Thursday, February 25, 2010

A few thoughts on today's Socialism Summit

A few thoughts on the upcoming Healthcare summit:

1)  Things are expensive because they are scarce. 
2)  There is nothing in the proposals currently on the table to get more doctors pumped into the healthcare system.  The AMA's deathgrip on the number of M.D.'s produced each year isn't going to be relaxed.  Doctors will remain scarce, and therefore, expensive. 
3)  There is nothing in the proposals that would allow insurance companies to compete in states other than the ones where they currently have monopolies. 
4)  There is nothing in the current proposals that would allow consumers to opt for less coverage.  Electric wheelchairs, hovercraft, and teleporters have been declared a mandatory part of insurance packages, thanks to lobbying efforts by the manufacturers of electric wheelchairs, hovercraft, and teleporters.  Depending on your state, your insurance company now has to charge you enough to cover the possibility of an electric wheelchair, hovercraft, or teleporter in your future. 
5)  I've never met a nurse who didn't believe that she/he couldn't do 90% of what an M.D. does, at half the price. 
6)  Tort reform, and therefore, the expense of practicing defensive medicine, aren't on the table. 
7)  No one will allow me to purchase retroactive homeowner's insurance policy after my house has already burned down.  If my uninsured home burned to the ground, no one in his right mind would take one insurance payment from me and then build me a new house.  People with pre-existing conditions need help, but they don't need insurance.  Insurance is intended to guard against the bad thing that has not yet happened.
8)  Danny Williams, the Canadian premier who took a long, long look at his nation's socialized system and decided to come to the U.S. for his heart surgery?  He's doing well.
9) It costs somewhere around a billion dollars to lawyer-proof a new medication.  Big Pharma saves the lives of millions every year, but there's nothing in this vile healthcare package to protect them from Big John Edwards and his ilk.  We need a lower cost option for "unregulated" medication and medical treatment.  We have a former Marine medic at our workplace, and I see no reason at all why I shouldn't be able to go to him for stitches, broken bones, etc.  After all, I belong to me.  I guarantee you that given the choice, most of us would choose the unregulated option if it cost us as little as 20% less.  I don't have that much faith in government regulators.
10)  Speaking of John Edwards, no one has given us any genuine assurances that all copies of his sex tape have been destroyed.  This issue should be treated as a greater threat to the nation than anthrax or the remaining vials of the polio virus. 
11)  Ever wonder why the insurance companies aren't fighting this thing very hard?  Well, they're about to get 30 million new customers, and any new competitors will have to clear a huge regulatory burden before entering the market.  They're doing everything but begging Obama not to throw them into that briar patch.


Dr Ralph said...

Don't have time to respond to all of your thoughts (and probably never will), but regarding the number of physicians in the system, here's a breakdown of number of physicians per capita. For all I know it supports your stance.

U.S. has 2.3 physicians per 1000 people. By way of comparison:

- Cuba has 5.91
- Russia has 4.25
- Italy has 4.2
- Turkmenistan has 4.18
- Israel has 3.82
- Iceland has 3.62
- Switzerland has 3.6
- Germany has 3.4
- North Korea has 3.29
(jump down now)
- United Kingdom has 2.2
- Canada has 2.1
- Puerto Rico has 1.75
- South Korea has 1.6
- Nicaragua has 0.37
- Afghanistan has 0.19

I have no point to make, but thought you might have an observation on these numbers.

Dr Ralph said...

...Back with a little more time for this fascinating discussion.

So, what is your proposal to pump more doctors into the system? What is your alternative to the AMA's deathgrip, since people routinely refer to American healthcare as the best in the world. Seriously, I'd like to know. Note: I do absolutely agree that having qualified Nurse Practitioners out there is a reasonable practice -- is this all you are referring to?

A big part of the problem (IMHO) is how the insurance companies have become the paid gatekeepers of healthcare. As long as the focus is on insurance instead of delivery of care (your number 7), this conundrum is never going to get fixed. Of course, since the insurance industry is massive, wealthy, and politically well connected, that is never going to happen.

I've had several of my doctors decide to quit practicing because the administrative hassle of dealing with insurance company bureaucracy. Essentially they said, screw it. So what results is medicalcare corporations which are large enough to have a dedicated staff to deal with the insurance company paperwork (locally we have Cook's Childrens and the Healthcare Provider Formerly Known As Harris) - they all tend to be expensive as hell.

So when I see things like (3)(4)(6), I see what sounds like an apologist for monolithic financial firms (which is what insurance companies are). You almost acknowledge the problem in (11) -- so what happened?

Number (9) - Are you kidding me? Haven't we had enough untested drugs thrown out there to keep Big Pharma's profits up? Sort of goes hand in hand with (6) tort reform, eh?

ΛΕΟΝΙΔΑΣ said...

Dr Ralph,
Your point regarding dealing with insurance bureaucracies is spot on. The only thing worse (and more expensive) is of course dealing with an additional layer of government bureaucracy. The AMA "deathgrip" on the number of med school slots and the insistance on ethnic affirmative action (quotas) has arguably resulted in a deterioration in the quality of health care. I, having spent many years at sea exposed to tropical sunlight have reluctantly become somewhat of an expert on the quality of dermatologists. The only ones I have found to border on incompetence have been the obvious results of the ethnic quota system. Fortunately, absent a complete monopoly one can still choose competent medical practitioners. The point being that "government certification" is far from an assurance of competence.

Can you advise us which and how many "untested drugs" have been "thrown out there to keep Big Pharma's profits up?" Also, as you are adept at ferreting out statistics, can you give us the number of patients who have died during the last 15 years who were denied life saving "untested" treatments that were subsequently "approved" by the FDA?

Dr Ralph said...

ΛΕΟΝΙΔΑΣ -- allow me to amend my remark from "untested" to "poorly tested" drugs. I willingly concede there is a difference, however the point I wished to make is Big Pharma (aided by the poor oversight of the FDA) has rushed several drugs to market that either (1) show no real improvement of an existing drug, other than it can be patented, while the existing drug's patent has expired, or (2) have serious side effects that are ignored, suppressed or glossed over.

While one might argue the FDA does a poor job of providing oversight for drug safety, I'm open to your suggestions as to what would be a better system. My initial reaction to a system that depends upon the drug companies to self-police is one of skepticism.

Now if you'll excuse me, I'm trying to get my taxes filed. Surely you appreciate my pain.

ΛΕΟΝΙΔΑΣ said...

Dr Ralph,
We are definitely in agreement on the "self policing" issue. There is however available a regulatory system that works effectively. It is known as the free market. Perhaps one day it will be tried. We would do well however to avoid holding our breath.

You are herewith excused to resume your government mandated journey "through the looking glass" to calculate to what extent you will be shorn of your hard earned cash.

Segue: Try viewing the rebroadcast this week end of John Stossel's presentation on the Fox Business Network. You will probably be either angered or inspired.

Ta Ta

Dr Ralph said...

ΛΕΟΝΙΔΑΣ - I appreciate the pass.

It has not been a great week for me.

The Whited Sepulchre said...

Thanks for the list of Doctors. My only tie-in would be that where they're plentiful, the oost goes down.

r.e. your commentary about the possible contradictions on my list.... Please remember that I don't see any of through the left/right glasses. There's Statist vs. Freedom, and it's pretty much a zero sum game.

IMAO, the biggest misconception in American politics is that Big Business doesn't love Big Government (and vice-versa). If you ever see politics through that set of glasses for 24 hours, you'll never take them off.

As far as Doctors, Insurance companies, and you are concerned, don't hate The Players, hate The Game.

Also, through a happy coincidence, John Stossel had one of the best shows on this I've ever seen last night. Please TIVO. It covered the FDA's testing requirements beautifully. Will rant more on this ASAP. It was great. Loved all of it.

Dr Ralph said...

WS -- thanks for the advice. I do occasionally take it (believe it or not).

Re: big business and big government; no argument with you there. With a grin I again point out I never heard you get around to mentioning this during the previous administration. But I was given a pass by ΛΕΟΝΙΔΑΣ and I'll give you one too.

Tell me: is John Stossel viewable online (like on Hulu the NBC website)? I'd probably never get around to recording him but I'd be willing to check out a video stream.