Sunday, October 5, 2008

In polite company... Healthcare

I think it's a grand idea to have health care for all. I'm not sure how exactly it should be funded. I would hate for taxes to be higher so that I can pay for other peoples health care and get rid of the great health care I get through my job. I know that sounds selfish, but honestly I don't see why I should pay for someones survival when I have a long list of things that I need to spend the money on for my family's welfare.

I've also had "free" health care before. I spent four years on active duty military, and an additional two years after that my wife was active duty. If the government's health care is anything like the army health care than it's not worth it. People went to the doctor way to often simply because it was free. Every little cough or sniffle sent people into the waiting room. The doctors had no incentive to give good care. They didn't give a rat's ass in most cases (There were a few good doctors). Everyone was over worked, under appreciated and bitter. I also don't like being forced to do something. If I'm getting taxed an extra 500 dollars a month for health care that sucks, I'd much rather take my money and buy my own. I guess it comes down to how well it was managed. If it's run like medicare and social security have been run then I'd rather keep my money. So I guess I'm for it if they do it right, but I'm mostly against it because I don't think they can. I also don't have the slightest idea how running it the right way would even work. I don't think I would recognize a good plan for universal health care if I saw one. If they could fix all the other disastrous government programs then I would be a lot less hesitant to support government health care.

5 comments:

  1. This is something I've been meaning to blog about, too. I tend to lean towards support of some sort of nationalized health care, but given government agencies' mixed success rates (NASA - good, Welfare - bad), I'd have to be really convinced that the actual implementation was a good one before agreeing with it.

    One issue is that we already do have a de facto national health care system. Publicly funded hospitals cannot turn away anyone for a life threatening emergency. And honestly, I like that. I don't want to show up at a hospital bleeding out, and have to wait on some clerk to clear my insurance before the surgeons fix me up. And that means that insured and non-insured alike get treated. And some of the treatments are too expensive to ever be paid off by the people that received them, even if you garnished 100% of their wages for the rest of their lives. So, the bills for those treatments gets footed by the rest of us, through raised insurance premiums and higher taxes. Now, consider that some of those emergencies, like heart attacks or strokes, could be avoided through preventative treatment, which in many cases are cheaper to implement than the emergency care. So, if you accept that hospitals are going to provide emergency treatment to everybody, the question becomes, is it cheaper to provide everybody with ongoing healthcare to avoid those emergencies, or to just stick to the status quo? I think a strong case can be made for the former.

    The other issue is that national health care does not have to be an all or nothing issue. The government could provide a base health care system, which individuals could supplement with private insurance. The problem I see with that, is that many companies which currently provide health care to their employees will drop it once the government provides anything, no matter how minimal, and better coverage will be an additional expense of the individual.

    My wife currently works at a clinic on base, and I know a few providers, so I've heard a lot of stories of what goes on. I think a big part of the accountability issue for military doctors is how difficult it is for enlisted personnel to sue them for malpractice (more info). As much as people like to criticize our litigious society, I think that the threat of a lawsuit does help to keep doctors in check. If we went to a national health care system, we would have to ensure that doctors still have that accountability.

    I had to chuckle when you wrote about military personnel going to a clinic for every little sniffle. A friend of mine was a contract nurse practitioner on base, and recently quit to go back to a private clinic, in part due to things like that (but also just because of the whole way the military practices medicine). In fact, some private clinics around here have quit taking military patients because of their attitudes.

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  2. Oh, I should have mentioned that those private clinics do take welfare patients, so it's a specific attitude of the military, and not a general attitude of people getting free healthcare. I wonder why it's like that?

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  3. One more thing regarding the free healthcare in the military. My wife has had patients call just so the clinic would give them a prescription for advil, because then they could get it for free from the pharmacy instead of having to buy it themselves. There has to be some type of co-pay for a health care system, or else you'll get this type of abuse.

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  4. I never even thought about all the life threatening emergencies that get treated but never paid for. In a lot of cases it probably would be cheaper to pay for preventative medicine instead.

    I don't know why the military care is so bad. In a lot of ways it's really good, but something just isn't right about it. I think most of the people that work in the clinics want to help, but they are limited by the system. A lot of the soldiers and their family really try to take advantage of the system as well. I don't know how many times I waited in long lines at the pharmacy and half of the people in front of me walked out with Advil just like you were talking about.

    When I was in Ft. Huachuca they had a really good system to help out with over the counter medicines. There was a special place that was staffed with a few nurses that would basically just give you what you said you needed, antihistamines, Tylenol, Sudafed, etc. The nurses just basically made sure you didn't have anything to serious, and then let you have your pick.

    Does your wife work for the air force? All my experience is with the army, but I hear that the air force takes better care of their soldiers(airmen).

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  5. Yeah - my wife works at Sheppard AFB. It's a NATO training base, so in addition to airmen (airpeople?) & their spouses, she sees all branches of the U.S. Armed Forces as well as quite a few foreigners.

    Anyway, the military health care system being the way it is is one of the reasons why I'd be concerned about the actual implementation of a national health care system.

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