Health Care: The Real Issues

With all the heated debate regarding health care, it's time I weighed in.

Like the tea parties I commented a few months back, I think there is not enough focus. Not on just one side but perhaps both sides.

And just like the tea parties, the focus needs to be on overspending.

What good is it to have the finest medical technology in the world if the average American can't afford to use it? There is a lot of irresponsibility and blame to be focused on several parties.

INSURANCE COMPANIES SAY THEY AREN'T THE BAD GUYS

Well, that's what they say. But let's be honest. They are. It is quite apparent that, given the opportunity, the insurance companies cannot be trusted to police themselves, nor can they follow practices that make sense. They brought this mess down upon themselves.

In the face of mounting costs, the insurance industry has done little - if anything - to address the situation. They have failed to lobby our lawmakers to pass reasonable tort reform. They have failed to call out the pharmaceutical companies over ever-increasing drug costs.

Despite overtures to the contrary, the average American has little choice in their insurance carriers. If they are fortunate enough to have an employer that offers insurance, they pretty much can only take what the company offers - if they are really lucky, they have more than one insurer to choose from. And if one wants a different insurance carrier, they have to purchase that on their own - at a substantially higher price. No wonder so many Americans go without.

Insurance companies also have stupid rules. A good example is pre-existing conditions. I have had health insurance under my current employer for 23 years. Thirteen years ago I was diagnosed with type 2 diabetes. If I were to lose my job, I would have to find health insurance on my own - but I could very easily be denied because of my now-pre-existing medical condition. Never mind that it is quite treatable. The insurance companies could care less. Not me. Have you seen the price on the most common medications for diabetes?

Health insurance is also not universal. You may learn that the hard way next time you go to the emergency room. Even though emergency room visits are typically covered, and you may be going to a hospital that is also in-network, and all the drugs they give you are covered, the doctor who treats you may be one who doesn't take your insurance. Guess what? You're stuck paying his fee.

You may also run into the nightmare we ran into with my wife a few years back. She had been suffering repeated attacks of acute pancreatitis. She was under treatment for a couple years under one particular specialist who realized that her problem was beyond her expertise. So she referred her to another specialist who performed additional diagnostic tests and treatments which eventually relieved her condition, and she actually began to heal. Unfortunately, our insurer at the time (despite having told us they would cover the procedure) did not cover the procedure after all. They claimed this was a routine procedure that could have been handled by the previous doctor. Thanks to United Healthcare (I mention their name because this is NOT slander), we had to pay about $11,000 out of our own pockets. Instead of paying $11,000 to heal my wife, United Healthcare was satisfied to keep paying for numerous hospitalization (each costing well into five figures, and even a 3-week stay in the ICU which was into six figures) I would guess these hospitalizations cost insurance over a quarter million dollars).

Insurance needs to universal and not be denied due to pre-existing conditions that are treatable.

DOCTORS ARE ONLY HUMAN

As a society we expect doctors to be able to cure everything. The fact is they take care of most things. One also has to take a physician's speciality into account. Dermatologists tend to have a high success/low mortality rate. Oncologists have the opposite. That's the nature of human physiology.

Believe it or not, doctors don't know everything, and they can't accurately diagnose everything. If you don't believe that, watch Mystery Diagnosis on the Discovery Health Channel sometime. I think you'll be appalled at how simple, treatable conditions get missed by doctors all the time.

Despite that, I think we can trust our physicians to do their jobs. Just because a rash doesn't clear up as quickly as a patient would like - that does not constitute malpractice. If - on the other hand - a surgeon who does something blatant such as leaving a sponge in an incision or amputating the wrong limb is fair game.

PHARMACEUTICAL COMPANIES - THE REAL DRUG LORDS

Have you noticed all the advertisements for all kinds of drugs? What a creative way to hook potential users! And it's all legal!

The pharmaceutical companies push their drugs on us and justify their exorbitant prices to fund their research. They invent diseases that their drugs will cure and send gullible patients to their doctors to convince them they have this dreaded disease. There's even a prescription mascara for those who can't grow enough of their own eyelashes!!!!

The Food and Drug Administration is of no help. In fact they are likely in league with the drug companies.

And you would think that if they are spending so many billions on research, they would get it right. Apparently that is not the case, either. How many "wonder" drugs have we seen advertised only to be followed by an ad on daytime TV a few years later: "If you or your loved one has been seriously injured after taking ______, call the law offices of _____, _____ & _____." That happens WAY too much.

TORT REFORM WOULDN'T BE A BAD IDEA, EITHER

One way to bring about true health care reform would be some real tort reform. As I stated above, some malpractice suits are legitimate. Many are frivolous. The health care system is not your ATM.

SO WHAT SHOULD WE DO?

I have to agree with most Americans that we can't do nothing. But the health care reform legislation being mulled around in Congress simply goes way too far.

And where is the talk about overspending? Or is Congress still giddy with excitement over the stimulus bills and cash-for-clunkers. Our treasury is not your ATM machine.

We cannot just throw money at the problem. We simply have to get costs under control.

The ideas I outlined above are a good start.

WE NEED A GOOD OLD FASHIONED CONGRESSIONAL HEARING

I remember the Watergate hearings when I was lot younger. Those were pretty exciting. Got some people in hot water - people who needed to be in hot water - right up to the President himself. Changed things for the better in the long run.

We need to the same thing again. Let's start off by serving subpoenas to the CEOs of the pharmaceutical companies. Let's haul their asses in front of a nationally-televised Senate hearing and make them explain to the American people why drug prices or so high and why their research sucks. Let's get their names and make them famous. And let's see where that leads us next.

LET'S GET REAL

There's a lot of healthy debate, and that's a good thing.

But remember, the health care system can't heal you. Your doctor is specially trained to promote your healing. Your nurse is trained to - well - nurse you to health. Your drugs are created to alter body chemistry - for good AND for bad. But the real healing is within you and - if you are so blessed - from God - a source no one can or ever will be able to manipulate. No matter how this turns out, no government can ever take that away from you.