Prescription For Change: Take 2 Bureaucrats And Call Me While You’re Mourning

   Sticks and stones may break my bones but socialized medicine might kill me. Folksy sayings like these may replace familiar ones if Mr. Obama’s proposed $637 billion down payment to disastrous socialized medicine occurs.

   U.S. health care is a $ 2.3 trillion industry with premiums rising 6-8 times faster than personal income. Around 50 million fellow citizens are either in the small, but by no means ethically, politically or economically insignificant class of folks who are uninsured or chronically underinsured, or in the multifold larger dynamic group.

   Laws which make it illegal to refuse care at the nation’s emergency rooms are not uniformly applied. E.R. care is prohibitively expensive and often too little, too late and without follow-up. General Motors and Starbucks spend more on health care than steel and coffee respectively and medical-related issues are a top reason for personal bankruptcy.

   However, we have more of the best level of care than any first-world nation and more care to more people at more points in their lives. We are among the healthiest and happiest with our care but the cost is threatening the health of this nation.

   U.S. cancer screening, mortality, immunization and access to care rates are first rate. Working and non working poor have dramatically shorter waits for access than other industrialized nations. Per capita crucial diagnostic tests such as CAT scans and MRI’s, as well state of the art care for diabetes and cardiovascular disease are world leading.

   All economic classes of U.S. citizens express higher satisfaction with their health care than other nations. Per capita, the U.S. has more medical Nobel Prize winners, patents and clinical trials. Our top five medical institutions combined are responsible for more innovations in health care than any other nation. Why? It is because private enterprise is coddled in capitalism and nurtured in a tricameral constitutional republic.

   “Ring around the regulation, pocket full of government intervention, ashes ashes, all fall down” could be a new medical mantra. Social Security, Medicare and Medicaid will consume our budget by 2040 with states and the feds paying over half. These unfunded promises to present entitled beneficiaries total $56 trillion. Government as the primary payer or as a competing payer will mean, in time “only payer”. Rationing, limiting or directing how folks are treated will follow fueling malpractice litigation, stoking hundreds of billions in defensive medicine costs and dousing any flames for tort reform. Waste, fraud and abuse will multiply faster than antibiotic resistant flesh eating bacteria.

   That’s some prescription for change. Take two thousand bureaucrats and call me while you’re mourning.

   American doctors thrive as “buck stops here” decision makers cherishing the personal responsibility of making evidence based, data driven and ethically grounded decisions. Medicine is no more a socialized team sport than celibacy or fidelity is the credo of rabbits in spring. To healers with a bazillion years of education, the administrivia of socialized medicine is an anathema.

   Digitizing the data rich environment of medicine and institutionalizing education towards non punitive consensus based national treatment guidelines and preventive practices is crucial. Resurrect the President’s Physical Fitness Awards from cradle to grave. Facilitate maximal enrollment of patients in cooperative peer-reviewed clinical trials. End free passes for some complementary and alternative medicines. If Uncle Joes Kickapoo joy juice or Miracle-O-Matic remedy is not proven safe and effective, then it compliments nothing and wastes dollars.

   A health care solution must be portable, funded with pretax payments, provide premium assistance in a principally private payer system and be done quickly and assure choice. Coordination of care, a prevention emphasis and the right care at the right place and time will change hospital incentives from government reimbursement of the uninsured to outcomes based redirecting care into a competitive private sector.

   Socialized medicine doesn’t even work, even in socialized nations. Remember, an administrator a day keeps the doctor away.

© Kevin Ryan 2009