The Modest Healthcare Proposal
Philadelphia’s “The Bulletin” recently had an interesting article published on the Healthcare dilemma. The link is here: A Modest Health-Care Proposal - The Philadelphia Bulletin Archives
Sure, the viewpoint is radical, but isn’t this really what some of the fanatical left really want?
A Modest Health-Care Proposal
By Sheldon Richman, For The Bulletin
Sunday, September 20, 2009
Enough dithering! President Barack Obama says it’s time to act on health care. I agree.
But act how? Are we really going to be happy with the pussy-footing proposals floating around Congress? All the so-called reformers want to do is tinker with insurance regulations. But how effective would that be, considering that the insurance companies themselves support the changes?
We have taken our eyes off the ball, people. Let’s get back to first principles. Mr. Obama’s premise is that we have a right to health care. A right.
America was founded on the idea of rights — inalienable rights. No one can take them away. I assume that when people say that health care is a right, they mean that health care is an inalienable right. Mr. Obama apparently agrees. In his speech before Congress he called for free services, such as physical exams, colonoscopies, and mammograms. Free! You have a right to those things.
Well, OK. But why stop at free preventive services? Why not free treatments, free surgery, free drugs, and so on? We need those things as much as a physical exam. If we have a right to health care and if we are unable to obtain those services, our rights have been denied or violated. That is something the advocates of health-care “reform” say we must not tolerate.
Okay, let’s not tolerate it. Let’s make sure no one’s right to health care is violated. Let’s get serious for a change.
But how? I can think of only one efficient way to accomplish this. Let’s enslave the providers of medical services — doctors, nurses, paramedics, dentists, chiropractors, acupuncturists, psychiatrists, and the rest. My proposal may shock people, but I am confident that this feeling will wear off as we think about how logically it flows from the principle that we have a right to health care.
First, let me point out that there is no other good alternative. Any other system designed to deliver health care as a matter of right will have gaps through which the least fortunate inevitably will slip. Isn’t that the problem we’re trying to fix? Obama’s approach isn’t much better. He wants to force the insurance companies, with taxpayer subsidies if necessary, to insure everyone — healthy or sick, young or old — at the same price. He might even like a government insurance option, though he can’t make up his mind whether or not that is an essential feature of his plan.
Regardless, it’s a bad plan. Requiring insurance companies to pay for our medical care misses the point. Where do you think insurance companies get their money? From us! What kind of right to health care is it if we end up paying for it anyway? Obama means well, but his plan is a shell game.
On the other hand, enslaving the doctors and other providers would have none of the defects of the current system or the leading reform plans. It goes right to the source. We have a right to health care? Fine. Force the doctors to provide it.
Of course, this wouldn’t be free. I’m no pie-in-the-sky utopian. The doctors and the others would have to be fed, clothed, and housed. They’d need certain comforts. That’s understood. But it would be far easier to keep a lid on costs by enslaving the providers than by the patchwork system we have now, or would have under Mr. Obama’s plan.
The biggest problem I can see is that if doctors are going to be our slaves, no one will want to be a doctor. Most people don’t relish the idea of being slaves even in the national interest. They’re selfish that way.
We certainly can’t be a world-class country without doctors and nurses, so I have a solution to this problem: conscription. President Obama should direct the nation’s schools to look out for students with an aptitude for biology and direct them into medical studies. Then, at the appropriate time, the government should draft those young people into the newly created U.S. Medical Service Corps.
I know what you’re thinking: As word of this got around, the best students will play dumb. If that happens, we’ll have no other choice than to pick our doctors by lottery.
Sure, the viewpoint is radical, but isn’t this really what some of the fanatical left really want?
A Modest Health-Care Proposal
By Sheldon Richman, For The Bulletin
Sunday, September 20, 2009
Enough dithering! President Barack Obama says it’s time to act on health care. I agree.
But act how? Are we really going to be happy with the pussy-footing proposals floating around Congress? All the so-called reformers want to do is tinker with insurance regulations. But how effective would that be, considering that the insurance companies themselves support the changes?
We have taken our eyes off the ball, people. Let’s get back to first principles. Mr. Obama’s premise is that we have a right to health care. A right.
America was founded on the idea of rights — inalienable rights. No one can take them away. I assume that when people say that health care is a right, they mean that health care is an inalienable right. Mr. Obama apparently agrees. In his speech before Congress he called for free services, such as physical exams, colonoscopies, and mammograms. Free! You have a right to those things.
Well, OK. But why stop at free preventive services? Why not free treatments, free surgery, free drugs, and so on? We need those things as much as a physical exam. If we have a right to health care and if we are unable to obtain those services, our rights have been denied or violated. That is something the advocates of health-care “reform” say we must not tolerate.
Okay, let’s not tolerate it. Let’s make sure no one’s right to health care is violated. Let’s get serious for a change.
But how? I can think of only one efficient way to accomplish this. Let’s enslave the providers of medical services — doctors, nurses, paramedics, dentists, chiropractors, acupuncturists, psychiatrists, and the rest. My proposal may shock people, but I am confident that this feeling will wear off as we think about how logically it flows from the principle that we have a right to health care.
First, let me point out that there is no other good alternative. Any other system designed to deliver health care as a matter of right will have gaps through which the least fortunate inevitably will slip. Isn’t that the problem we’re trying to fix? Obama’s approach isn’t much better. He wants to force the insurance companies, with taxpayer subsidies if necessary, to insure everyone — healthy or sick, young or old — at the same price. He might even like a government insurance option, though he can’t make up his mind whether or not that is an essential feature of his plan.
Regardless, it’s a bad plan. Requiring insurance companies to pay for our medical care misses the point. Where do you think insurance companies get their money? From us! What kind of right to health care is it if we end up paying for it anyway? Obama means well, but his plan is a shell game.
On the other hand, enslaving the doctors and other providers would have none of the defects of the current system or the leading reform plans. It goes right to the source. We have a right to health care? Fine. Force the doctors to provide it.
Of course, this wouldn’t be free. I’m no pie-in-the-sky utopian. The doctors and the others would have to be fed, clothed, and housed. They’d need certain comforts. That’s understood. But it would be far easier to keep a lid on costs by enslaving the providers than by the patchwork system we have now, or would have under Mr. Obama’s plan.
The biggest problem I can see is that if doctors are going to be our slaves, no one will want to be a doctor. Most people don’t relish the idea of being slaves even in the national interest. They’re selfish that way.
We certainly can’t be a world-class country without doctors and nurses, so I have a solution to this problem: conscription. President Obama should direct the nation’s schools to look out for students with an aptitude for biology and direct them into medical studies. Then, at the appropriate time, the government should draft those young people into the newly created U.S. Medical Service Corps.
I know what you’re thinking: As word of this got around, the best students will play dumb. If that happens, we’ll have no other choice than to pick our doctors by lottery.
Labels: healthcare reform
posted by Anonymous at 5:35 AM
8 Comments:
This plan makes as much sense as the idiotic programs being proposed by the Libs in Congress. Yesterday, the Libs defeated two amendments - one to require a picture ID to prove one's eligibility (read: citizenship) to receive health care, and two, one that would forbid funding for abortions. As usual, the Libs want to give amnesty to illegals and kill the unborn. Euthanasia is in the Obamacare (read: Oh, Bomb our care) plan. The Libs have always wanted to take advantage of the weak and defenseless, while claiming to be the champions of the people. What a Lie.
In the meantime, the great dictator, BHO, who started this big debate on health care, is off to Denmark, to try to win the 2016 Olympics for his godfather, Mayor Daley, in Chicago. Of course, everyone knows that the Chicago ruling class, including BHO, will personally benefit from the Olympics, while placing an already bankrupt city further in debt. BHO is good at spending money that does not exist. The USA is quickly becoming a typical third world country governed by the elites while the population becomes paupers.
Eating is a right. But you still have to pay for your food.
On this issue I consider myself a liberal.
All of these plans that are being proposed are only small pieces of the puzzle that need to be fixed to fix the healthcare crisis we are facing.
Some of the things that I feel need to happen is:
Tort Reform: Limit awards on frivolous medical malpractice lawsuits (the ones like , "I dont like the way the scar from my stitches look, I am suing you for $2.5m)
Unwarrranted lawuits need to be tossed before they even hit the dockets, so Practitioners can provide care with out fear of a lawsuit, and with out the costs for skyrocketing malpractice insurance costs being passed on to patients
#2) Stop gap coverage:
This can take two forms, either an insurance program backed for the government to provide coverage for those who are too sick to work, but not sick enough to get medicaid or medicare.
A separate, affordable insurance available to small business owners, employees of small businesses. This does not have to be a government backed plan, just laws that allow small companies to form "health insurance co-ops" to obtain policies for themselves and their employees at an affordble cost.
OR
Expand the current system of Federally Qualified Community Health Centers, where comprehensive medical care is provided to the uninsured, and underinsured, based on a sliding fee scale which is derived from the clients income/# of people in the household.
It works VERY well at 1200 FQHC's across the country, and the cost for the return is extremely reasonable, a hell of a lot more affordable than a completely government run healthcare system.
But the truth is there is no ONE fix to this situation, it has to be a combination of the several things, FQHC's, Insurance co-ops, Tort Reform, Stop gap coverage.
The reality is, we will NEVER reach this goal, too many things have to come together to fix the problem, and as long as the fat cats in DC, on both sides of the sentate/congress have anything to do with it, it will be lost in the partisan political grandstanding and stalling.
Just in case someone thinks Sheldon Richman is really advocating this, he is not. This was to show how absurd the logic of the left carried out to the natural conclusion of what they what they propose would be. Richman is firmly a true "free market" advocate.
Tort reform, sure, but this is not a federal issue. Malpractice is a state problem. Do we really want the federal government running another part of our lives?
One thing that could be done quickly at the federal level is let the tax credit become the individual's, not the employer's. This would help quickly make insurance more affordable and portable. Instead of a thousand pages, it would take about a half page. Saves a lot of trees, good for the environment, etc. Of course then the PEOPLE would be in more control of their lives and less dependant on the government. The political class wont let that happen!
Christopher -
Come see me some afternoon and let's talk about my malpractice case load, which is about 90% of what I do on a daily basis. If you can find any frivolous cases amongst them, I will dismiss it then and there. Most of my clients are either dead from the negligence at issue, or profoundly harmed.
We're all in favor of BS cases going away, as it makes it harder for me to help the seriously and legitimately injured folks without the skeptical eye of the world against us. However, the truth is that the judicial system does catch and eliminate frivolous cases. Without appropriately qualified experts to testify in support of a claim, such claims are always dismissed by the Court system. Physicians and lawyers may disagree about what is and what isnt malpractice, but if there is a difference of opinion and its supported by physicians in both directions, its anything but frivolous. Besides, who should be the arbiter of what constitutes frivolous? You? Me? HB? I truly think juries do a damn good job, and when silly cases are filed, they are most often lost, and the filing attorney not only makes nothing, but it costs him time and expenses too. Trust me when I say that there arent any lawyers out there looking for quick bucks in malpractice cases - its just not possible. I only know of 1 verdict in Clark, Floyd or Harrison counties in malpractice cases in the past 5 years against a healthcare provider.
Sure, there is a rare case out there each year that produces a crazy verdict that we all hear about, but trust me when I tell you that no frivolous lawsuits are ever paying out ANY dollars, let alone $2.5 million. It's simply not true. The other fact is that medical malpractice insurers have demonstrated increased (and record) profits each of the last 5 years. If there really was a "malpractice crisis", would they really be making such profits?
There is a great article in Modern Medicine journal about it...
http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?id=518786
Its a publication by physicians, and comments very candidly on the downside of tort reform.
Do doctors practice defensive medicine, which affects costs? Perhaps, but have you ever had a doctor tell you that "I am ordering this test not because you need, it, but because I dont want to get sued?". If they order it, and get paid for doing so, I would suggest that they probably did so because the thought you needed it, whether their index of suspicion was high or not.
Besides, if the malpractice cases were such a money making racket, there would be more than just 2 of us handling these cases south of Columbus. But, there are just two of us that focus on such things, which might suggest that they're anything but quick and easy cases.
Anyhow, this is just my two cents, of course. I would be delighted to discuss the issues with you or anyone else (including HB) over a beer at Bank Street Brewhouse sometime. I would think that fellow blogger Meatbe (who defends these sort of cases) might also voice an opinion that the concept of a myriad of frivolous cases is more of a myth.
Cheers.
Lawguy, let's see.
90% of what you do is medical malpractice.
Only one case in the local three county area went against the provider in the past five years.
The lawyer who loses makes nothing and has great costs. ( pardon me while I wipe away my tears)
Either you are independantly wealthy and are motivated by altruism or something else is going on here.
The defense guy's are paid well by the insurance companies, so why should they care how many cases are filed and why? Their clock like yours is always running! These cases often go on for years before being thrown out, and there is cost bore by the defense. Provider rates go up, regardless of the outcome.
As to your sarcastic skepticism about the cost of defensive medicine, give us all a break!
And since when was it illegal for an insurance company to make profits? I do not know the industries bottom line, but as the economy has taken a big hit and investments have lost, insurance companies also lost. They may have had some recovery in the past few months. Also, if doctor's were allowed to go bare, you would be looking for a different client group.
Anony -
You misunderstood.
I said only one VERDICT, not one case. There are obviously more, the majority of which are either found without merit (and dismissed or successfully defended) or they're meritorious and resolved by the healthcare provider and its carrier. My point was simply in response to illustrate a misperception of tons of merit-less cases being filed for which millions of dollars are being paid. It just isnt so.
I wasnt intending to be sarcastic about defensive medicine. I would presume that doctors who get paid to order and interpet tests are doing so because they are neccessary, not to "CYA". If the tests arent neccessary, dont order them (or charge to interpret them). Its that simple.
As to your point about insurance companies, like all businesses, are certainly entitled to profits. However, it seems a bit disingenuous for them to make record profits year after year (and we arent talking about a recovery in the past few months - they're making historical record profits), yet they keep raising premiums to healthcare providers based on their claims that lawsuits are destroying them. I might give them some credence if their premium dollars were being raised to cover increased losses on claims, but that is clearly not the case.
I'm neither wealthy, nor altruistic. Just a guy who works hard, enjoys what he does and enjoys helping people.
Lawguy,
I wonder how many of those cases are "settled" before going to trial simply because of the ridiculous amount of time, time out of office and potential for defamation of character in the community? How many docs simply choose to settle, not because they believe they malpracticed but because their malpractice insurance company defense lawyers convince them to do so (likely because they get paid regardless of whether it is taken to trial or regardless of the verdict and they really do not care to spend the time to defend the doctor)?
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