Killing Tiger Woods

Every time I suggest that our current medical care system is not perfect, I get asked "So you like socialized medicine? How will you like it when you're denied treatment because you're too old? Oh, so you want the government to run everything?" This is like saying I don't play golf and getting the reaction "So you want to kill Tiger Woods?"

I'd like to make three points:
A) Our current health care system sucks.
B) The U.S. rations health care worse than any system in any other developed country.
C) Improving our system has more to do with how we change it than with who runs it.
Details follow

A) Our current system sucks. Look up objective data from the Census Bureau, the Centers for Disease Control, or the Statistical Abstracts. (The "liberal media" show some bias on the topic; Fox News and Rush are intentionally deceptive.) You will find we spend more per person than the next 20 countries and have shorter life span, higher infant mortality, and higher fatality from disease because of late diagnosis. The only high-performing measures are profitability of health care providers and pharmaceutical companies. There is a growing trend toward U.S. citizens flying to other countries to get treatment because it's cheaper and has higher success ratio. These include several countries with full government run systems. If you put all these systems in a hat and pull one out at random, you will find it works better than our system.

B) The U.S. rations health care. We hear about somebody in England or Canada who couldn't get an MRI or a kidney transplant or whatever. In the U.S. people are denied simple antibiotics. I was on a jury a trial regarding a man who DIED because he didn't have insurance to cover treatment for a simple stomach ulcer. Other systems may deny you health care but they at least have some logical reason. The U.S. denies you health care solely based solely on your wealth. You can get any treatment you can pay for. If you are not rich and don't have insurance, you can't get any reasonable health care at all.

C) Criteria for a good health care proposal. Health care in other countries, no matter who runs it or how it's paid for, gets better results at lower cost than ours because they meet some of these criteria. The U.S. doesn't meet any of them.

1) Statistically valid risk sharing; people of any age or state of health can obtain insurance at a cost that is not prohibitive. Insurers cannot offer low rates to healthy people and then ditch them when the need treatment.
2) Minimum participation requirements; people cannot stay uninsured while healthy, then scam the system by jumping into it when their health goes bad.
3) Support preventive care as well as curative.
4) Compensation to service providers is based on results, not on the volume of procedures carried out.
5) Sound analysis of the success of various treatments. Information available to both providers and consumers; providers cannot simply recommend the most profitable treatments first.
6) Fast, accurate sharing of medical info; a patient will not have to answer the same questions five times on each hospital visit or get the same test repeated for each of six specialists.
7) A competent medical expert develops treatment plans, using input from a coordinated team of specialists. (In today's system, plans are nothing more than the compiled notes of several specialists who may never talk to each other.)
8) A competent medical expert maintains continuity of treatment regardless of changes in doctors or hospitals.
9) Participants have free choice of providers.
10) Providers compete for business based on quality and cost that is measured objectively with results available to consumers.
11) Useful, objective, audited data on cost and quality must be available on every service provider.
12) Fast, accurate sharing of records prevents patients from obtaining multiple treatments or prescriptions from providers who are unaware of each other.
13) All children are insured, at taxpayer expense if that is the only way. Parents may make poor choices in life, and it is irrational and unChristian to punish the children for them. (Yeah, yeah, the Bible says sins of the fathers are to be visited on the sons. You can go by that, if you want.)

We will never see a proposal meeting these criteria because of my Painfully Drawn Conclusions about democracy:

1. Both parties have very wise, capable people, and some incredibly brainless yahoos. The public mostly pays attention to the latter; listening to the first group takes too much mental effort.
   
2. Both parties judge ideas based on how well they conform to pre-conceived ideology, regardless of whether the ideas are workable or will do any good.
3. Many on both sides will leave the public worse off rather than let the other party share in the credit for making anything better.
4. Neither party will propose anything that is not trite and simplistic. Any serious proposal will displease enough voters to keep them out of office, so what's the point?

I want to acknowledge my long-term co-worker and friend Richard Cotton, whose discussion and challenges to my thinking led to the formulation of these ideas. His ability to provide this help to me is no doubt directly related to te fact that he is a graduate of Auburn.