Tuesday, July 21, 2009

Nationalized Health Care

So all the talk lately has been of the "single payer system" - basically, that one party centralizes all the cash and pays out from there for health costs. The idea being that there are great efficiencies and a greater average quality of care to be had from this. The argument includes things such as that Europe does this and all that.

I won't go through the horror stories of people who actually live in those countries. I know them. I've lived in those countries. I've experienced the waits, the poor quality, I've watched friends' family members die due to lack of care. I know the liberals don't want to hear it, but it's true.

My issue is this: currently, I have a mediocre but relatively speaking decent health care program. That's a judgment based on an absolute basis. That is, I can't get myself into Mayo to get things treated but I can get into the best local hospital and get treatment that doctors generally agree is appropriate. Not great, but things could (possibly, who knows really) be worse. I would prefer to be able to go to Mayo and lay out my health issues and have someone bloody fix them, but fine, whatever, save that for people who have specific issues (this is a very odd quirk of the modern incarnation of Mayo: you can only really go if you already know, more or less, what's wrong with you - I find this odd as the whole point of really quality health care has to include being able to diagnose really obscure things - like, if not Mayo, where do I go for a proper diagnostician? am I meant to track down House in the mythical Princeton Plano medical center?).

But here's the important part: I in no way question that we will have at least a delay in deaths due to cardiac failure, an increase in health maintenance, so on and so forth. And that's all good and well. But someone, someone, just someone, absolutely must acknowledge that this gain will indeed come at the expense of people like myself who fall somewhere on the other side of the bell curve but not far enough to pull strings to get the best treatment.

The reprise to this is what I began with - that really health care will go up. Sure, if you currently don't bother to see your doctor and whatever, yes, your quality of health care will go up. Of course, that's sort of irrelevant. The beauty of America, as I understood it, was that you fight for yourself, tooth and nail. Around every corner people are going to be plotting against you, not because they have issues with you, but just to benefit themselves. And to the winners go the spoils, quality health care included.

So my question is this: where do I move to once socialized health care kicks in so that I can still get the top quality health care and not have to wait in line behind people who haven't bothered to have a physical in 20 years? I simply am not willing to have my health care go the way of the industrialized american worker, whose job was exported in the name of "globalization" and with the horrifically ill-applied economic argument that this was better for everyone - I should clarify that this argument succeeds because it confuses people by mixing up two notions of "everyone."

On the one hand, the logical one, one would think "everyone" meant just that - every person. However, there is another way in which "everyone" is used as a shorthand and in fact, by "everyone" it is meant that you take all people and aggregate them and that average person accounts for "everyone." It is in this sense that the proponents of universal health care move forward.

Of course, I recognize the argument that it is selfish etc. and I do indeed think that people should have health care. And in all likelihood, if I were asked to voluntarily contribute for universal health coverage, I would actually contribute quite a lot. However, the idea of forcing me to give my money for this purpose is simply un-American. Moreover, the problem with this is that it won't just expand care - it will serve to limit care.

While initially it will not have this impact, long-term the economic pressures will be such that prices will fall at certain levels, service will fall at certain levels, and that pesky reality that a different type of person will be attracted to medicine and research will begin to take shape. It's not a scare tactic - it's just another reality of economics. Perhaps we prefer the people who choose a profession because they want to help people but I'll be honest, I don't.

People who choose a profession to "help" other people tend (please note that this is not all inclusive) to really be boosting their own egos in some way by denigrating people who actually work towards goals. Again, generally speaking, they tend to be lazier, richer, sort of high on themselves. They tend to think they are better than everyone else. As a result, they are significantly less efficient, taken less seriously, less savvy in world affairs and, most importantly, are not overcome with the sense of neurotic focus on a specific task. Of course, some have motivation, but I've never had a not-for-profit party follow-up with me within even a week of a call, which I find maddening and confusing and simply cannot work with as I exist in the real world where things happen in real time. I really really want absolutely neurotic doctors who will keep searching and searching, quickly and with a sense of urgency, to figure something out. I don't want to wait 6-8 months for a follow-up - I want an answer now. Or as soon as possible.

Anyways, I suppose I'll need to take over a country or something to get proper medical care. Any suggestions are welcome.

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