 69%. 16 other states prohibit same-sex marriage by statute. 2 states (New Mexico and Rhode Island) have marriage undefined. Have these 44 states suffered negative backlash, being labeled as "bigots," "intolerant," "inhumane," "homophobes," "unjust," and "unconstitutional"?
Point #3: "Fundamental" and Civil Rights
I have heard the word, "fundamental rights" used repeatedly in the argument of the definition of marriage. Looking up the word "fundamental" in Webster's dictionary, the definition includes the synonym, "essential". Is homosexual marriage essential? Does it fall under the same category of other essential rights (freedom to protect one's property, free speech (communication), freedom of religion?) There has been argument that some of these rights would be violated if same-gender marriage is legalized.
The roots of marriage as found in JudeoChristian beliefs point to spiritual and moral reasons (including upholding chastity), as well as the perpetuation of the human species and upholding parental responsibilities. Other ancient anthropologic reasons for establishment of the family unit include safety, providing of needs to offspring, and again, species propagation. Some years ago I visited a rural, Peruvian village along the banks of the Amazon river. I learned that while some of the moral vales regarding chastity were not given importance among this small society, marriage was deemed essential once a girl (usually a teenager) was determined to be pregnant. It was then she was put into a monogamous relationship under the title of marriage to secure the physical and social needs of the child. Such is an example of why marriage is essential, or "fundamental" to this village and the global society in general. Is same-gender, or any other alternative marriage arrangement, equally essential to society as traditional marriage?
The issue of civil rights has also been brought up in the argument. According to the Constitution, civil rights are those guaranteed to all individuals by the 13th, 14th, 15th, and 19th Amendments. The 14th Amendment was first intended to secure the rights of former slaves and has since helped different cases that are mostly racial-based . The Equal Protection Clause, which includes the text in the latter portion: nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws, has had some debate with issues like afirmative action and proponents of same-gender marriage are claiming to fall under the protection of the Amendment. Many claim that their civil rights are violated because their domestic partner rights are not equal to those of married couples. Their argument is legitimate, but does that have to involve the changing of the definiton of marriage?
Often civil rights and natural rights are used interchangably. Thomas Jefferson wrote, "a free people [claim] their rights as derived from the laws of nature, and not as the gift of their chief magistrate."
Point #4: "Promoting the General Welfare...To Ourselves and Our Posterity" and Discrimination
"We the People of the United States, in Order to form a more perfect Union, establish Justice, ensure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity..."
This is the preamble, or the Constitution's statement of purpose. This is to show the principles for its existance and why it needs to be upheld.
Are there times when rights of some may have to be denied or restricted for the welfare of others? Is "discrimination," as often used in this argument, ever justified? One random example is the issue of convicted sex offenders. Is it unjustified to have their names made publicly known or restrict them to where they can live (certain distances away from schools, etc...). In California, the California Teachers Association, ACLU, and Equality California opposed a bill, SB1105, that would withdraw the teaching credential of a teacher who pleads "no contest" in a sexual offense case. Why did they oppose? Because they considered it "discrimination" against teachers who may be homosexual. Has our obsession with being "politically correct," our fear of offending another, or the opinions of our peers crossed the line?
On the other hand, others have justified discrimination when it comes to the welfare of others is held at a greater level of importance. France banned same-sex unions because they believed that it was in the best interest of children. The Michigan state constitution states, "To secure and preserve the benefits of marriage for our society and for future generations of children, the union of one man and one woman in marriage shall be the only agreement recognized as a marriage or similar union for any purpose." Is changing the definition of marriage, out of fear of being labeled "discriminators", justify the potential detrimental effects on society's views of marriage, family, and procreation? Will we have that same answer 10 year or 25 years from now?
There's more that could probably be said regarding this issue and the natural rights, democratic rights, and legal rights that encompass it. I hope all people, regardless of their politcal party or position on issues will look into the issues, become an informed electorate, and make decisions tomorrow that will uphold the prinicples of the Constitution.
This election season, much is being said in support of rights. From the rights of animals, to the rights of the unborn, rights of teenage mothers, and the rights of same-gender relationships. I have decided to take up Benson's challenge and review the Constitution and ponder about the meaning of rights. Much of this blog will focus on the same gender marriage debate that is happening in California, Arizona, and Florida.
Point#1 Protection of Voting/Democratic/Republican Rights
The United States shall guarantee to every State in this Union a Republican Form of Government... Article IV, Section 4 Clause 1
In regards to California's Prop 8, regardless of marriage, it is the right of the citizens to have their government respect the voice of the majority. The Founding Fathers did not intend to have the states run by a monarchy or a mobocracy, but they sought to preserve republican values to maintain the stability and liberty of the states. One of the issues behind California's Proposition 8 , regardless of one's opinion on the definition of marriage, was the abuse of power of 4 judges who overturned the will of 61% of Californian voters to legalize gay marriage. While some people may support this action, what is there to stop these judges from overturning the state's decision on another matter in the future.
Point #2 Constitutional Amendments in Other States
The controversy over same sex marriage is not new. This is an important issue to all Americans, and Americans have made their voices heard on the matter. Currently, defense of marriage amendments have been adopted into the state constitutions of 27 different states. Of these, eight make only same-sex marriage unconstitutional, seventeen make both same-sex marriage and civil unions unconstitutional and two states have their own unique laws. Hawaii grants legislature authority to ban same-sex marriages and Virginia prevents the state from recognizing private contracts of unions that "approximate" marriage. These amendments passed in their states with an affirmative vote ranging between 52% (South Dakota) to 86% (Mississippi) with an average of the combined states being 69%. 16 other states prohibit same-sex marriage by statute. 2 states (New Mexico and Rhode Island) have marriage undefined. Have these 44 states suffered negative backlash, being labeled as "bigots," "intolerant," "inhumane," "homophobes," "unjust," and "unconstitutional"?
Point #3: "Fundamental" and Civil Rights
I have heard the word, "fundamental rights" used repeatedly in the argument of the definition of marriage. Looking up the word "fundamental" in Webster's dictionary, the definition includes the synonym, "essential". Is homosexual marriage essential? Does it fall under the same category of other essential rights (freedom to protect one's property, free speech (communication), freedom of religion?) There has been argument that some of these rights would be violated if same-gender marriage is legalized.
The roots of marriage as found in JudeoChristian beliefs point to spiritual and moral reasons (including upholding chastity), as well as the perpetuation of the human species and upholding parental responsibilities. Other ancient anthropologic reasons for establishment of the family unit include safety, providing of needs to offspring, and again, species propagation. Some years ago I visited a rural, Peruvian village along the banks of the Amazon river. I learned that while some of the moral vales regarding chastity were not given importance among this small society, marriage was deemed essential once a girl (usually a teenager) was determined to be pregnant. It was then she was put into a monogamous relationship under the title of marriage to secure the physical and social needs of the child. Such is an example of why marriage is essential, or "fundamental" to this village and the global society in general. Is same-gender, or any other alternative marriage arrangement, equally essential to society as traditional marriage?
The issue of civil rights has also been brought up in the argument. According to the Constitution, civil rights are those guaranteed to all individuals by the 13th, 14th, 15th, and 19th Amendments. The 14th Amendment was first intended to secure the rights of former slaves and has since helped different cases that are mostly racial-based . The Equal Protection Clause, which includes the text in the latter portion: nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws, has had some debate with issues like afirmative action and proponents of same-gender marriage are claiming to fall under the protection of the Amendment. Many claim that their civil rights are violated because their domestic partner rights are not equal to those of married couples. Their argument is legitimate, but does that have to involve the changing of the definiton of marriage?
Often civil rights and natural rights are used interchangably. Thomas Jefferson wrote, "a free people [claim] their rights as derived from the laws of nature, and not as the gift of their chief magistrate."
Point #4: "Promoting the General Welfare...To Ourselves and Our Posterity" and Discrimination
"We the People of the United States, in Order to form a more perfect Union, establish Justice, ensure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity..."
This is the preamble, or the Constitution's statement of purpose. This is to show the principles for its existance and why it needs to be upheld.
Are there times when rights of some may have to be denied or restricted for the welfare of others? Is "discrimination," as often used in this argument, ever justified? One random example is the issue of convicted sex offenders. Is it unjustified to have their names made publicly known or restrict them to where they can live (certain distances away from schools, etc...). In California, the California Teachers Association, ACLU, and Equality California opposed a bill, SB1105, that would withdraw the teaching credential of a teacher who pleads "no contest" in a sexual offense case. Why did they oppose? Because they considered it "discrimination" against teachers who may be homosexual. Has our obsession with being "politically correct," our fear of offending another, or the opinions of our peers crossed the line?
On the other hand, others have justified discrimination when it comes to the welfare of others is held at a greater level of importance. France banned same-sex unions because they believed that it was in the best interest of children. The Michigan state constitution states, "To secure and preserve the benefits of marriage for our society and for future generations of children, the union of one man and one woman in marriage shall be the only agreement recognized as a marriage or similar union for any purpose." Is changing the definition of marriage, out of fear of being labeled "discriminators", justify the potential detrimental effects on society's views of marriage, family, and procreation? Will we have that same answer 10 year or 25 years from now?
There's more that could probably be said regarding this issue and the natural rights, democratic rights, and legal rights that encompass it. I hope all people, regardless of their politcal party or position on issues will look into the issues, become an informed electorate, and make decisions tomorrow that will uphold the prinicples of the Constitution.
Monday, October 13, 2008
Can Universal Healthcare Reeeeeaaaally Work?
This was the question I asked my boss during a political discussion not too long ago.
"Sure," he replied, "they just have to lower their costs." If only it was that easy...
This is my first attempt at a political blog, so bear with me. I have been thinking about blogging on this topic for a while. Part of this blog was a response I wrote on an online q&a board a few months back. Last week I had thought about it while I was frustrated with an insurance group but I didn't want to spoil the happy auntie euphoria. This weekend I thought about it some more as I engaged in activities that included exploring bat-infested abandoned mines and scrambling up and down boulders with the consistent thought: "I don't have health insurance, I better not break anything..." It may seem a little ironic that the licensed health care provider who performs physical exams and prescribes your kid's drugs does not have health coverage herself. Fortunately, for me that will change in a few more weeks. Unfortunately, that's not the case for millions of Americans.
We all know that the current health care system is wracked with problems. Our healthcare system is crippled. We pay more money per capita on healthcare than any other developed nation in the world, we still have large populations of the medically underserved, health care costs are grossly inflated, insurance companies have way too much overhead/administration costs (CEOs are being paid way too much), there is a severe problem of Medicaid fraud and abuse, and health care providers and patients are frustrated. No one wants an elderly person on a fixed income to struggle with paying for their medications, a person to be denied a surgery due to their inability to pay, or a child to go without proper medical care. My last point is what I am going to use as a model for this blog because most children, if their parents are responsible enough to look into it, are able to get healthcare, whether through government sponsored insurance (Medicaid) or private insurance. No child should be going without proper medical care in the United States (or at least in California, anyway). I know this because all of my patients are covered under two Medicare insurance branches. For the past couple months I have been able to get a greater understanding of this type of insurance and have pondered about its potential as a model for a universal healthcare system that many politicians are pushing for. Another question: Is a single-payer system the best cure for America's healthcare crisis? I'm not sure if it is, but if it happens, there has to be A LOT of CHANGE on everyone's part. Everyone including every citizen of the country. Below are some points to consider when comparing healthcare systems and some of the negative points of why such a system may not be the best/easiest option (nothing will be easy) for the United States. This is also keeping in mind that the single-payer system will either be controlled or otherwise heavily influenced by the government.
1. Every health care system in the world has three main objectives: Access, Quality, and Low Cost. Unfortunately you can only pick one or two of those things for your system. No healthcare system can have all 3 nor is there a perfect system.
2. Different American mentality. Americans want the best, Americans want choices, Americans want it now. Someone with bone-on-bone knee arthritis living in daily chronic pain doesn't want to wait 5 years for a knee replacement (I heard that's the average wait in Canada). A friend's father flew from Canada to New York for his heart bypass that he paid with his own money because he didn't want to wait months and months for it and risk having another heart attack while he's waiting. I have struggled recently as one of the government health insurance groups has began to crack down on medications that are not listed on its formulary. An allergy sufferer who had been on the same medication for a very long time was trying to get refills. I write on the prescription, "intolerant to A." The pre-authorization was turned down. The insurance company only offered two choices of nasal spray: Drug A or Drug B. "But he's allergic to drug A!" says the grandmother (intolerant to the side effects most likely). Still can't get favored drug... Drug B it is, or nothing...
3. There will always be people who abuse the system and wastes tax-payer money. It already happens with Medicaid, I've seen it. Just one example from a universal-healthcare country: My uncle was in an accident in Norway and his hospital roommate, who was perfectly healthy, was there just because he wanted a "holiday." But it's okay, the government will pay for his holiday. People get ticked off when their tax dollars are misused. People aren't too crazy about how high taxes would have to go to provide universal healthcare. On another level, people will feel like they can go to the doctor for every sniffle or insect bite they get (trust me, I see it every day), because, hey, they're paying for it with their taxes. Never mind the fact that they are exposing themselves to more germs in overcrowded clinics...
4. Reimbursement for government-sponsored programs is horrible. I was talking with one of the other doctors who sees some of the same patients that I do and she says that we (healthcare providers) are only paid for one visit per patient per month, and it's not much of a payment to start with. Therefore, a patient can come back as many times in a month (i.e. follow-up for visit #2, mosquito bites for visit #3, runny nose for visit #4. cough three days later for visit #5 - trust me, this happens) and the provider is paid for the first visit only.
5. Many people don't trust the government handling healthcare. They have seen how efficient the government is handling other issues.
6. There are some lifestyle issues that affect the cost of healthcare. People in the United States live differently. There's fast-food on every corner. We spend too much time in cars or indoors. We're overstressed. Other countries get 6 weeks of vacation a year. Poor lifestyle contributes to many chronic health problems such as diabetes, high cholesterol, arthritis, coronary artery disease, high blood pressure, and other problems. Chronic diseases are VERY expensive. A large percentage of people in the United States are overweight. Diabetes care (90% Type 2) used up 10% of government health spending in 2006. That's billions of dollars, and that will probably rise in the years to come. There's other cultural differences that can impact health and health costs.
7. Cost will still be an issue. Where will the money come from? The sponsored-insurance groups of my patients have seen some scary financial difficulty lately, but at least the Governator passed a bill recently that supplied more money. A temporary Band-aid.
8. Are people in single-payer healthcare system-countries satisfied with what they have? Many say no. Some countries are looking for other options. I heard that Canada passed a law making it illegal for Canadians to seek medical care in the United States. I don't have a source on that, but if it was really true...
So are universal healthcare and a single-payer system the main solutions to the United States healthcare problems? That's for the people to decide.
"Sure," he replied, "they just have to lower their costs." If only it was that easy...
This is my first attempt at a political blog, so bear with me. I have been thinking about blogging on this topic for a while. Part of this blog was a response I wrote on an online q&a board a few months back. Last week I had thought about it while I was frustrated with an insurance group but I didn't want to spoil the happy auntie euphoria. This weekend I thought about it some more as I engaged in activities that included exploring bat-infested abandoned mines and scrambling up and down boulders with the consistent thought: "I don't have health insurance, I better not break anything..." It may seem a little ironic that the licensed health care provider who performs physical exams and prescribes your kid's drugs does not have health coverage herself. Fortunately, for me that will change in a few more weeks. Unfortunately, that's not the case for millions of Americans.
We all know that the current health care system is wracked with problems. Our healthcare system is crippled. We pay more money per capita on healthcare than any other developed nation in the world, we still have large populations of the medically underserved, health care costs are grossly inflated, insurance companies have way too much overhead/administration costs (CEOs are being paid way too much), there is a severe problem of Medicaid fraud and abuse, and health care providers and patients are frustrated. No one wants an elderly person on a fixed income to struggle with paying for their medications, a person to be denied a surgery due to their inability to pay, or a child to go without proper medical care. My last point is what I am going to use as a model for this blog because most children, if their parents are responsible enough to look into it, are able to get healthcare, whether through government sponsored insurance (Medicaid) or private insurance. No child should be going without proper medical care in the United States (or at least in California, anyway). I know this because all of my patients are covered under two Medicare insurance branches. For the past couple months I have been able to get a greater understanding of this type of insurance and have pondered about its potential as a model for a universal healthcare system that many politicians are pushing for. Another question: Is a single-payer system the best cure for America's healthcare crisis? I'm not sure if it is, but if it happens, there has to be A LOT of CHANGE on everyone's part. Everyone including every citizen of the country. Below are some points to consider when comparing healthcare systems and some of the negative points of why such a system may not be the best/easiest option (nothing will be easy) for the United States. This is also keeping in mind that the single-payer system will either be controlled or otherwise heavily influenced by the government.
1. Every health care system in the world has three main objectives: Access, Quality, and Low Cost. Unfortunately you can only pick one or two of those things for your system. No healthcare system can have all 3 nor is there a perfect system.
2. Different American mentality. Americans want the best, Americans want choices, Americans want it now. Someone with bone-on-bone knee arthritis living in daily chronic pain doesn't want to wait 5 years for a knee replacement (I heard that's the average wait in Canada). A friend's father flew from Canada to New York for his heart bypass that he paid with his own money because he didn't want to wait months and months for it and risk having another heart attack while he's waiting. I have struggled recently as one of the government health insurance groups has began to crack down on medications that are not listed on its formulary. An allergy sufferer who had been on the same medication for a very long time was trying to get refills. I write on the prescription, "intolerant to A." The pre-authorization was turned down. The insurance company only offered two choices of nasal spray: Drug A or Drug B. "But he's allergic to drug A!" says the grandmother (intolerant to the side effects most likely). Still can't get favored drug... Drug B it is, or nothing...
3. There will always be people who abuse the system and wastes tax-payer money. It already happens with Medicaid, I've seen it. Just one example from a universal-healthcare country: My uncle was in an accident in Norway and his hospital roommate, who was perfectly healthy, was there just because he wanted a "holiday." But it's okay, the government will pay for his holiday. People get ticked off when their tax dollars are misused. People aren't too crazy about how high taxes would have to go to provide universal healthcare. On another level, people will feel like they can go to the doctor for every sniffle or insect bite they get (trust me, I see it every day), because, hey, they're paying for it with their taxes. Never mind the fact that they are exposing themselves to more germs in overcrowded clinics...
4. Reimbursement for government-sponsored programs is horrible. I was talking with one of the other doctors who sees some of the same patients that I do and she says that we (healthcare providers) are only paid for one visit per patient per month, and it's not much of a payment to start with. Therefore, a patient can come back as many times in a month (i.e. follow-up for visit #2, mosquito bites for visit #3, runny nose for visit #4. cough three days later for visit #5 - trust me, this happens) and the provider is paid for the first visit only.
5. Many people don't trust the government handling healthcare. They have seen how efficient the government is handling other issues.
6. There are some lifestyle issues that affect the cost of healthcare. People in the United States live differently. There's fast-food on every corner. We spend too much time in cars or indoors. We're overstressed. Other countries get 6 weeks of vacation a year. Poor lifestyle contributes to many chronic health problems such as diabetes, high cholesterol, arthritis, coronary artery disease, high blood pressure, and other problems. Chronic diseases are VERY expensive. A large percentage of people in the United States are overweight. Diabetes care (90% Type 2) used up 10% of government health spending in 2006. That's billions of dollars, and that will probably rise in the years to come. There's other cultural differences that can impact health and health costs.
7. Cost will still be an issue. Where will the money come from? The sponsored-insurance groups of my patients have seen some scary financial difficulty lately, but at least the Governator passed a bill recently that supplied more money. A temporary Band-aid.
8. Are people in single-payer healthcare system-countries satisfied with what they have? Many say no. Some countries are looking for other options. I heard that Canada passed a law making it illegal for Canadians to seek medical care in the United States. I don't have a source on that, but if it was really true...
So are universal healthcare and a single-payer system the main solutions to the United States healthcare problems? That's for the people to decide.
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