Archive for November, 2009
Where is this train wreck headed? Wending its way through the various Senate and House subcommittees, the health care reform debate of 2009 is approaching a crescendo. What do we have to show? The question I posed in a previous post still has yet to be answered – just what is the problem? Is the problem greater access? Is the problem escalating insurance premiums? Is the problem stratospheric and ruinous hospitalization bills? Is the problem rapidly declining quality of care? Or is this simply become a matter of whose team wins? The bill fails — the president sinks.
Andrew Weil concludes:
But what’s missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what’s even worse than its stratospheric cost is the fact that American health care doesn’t fulfill its prime directive — it does not help people become or stay healthy.
We have seen the emergence of “evidence-based medicine” in the last 10 years. This has been an effort to further legitimize and give scientific basis to common medical therapies. A medical version of “show me the money.” I have always thought this was rather inane, since it presumed that all medicine for the last 2000 years has been unscientific and irrational. Although the reality is medicine is not nearly as scientific as asserted. Only 10-20% of medical practice is based on sound scientific principles. This rankles most physicians who believe that conventional medicine is scientifically-based. The highest form of medicine is the practiced art using scientific principles and technology.
A series of US Task Force recommendations are being rolled out by the Department of Health and Human Services. These are well-intentioned and rational. Examining the literature and epidemiology of medical practices in an effort to determine what is safe, sane, practical and effective. The trap is “effective” as you will see.
After countless months the debate marches on. Congressional House and Senate bills proliferate. I have lost track. It is beyond our comprehension trying to read through each of these bills.
There have been many lost opportunities. This has never been about health care reform. This is about health insurance regulation. If you carefully sift through all the heartache stories and testimonials, you will see the real drama – unexpected hospitalizations. So the real crisis is coverage of catastrophic loss – astronomical hospital bills. Routine appendectomy — $50,000. Complicated heart attack — $250,000+. Catastrophe loss should have been the starting point.
Insurance is not the answer. It is the problem. Insurance subsidizes high costs.