Comments on: HEALTH CARE: RADICAL SURGERY NEEDED

By: drmatt

drmatt — Wed, 19 Dec 2007 14:00:35 +0000

Jeff, your precious insurance companies are doing the same kind of rationing, it is called; “prior authorization”, “covered services”, “copay”, “prefered medication list”. You are obviously healthy because if you ever had occasion to call on your “good value” health insurance you might be singing a different tune. By the way, I was homeless, without a car, without credit and bankrupt thanks to your precious for profit system, and as far as waiting lists, why dont you go to a rural community and see how long it takes to get care that can wait? there are waiting lists there because there is no money in opening or operating facilities there, try alaska, new mexico, the dakotas. Oh, I have a computer because the leasing company deemed the repossesion not worth the effort. We are not Canada, we can make a system that works for all of us, we have intelligence and resources. Oh by the way, the govt intervention that you harshly criticize, in every single case, is a response to where for profit medicine failed, health insurance didnt want the elderly or poor, thus medicare and medicaide, no profit in er care for the poor thus EMTALA, profit hospitals dumping expensive poor patients at other hospitals thus COBRA, health insurance companies leaving the working class uninsured between jobs, etc, thus HIPPA, no hospitals opening in poor or underserved areas thus “critical access”. If you precious, for profit health system worked at all you wouldnt see govt intervention.

By: Jeff Small

Jeff Small — Tue, 18 Dec 2007 20:51:16 +0000

Matt:

Thanks for the explanation. I’m sorry I misinterpreted you.

By: Matt Horn

Matt Horn — Tue, 18 Dec 2007 20:03:22 +0000

Jeff, that was not directed at you. I was getting a little cranky with the doc. I find most single payer arguments are at best, not well thought out, and at worst intentionally misleading. I was being sarcastic. Sorry about the confusion.

By: Jeff Small

Jeff Small — Mon, 17 Dec 2007 19:03:49 +0000

Hi Matt:

I know some doctors and have some friends in Vancouver, CA. They have this great health care system that you seek. Unfortunately, the caring, compassionate and all-knowing Oz, oops, I mean Canadian health care allocation board simply hasn’t figured out how to give every citizen hundreds of thousands of dollars of health care while only taxing them for a fraction of that amount. So there solution is to ration care based upon tax revenues, not medical needs. Hospitals and clinics are not allowed to purchase MRI equipment to meet demand – instead, they are allocated equipment based upon available budgets. Thus, when someone is diagnosed with a tumor, they get placed on a waiting list and it may take months to get the scan. Meantime, the tumor grows. Maybe they will die in the process, saving the Canadian system the need for the $140,000 operation and follow-up care. Of course, there is no conflict of interest operating here, since there are no greedy, private, medical personnel involved in the decision-making process. And anyway, that’s the price for progress. Right?

In Canada, doctors are prohibited by law from dealing privately with citizens for their medical needs. Also, the number of operating rooms available is determined by the government and surgeons are told how many operations they are allowed do in a given day. The result is that the wait can be so long for many critical procedures that I personally know of a number of people who have come to the US and privately paid for operations that they could not receive there. I’m sure these people look forward to the US adopting their rationed health care system so they no longer have any alternative to choose in these situations. Once we have a similar system here, let’s say your wife needs a life-saving operation and you just got place on the 13-month waiting list. How much is her life worth to you? Would you be willing to go into debt in order to pay for that operation? But should you decide on that course, where will you go? Not Canada. Of course, sitting by her bedside watching her slip away, you will be comforted in the knowledge that by handing over the right to make personal decisions for your medical treatment to some government bureaucratic agency, she is now getting the “fairest” treatment possible. But come on, that’s just an idiotic hypothetical scenario. What the hell, “Maybe we should try it.”

Matt, you seem to be confusing the concepts of “needs” with “rights”. They are two different things. Just because you identify something as a “need”, it doesn’t magically transform into a “right”. And that is especially true when you are demanding that others assume a responsibility for your medical care. We already have the ability to share the risk and cost. It’s called insurance. My wife and I purchase car insurance, home owners insurance, personal-property insurance, life insurance and medical insurance. At times we might purchase special limited policies such as trip insurance. We purchase these things because we know that we have to take personal responsibility for our lives and we judge these policies to be a good value for their cost. Like just about any other person on the planet, I would love to see my insurance costs be less than they are, but unlike some others, I’m not interested in this if it means forcing others to work and pay for my care. There is a name for this type of use of force. It’s called theft. Also, when doctors can no longer practice their profession as they see fit; when they cannot decide whom they wish to treat, when and how to conduct that treatment, and how much they wish to charge for their services, there is a name for this condition. It’s called slavery.

So let’s be clear. Those advocating nationalized health care are advocating theft and slavery of other citizens so that they can abdicate responsibility for managing their own lives and foist that responsibility upon others.

And my name’s not junior.

By: Matt Horn

Matt Horn — Mon, 17 Dec 2007 16:03:36 +0000

Maybe we should try it. No more medical economics.

“Sorry, sir, that Ambulance trip and level 1 Trauma facility is going to cost you $140,000. Seeing that the car you wrapped around the telephone pole was a ’92 Cavalier, were going to have to leave you inside until we can be sure you are financially able to afford the treatment.”

“Yep, there seems to be a tumor, but we can’t be sure until you pay for an MRI.”

“Congratulations, we were able to save your pre-mature daughter. After the surgeries, she will need to stay in the IICU for a couple of months until her lungs start working properly. That should be plenty of time for you to round up $800,000.”

If there wasn’t a need for risk sharing and financng, it wouldn’t exist. Pull your head out junior.

By: Jeff Small

Jeff Small — Sun, 16 Dec 2007 21:24:12 +0000

I would hope that Dr. Kirkwood would practice what he preaches, but that doesn’t appear to be the case. If he makes enough money to afford a computer to post the response above, then I suggest that he himself is acting greedily. How can he justify that luxury when it clearly comes at the expense of overcharging some patient for services that could be more affordable if he were to forgo that non-essential expenditure and reduce his medical fees by a corresponding amount. It doesn’t appear that he was really thinking properly about his own doctor-patient relationships when he made the choice he did in overcharging his patients so that he could purchase the computer. Well, no worry. I’m sure that the coming nationalization of US medicine will soon relieve Dr. Kirkwood and others in the profession of having to make these weighty decisions. Unlike Dr. Kirkwood, who is so obviously incapable of properly managing his own doctor-patient relationships in a non-greedy fashion, there will be boards of caring, compassionate bureaucrats who will decide what is just and right. They will help Dr. Kirkwood get on the correct path to finally doing what he so genuinely believes in and should have been doing all along: stop thinking of his own non-essential role as a highly trained professional with years of practical experience and a large measure of personal responsibility for the lives and wellbeing of his patients, stop thinking greedily about computers, or going to the movies, or taking a European vacation, or sending his kids to an expensive college, and instead focus solely on the needs of the patients which are obviously paramount. Since Dr. Kirkwood doesn’t seem to be properly motivated by the “carrot” of altruism, I can’t wait to see how he responds to the coming “stick”.

By the way Dr. Kirkwood, if you had read the op-ed piece by Brook/Lockitch carefully, you would see that your observation about strengthening the direct relationship between the patient and the doctor is exactly what they are proposing. It is their observation that the interference in this relationship by government programs such as Medicare, and regulations of the insurance industry, are what have destroyed that relationship. If this is truly the principle concern of yours, then you should be a loud supporter of their message.

By: R. Garth Kirkwood MD

R. Garth Kirkwood MD — Sun, 16 Dec 2007 17:56:27 +0000

The book, EQUAL HEALTH CARE FOR ALL, offers a radical surgery to remove the cancer plaguing our health care system. However, the cancer is the concept that health care is a business. Until the dollar bill is no longer seen as the bottom line, the system will not be changed. Health care is the doctor—patient relationship, nothing more and nothing less. When the penetration of sound, ongoing doctor—patient relationships into every community in America becomes our new bottom line and relegates the dollar bill to a support role for this accomplishment, we will be on our way to true health care reform.
This op-ed piece by the authors, Brook and Lockitch, of the Ayn Rand Institute states that the fundamental cause of skyrocketing health insurance premiums is the shifting of responsibility for healthcare costs away from the consumers of medical services. I suggest that this is wrong. In my view, the fundamental problem is GREED within the health care economic marketplace and that the other problems described by these authors occur as a consequence of trying to satisfy this greed, i.e., trying to maintain huge dollar profits, with actual health care, sound, ongoing doctor—patient relationships, assigned a secondary role.

The solution begins with reversing this thinking, i.e., reassigning the order of these two bottom lines, and then structuring our health care delivery system in accord with that.

R. Garth Kirkwood M.D.