08 September 2009


Spent the weekend down at Mom's, not talking about healthcare. Probably just as well.

Actually, she wanted to discuss. Mentioned to my spouse on the phone that she wanted to know what was going to happen to her healthcare. Short answer: not a thing, Mom. But she's concerned, and I understand that. And I apologize, in case anyone mentions this blog to her, for failing to open the discussion. Next week, maybe? Will that work, Ma? Call me!

What I don't understand is the hysteria - the downright psychotic ravings - of the Right. Unfortunately, I'm pretty sure a good bit of Mom's concern is fed by those ravings, from friends and (God help us all) relations all too ready to jump on any right-wing conspiracy theory that waves at them.

On the other hand, I'm also frustrated and annoyed at the political rhetoric and blame-laying that targets only the insurance companies. There's plenty of blame to go around, guys. And we've got to stop pointing fingers and figure out how to work together, or we're not going to solve this - not really.

Here's what I know:
  • We need medical professionals and institutions. But we also need them to be in it for something other than the money. Yes, I know, a lot of doctors chose medicine so they could do good in the world - the paycheck was gravy. But these days, we have a shortage of family practitioners and other primary care professionals, because medical students are choosing to go into specialties instead. And I'm sure some of them are becoming specialists so they can save the world, one joint or kidney or cervix at a time. My educated guess, though, is that the paycheck is a bit more than gravy. How about a little humanitarianism, kids? And how about hospitals not padding the bills they send insurance companies to make up for the bills they know they're not going to be able to collect, even if they do put liens on people's mobile homes? (Anyone remember that story? It was reported in that radical left-wing publication, the Wall Street Journal, a few years ago - a VERY few years. I want to say 2006.)
  • We need pharmaceutical companies. We need research and development, and we need medications that fight cancer, flu, and vertigo. We need vaccines so we don't get smallpox or polio or chickenpox. What we don't need is new prescription drugs rolled out regularly, marketed like they're God's Gift, with doctors being pressured to prescribe them and people being persuaded to beg for them - with R&D quietly being carried on in the meantime because, in a few years, the patent is going to run out and the cash cow is going to stop producing. Have you ever noticed that every time the previous God's Gift from the Chem Lab goes generic (or worse, OTC), it's either closely followed or else actually preceded by a "new and improved" version? One that is marketed even more intensively, priced even higher, and - it turns out - may or may not actually work better...
  • We need insurance companies. Face it: the majority of Americans who have insurance actually like the coverage they have and don't plan to change any time soon. Most insurance companies, honest or not, have some decent plans out there. There's even at least one U.S. medical insurance company with a CEO who's been preaching healthcare reform for years. And he's not just talking about "cost-shifting." He's talking about freedom of choice, 21st-century electronic record-keeping, cost transparency from all players, evidence-based medicine, and even (brace yourself) personal accountability. And his company is trying to shift its focus from being the fallback position when people get sick, to rewarding people for finding ways to stay well - and then being there to help when they get sick after all. But I digress... What we don't need is actuaries rejecting people out of hand or charging them exponentially more for coverage because they have chronic health conditions they need help managing, or because they once had a condition that left them in a wheelchair. And for the record, we need a public option. Yes, we need to level the playing field, but let's really level it. Let's all accept our share of the responsibility, instead of just pointing fingers at an easy mark.
  • Finally, we need personal responsibility. We need to wake up and smell the coffee: The fact is, the vast majority of healthcare dollars go to pay for treating preventable conditions. Most of the things that kill us come from doing things we chose to do, knowing they were bad for us. Heart conditions, type 2 diabetes, obesity... We need to get off our fat butts, turn off the TVs, and start walking to the bus stop instead of driving two blocks to the grocery store. We need to find a buddy and quit smoking. We need to demand that the nutrition information on foods be printed in a font big enough to read - and we need to read it, and use it. We need to knock off the sodas and drink more water. We need more cookbook authors like Holly Clegg (shameless plug there), who publishes the complete nutrition info per serving for every recipe in every book she publishes.
The other thing we need to do - we left-leaning believers in healthcare reform who know darn well there's more than enough blame to go around - is get over our anxiety about being yelled at and start talking back. We have to stop just rolling our eyes at the paranoid conspiracy theorists and talking about them behind their backs, and tell them to shut up. Ask them for documentation of their claims. Don't accept hysterical ravings and meandering rants that mean nothing. Just push them to clearly, logically, factually back up their arguments.

I betcha money they can't do it.

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