Tuesday, August 18, 2009

some thoughts on healthcare issues

As this is not a debate about the value of various theorists, but a conversation on how to solve serious social dilemmas, why not concentrate on defining how healthcare distribution might best work for the general improvement of health, suiting the economics to the solution, and not vice versa.

I find it amusing that those who are recipients of socialized healthcare and appear to want an oligarchic system are blaming the other side for their own failings and railing against a proposed system employing a capitalist solution -- competition.

It is not (in the case of the plans being proposed in Congress) private or public insurance, but a choice between the two. Theoretically (if you believe in capitalist theory), the competition will bring about better products coming to the market in terms of benefits and costs.

What are these big unruly unpayable expenses opponents refer to? If many people are keeping the insurance they have, and many others are opting in to an extension of the federal civil services system, and the costs of the government system are lower due to lack of need to make a profit or pay huge salaries/bonuses or scare us with expensive advertising, et al, with the idea that either the private corps will do what they need to to compete or wither away into single payer, where are all these expenses? Yes, there are programs intended to streamline data, improve communications, learn the best practices and get the information out there, encourage more people to become doctors and nurses with tuition reimbursements for those willing to work in needed areas, but after the initial outlay these will actually save money in the healthcare industry.

The "public" plan is not your scary "single-payer government run health maintanence by fiat" system as some seem to think. It is basically an extension of the federal civil service plan, which the congressional reps who use it seem to think is first rate. People pay in and get health insurance, just like the private plans. Everyone gets the same rules as far as governmental regulation of health insurance is concerned, basically to insure that the customer gets what he/she wants to be paying for. If private insurers can't give the customers what we want, they ought to be in another business anyway.

If the private healthcare insurance industry was so interested in actually giving the best product to the American people, they've had decades of cries for healthcare reform from the American people in which to make a better product. Obviously, they are happy with their profits which often come from the despicable behavior of keeping people from the healthcare they need in order to get back to productive lives -- short term profit over long term benefit. If they can't make a decent living from selling a quality product, they ought to be in another line of work.

Even if we were to postulate that "costs" equal actual monetary exchange, there are far more costs to denying affordable healthcare for a population than the outlay on the bottom line. The reason the free market (so-called) doesn't work is because it is based on short-sighted profit/loss and not on the actual work needed by the populace. If we were to devise a national attitude toward providing healthcare based on the true goals of optimizing the health of the people while assuring their freedoms of choice, the ultimate result could well be far less costly in the bottom line sense, while tremendously value generating in the larger sense.

I envision community healthcare facilities, community healthcare professionals, community healthcare colleges. Those who could easily afford it would be encouraged to pay for sustaining subscriptions. Those who had nothing would get free subscriptions, or would get government subsidies such as Medicaid, but with much less cost. Those of moderate means would pay less than they do now for "insurance" yet get much better care without all the denials. Healthcare professionals could spend their time giving care, not dealing with insurance companies or billings. Just a little common sense, enlightened self-interest and calm deliberation could do it.

It occurs to me that a big part of where we went wrong with healthcare was in not sufficiently optimizing our corps of primary care physicians. Perhaps the emphais should be to build the hospitals, manufacture the equipment, train the doctors, invest in a healthy society.

How did we get to this point where we have a "healthcare" payment system which excludes those who most need it? How did we allow bureaucrats working for the health insurance industry to make the rules about how we are allowed to access the care and advice we need to be healthy and productive citizens?

What if we boycotted unsatisfactory "health" insurance? What if instead of paying these corporations, we had direct subscriptions to healthcare facilities and providers? What if people within communities got together with local healthcare providers and developed systems in the best interests of all groups involved?

We need to take back our health; take back our bodies; take back our minds; take back responsibility to make sure the marketplace provides what we need at a cost we can afford -- or find a different market place, and paradigm.

There are a lot of systems that could work. What can't work is the mess we've got here now.

Compassion is not necessary to understand that the healthier we all are, the healthier we all become. When there are people carrying disease because they can't get the healthcare to cure them, they are spreading more disease. When there are people chronically too ill to work, the work they would have done is left to overworked others, or left undone to all of our detriment. When children are too sick to learn, they do not become our hoped for future. When older people are left too sick to care for themselves, the subsequent loss from our lives of what they have to pass on is ever more incalculable and their subsequent depression brings us all down. We find ourselves with a system creating much more spiraling of pain, hardship, loss, despair, erosion of values, sickness. More to the point than compassion (which is so often passive) is enlightened self-interest.

I (as a thinking person) would think that if the insurance companies actually wanted to be old school capitalists, providing goods and services in return for profits by working better than the competition, they would usefully pay for the healthcare of their customer base (we, the people). It's not about capitalism v. socialism. It's about idiocy (or was that "the definition of insanity) v. trying to figure out a system that provides healthcare for American bodies.

The truly disgusting (and probably illegal if some really creative hotshot class action lawyer wants to do the work) part is where these companies take all these people's money on the false claim of providing payment for these clients' healthcare needs while fully actively working to deny payment any way they can.

What many so-called pro-capitalists neglect to take into account is that what these insurance companies are doing is not capitalism but charlatanism.

People seem to be afraid of the word "socialized." Think of it this way:

We as a nation created a government to serve our needs that are about social/physical/legal infrastructure because these underlying services allow us all and each to have a secure and useful structure in which to order our lives in our each individual own direction. It was something we did, quite consciously back after the Revolution to make our lives easier and allow for greater productivity. Thus, government services are not our enemies, unless we leave their control to our enemies. Aha! We see our civil servants as our enemies. We probably see everybody who isn't us (or maybe as in Pogo: "We have seen the enemy and he is us!") as "the enemy" whom we must defend against at all cost. Well, the cost is the lose/lose/lose situation we make of all of our lives.

On the other hand, the current plan is not about socialized medicine (though the planners, getting their excellent healthcare from taxpayer funds are recipients of socialized medicine). The government option is actually based on the capitalist theory's wonderful idea of competition to create a more broad-based market of choice for the consumer. If the private insurance industry doesn't want government competition, they ought to provide that broad base that the consumers actually want, like proper capitalists, instead of whining about theories and hypotheticals that they don't even properly understand. But why go through all the trouble of creating business models that serve the consumer when you can pay congressional reps and clever ad agencies to get the consumer to be your foodsource: suck em dry and throw em away.

So you folks got your widgets up your yaya over a theory -- not even as good as Evolution. Evolution is a scientific theory with years of research as yet keeping it alive. Socialism is merely an economic theory, a theory about a theory. It is a bunch of words/ideas that have been thrown about. No one is forcing anyone to socialize or share wealth which isn't even real here. We are talking, thinking, finding some manner of fixing a situation which most agree is untenable. I don't care if what we come up with is part communist theory, part capitalist theory, a whole lot of science fiction theory and more fantasy than fact as long as in the actual practice people get the healthcare they need and no one is made a pauper.

The insurance industry has big gun lobbyists, big money interests that speak loudly to lawmakers. Yet, for all those employers complaining about paying for their employees' health insurance (and those maligned because they don't provide employees health insurance), for all the people spreading diseases because they can't afford medical treatment, for all those people getting so sick that their treatment costs when unavoidable are much higher than necessary thus increasing the spread out cost to us all, for all those much lauded anchor of our economy small businesses who again lose so much potential business because people are bankrupt or just broke and hopeless due to medical bills they cannot possibly pay, for all those with pre-existing medical conditions who can't get insurance at any kind of reasonable price because they actually need the services, for all those seriously ill or with close family members seriously ill who have to stress out over healthcare costs when they need to be concentrating on wellness, and so on, and so on, and so on ... can't we figure out a way to do the right thing for all of us?

It is the paying for healthcare that is the issue, here. There are a great many other possible issues about healthcare, service providers, availability, greater inclusion of modalities, and so on. There is no free healthcare, unless you are caring for yourself (which we each ought to be, not because the government says we have to). When we have healthcare insurance, the point as far as the insurance company is concerned is their profit -- not our health.

Doesn't it strike you as a bit weird that we have to fight over status in terms of institutions like marriage or employment to get such "benefits" as health insurance?

Much as I understand the efficacy a well-appointed single payer plan, I also can understand some of the concerns of the more fiscally conservative and those who fear a one size (which never) fits all government-sponsored health insurance maybe without the kinds of restrictions we loathe from the private insurers, but with an aura of "health police." I have been advocating (for decades) a nonprofit sector solution. The strongly positive element I foresee in health coops is that they can be customized for the individual group, creating what we like to call multi-solution experimentation.

My point is that we need the mixing-up of the normative, the change to get the insurance industry to be actually responsive to the needs of their consumers. The plan being considered by Congress does not negate the possibility of any other private/nongovernmental nonprofit ideas being considered in individual communities. Meanwhile, we do need reform as immediately as possible to save lives and resources.

some articles on health and healthcare:


Is ANY Health Insurance a Good Idea?


How American Health Care Killed My Father


Top 18 Foods That Improve Your Brain Function


Dance More , Live More Healthy


Live Naturally with Herbs: Thyme


Why I Am a Conservative on Health Care Reform


Medical Marijuana urls list


5 Myths on Our Sick Health Care System


Universal Health Care throughout the world


from: A Return To Healing: Radical Health Care Reform and the Future of Medicine

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