July 22, 2009

Health Care Reform

There's so much here that I could write a page and really not even scratch the surface. Right now, I really ought to go to bed, but I've been grinding this over. A couple of thoughts:

Doctors: One of the biggest reason that many of the best and brightest pursue the field of healthcare is the money involved. For those who argue that it's not about the money, I would urge you to look at the current shortage of general-care physicians, especially in rural communities. Obviously it's not as simple as that what with the average cost of a medical degree being solidly into the 6-figures, but there is a good reason that this stressful and critical job is well-paid. Trying to figure out how to pay doctors seems to be a bad idea... much like trying to figure out how to pay teachers less, only with more disease, infirmity and dying.

Insurance Companies Large corporations figuring out how to make billions of dollars a year providing insurance have no appeal to me whatsoever. I understand that doctors need to be paid well to compensate their skill, sacrifice and liability (with that last one being something that the tort reform crowd can tackle elsewhere.) At the same time, Blue Cross/Blue Shield, MetLife and others don't really provide a service that it requires great skill to provide nor is it something, like research (for instance), that sapping the profit out of really hurts anyone except for investors and a bunch of accountants and pencil-pushers.

Is anyone going to be really sorry if the private insurance companies get screwed here? I mean, these guys are essentially one step up from collections agencies and telemarketers, at least as far as I'm concerned... especially with the evil maneuvers like rescission and forcing paying customers to fight them every step of the way to get procedures paid for.

Drug Companies: Here's the thing: drug research isn't cheap, at all. And as much as people complain about the FDA approval process (which, I think most can agree, needs some work), I don't think anyone wants to compromise on extensive research with regards to the impact of medicine on humans. Also, see the argument above for paying doctors well and extend it to talented people researching new medicines. At the same time, when a drug company nets billions of dollars in profit annually, I think we may have an issue.

For all of those who would argue that my sentiments are overly populist and not in keeping with capitalism, a couple of points:

1) Doctors are subjected to increasing costs of practicing in terms of malpractice insurance. This is furthered by the government-run court systems... with the irony that the "pure capitalists" who don't want government interference want the government to step in and interfere with the courts' handling of liability for doctors practicing medicine. Obviously something has to be done in this situation.

2) Drug companies are essentially protected by the entirely-broken US Patent System. If anyone wants to know how broken the USPTO is, do a bit of digging around regarding such awful patents as "one-click buying", mounting touch-pads on mobile devices, and others. Basically, drug companies exist entirely because of the USPTO and treaties such as WIPO... and as entities who owe their existence to an arcane series of government regulations, pure capitalists ought to be all for examining the status of such companies.

And really, my closing point is that I'm hearing a lot of people saying things like "the government shouldn't get involved in health care." I'm of several minds on this... mostly because I don't trust big government... but neither do I trust large corporations. And it seems to me that a lot of the arguments for distrusting one apply equally to the other, and very few people are applying an equal level of skepticism and critical analysis to both.

Posted by Vengeful Cynic at 11:45 PM | TrackBack