Tuesday, January 5, 2010

The Health Care "pie" ...

I just caught the tail end of some Public Radio comment about there being many studies and pilot projects regarding cost cutting in US health care but that nothing will really happen because any actual cost cutting is more a political decision in that "cost saving" in one area of health care really means "lower income" to someone else.

I think doctors sure know this, which is why "watchful waiting" often means let the patient suffer until its diagnosable as an illness that qualifies for better payments. Some diseases simply have good funding. Diabetes patients can get two days of free schooling and you know there is no such thing as "free". All those TV ads for diabetic supplies and mobility scooters: you think those companies want reduced health care costs?

In Canada there are hurdles, waiting lists and appointments at inconvenient times so as to maximize utilization. In the UK there is just about the same situation as the USA but at half the cost.

The real problem is that health care is much like water in the western USA. Government interference is so pervasive that there is no such thing as a free market price for water. Its the same with health care. Its not just supply and demand and accountability problems, its simply that "costs" are governmentally defined. One doctor handed me a tiny little three by five inch box of tissues that was about two-thirds empty. I knew he was making a point to do that because he can then bill a humungous sum for it. Its supposedly "free" to me, but its really a built-in cost induced by government reimbursement schemes. Forty years ago TV commedians made jokes about getting two aspirin tablets for twenty dollars. Now the jokes are about getting two aspirin tablets in a hospital for two hundred dollars. Nothing has really changed. Probably nothing ever will.

All the costs of the events of September 11th and all the costs of the senseless futile wars in Godknowswherestan would have been avoided if that Information Specialist in Seattle had received better medical care. Yet even he feels it would be better if the government got out of the health care marketplace.