Healthcare Reform

[Barry]

Man, are we tired of hearing about this yet?

Do we have any real hope that whatever happens is going to actually be better in any way?

Tonight there was another story on the national news, which caught my ear because my city was mentioned.

In Portland, Oregon, NBC says, Medicare pays about $7000 per patient. In Ft. Lauderdale, Florida, pretty much as far away from Oregon as you can get and still be in the US, Medicare pays about $10,000 per patient. In Miami, it's over $16,000.

This is all treated as some big mystery by the producers of the story.

"It's a system that rewards more care," says the hired talking head, as if this sets it all aright in the viewers mind.

And I'm thinking, "Well, duh...It's a for-profit industry. Industry survives to make more of itself. Don't treat healthcare as an industry, think of it as a service. Stop thinking of each procedure as a product. It's a matter of the accounting, is all." Not all of that in words, just the, "Well, duh," part.

In Japan they have a set pricelist. It gets negotiated every year or two. Every doctor is bound by it. All they can charge is what the pricelist says, for every procedure. They live well, but doctors in Japan don't get super rich like they can here in America. And there's apparently no shortage of them willing to do it.

Other methods are employed in other countries. They manage to do it, provide care for all their citizens, without breaking anyone's bank. The government isn't suffering financially, and neither are the individual citizens.

Yet in America it's this big mystery, all this time is devoted to it, all this energy.

Why is the healthcare system so screwed up?

Because it's for-profit. Same with the news. This is where private enterprise finds the place it's not welcome.

Because it's not effective.

Imagine if it was this way with firefighting, you had to pay for it, for profit.

Well, it actually was once that way. Insurance companies hired firefighting companies to put out the fires of homeowners and businesspeople on their client lists. Address numbers posted in plain sight on or near your house were originated to tell who was who, which company represented which home or business.

In San Francisco the police force is, to this day, still in essense a private force employed by the city.

So there are examples of how it can be done, vital services rendered as a private enterprise, but they seem to be few and far between. Around the world, police and fire departments are mostly composed of civil servants: employees of the people.

Why not with healthcare workers, too?

Clearly the current system is not working. It's been talked about for as long as I've been alive. So far, it hasn't been fixed. And it's still talked about as if it's this big mystery what the problem is.

The problem is, there's a lot of money to be made from the healthcare industry in America, and nobody wants to step away from the feed trough.

It's a manner of thinking, thinking of it as a feed trough. So okay, fine...let's still think of it as a feed trough. How about if we see ourselves not as feeding from the feed trough but as feeding the trough? What if the people involved, not so much the healthcare professionals, because we all know they're truly good at heart - they wouldn't be healthcare workers if not so - but the insurance folks...What if they stopped seeing themselves as feeding from the trough like pigs on a farm, but began to look upon their role as that of farmworkers pouring feed into the trough?

It's a non-specific fundamental change. And how to bring such a thing about?

The only word I can think of is "groundswell."
(Not like it will ever happen.)

Peace,
Barry