Thought You'd Never Ask

Just mouthing off -- because I can.

Monday, July 16, 2007

Call your Senator and demand decent health care

Here's a dilemma:

A dear friend of mine who is a breast cancer survivor forwarded an email to me (and to several other friends of hers) asking us to sign a petition to combat "drive-by mastectomies." "I cried when I read this," she wrote, and "it happened to me."

Of course I sympathize with the pain and fear of being sent home from a mastectomy with drainage tubes still hanging from your body because your insurance won't pay for a longer stay. Of course I am angered and saddened by such stories of women struggling to deal with the emotional and medical aftermath of losing a breast and facing cancer. Of course I agree that a 48-hour paid stay in the hospital after such traumatic surgery would be great for all women wanting and needing to recoup under close medical supervision (in fact, why not a paid week, including psychological or even spiritual counseling, survivor support group meetings, and more?). Of course I want to be a mensch and step up to show support for my emotionally traumatized friend and all other breast cancer patients and survivors who suffer this catastrophe through no fault of their own.

In fact, why limit our sympathy to mastectomy patients? Anyone facing a medical crisis deserves our compassion, support, and help. It is a reminder to us all once again that life is definitely not fair.

But isn't inserting your Senator or any other elected or appointed official between you and your health care bound to make things even worse?

Not that they wouldn't leap at the chance to be there. But do Senators know even more about, or have even more compassion, time, or attention to deal with medical matters than do insurance companies? Wouldn't you think that insurance companies and medical professionals might be the real experts here? Certainly they have more knowledge and experience in dealing with individual patients, procedures, and medical cases. The thought of my own Senators pouring over medical minutiae gives me the willies. Shouldn't Senators, with their limited capacities and time, be passing and funding laws dealing with fraud and injustice in general, along with crafting all those resolutions?

What sort of Americans think Senators or any other politicians or appointed bureaucratic minions will be more compassionate, effective, efficient, knowledgeable or even honorable than medical and insurance workers liable to being fired for incompetence?

As for me answering my friend's email: if I am against socialized health care, how can I sign a petition calling for laws mandating specific medical treatment? What if medical advances outstrip the codification of Senatorial intervention in this and other cases?

Does the average American, let alone the average traumatized breast cancer survivor, ever think about a political or bureaucratic solution to a problem always being less efficient, less responsive, more bloated, more slow, more dumb and more susceptible to corruption than a free market solution? Do they ever recognize all the unintended consequences that will be brought about by their good intentions?

Just because insurance companies are profit-seeking entities dealing with aggregates and are not run to look out for the best interests of all patients in all cases is no reason to call for more intrusion of politicians and laws into the process and less freedom of choice for the consumer.

How about these alternatives for women considering signing such a petition:

--Inform your doctors, your insurance companies, your employers who carry your insurance, and your family members and friends about the issue and your displeasure at the status quo. Public persuasion, buzz, and shame have a lot of influence, and more so on people you know and the companies that serve you than on distant politicians or faceless bureaucracies.

--Familiarize yourself with all the ramifications of this problem, including the economic and political ones. How much more would a 48-hour hospital stay cost than a "drive-by mastectomy?" Who should pay this difference? Should it be a choice or a law? Who will pay this difference if it is mandated? If "insurance companies" are ordered by law to pay for it, where will they get the money? What will be the total cost for all Americans if such a law were passed? What effect (including unintended financial and behavioral consequences) will such a mandate have on doctors and hospitals, insurance companies and their premiums, and on the price level and quality of medical care in general? How will all of this be administered and by whom, and at what cost?

--Find out what your own health insurance now covers, in advance of a medical crisis. If you are angered or threatened by your insurance company not paying for anything more than a "drive-by" (outpatient) mastectomy, fire your insurance company and shop around for insurance you like better. With enough money, you can buy practically whatever insurance you like.

--Organize your finances and savings so that you will be able to pay for your own medical care above and beyond what insurance will pay for. Then make it clear to your doctors you are able and willing to pay for the best care possible, not the cheapest insurance-approved health care.

Too expensive, you say? Too time-consuming? Too hard to deal with statistics and finances? Too much to ask of women in pain and in turmoil? Too much thinking to require of average Americans?

Yes, it really is much easier to rally voters to form a self-serving special interest group to lobby politicians with emotion than it is to get Americans to accept the idea that their health care is their own responsibility. It has become such a received idea that someone else is supposed to pay to take care of your health that it is no longer even thought about. Now, along with one's employer "providing" our insurance coverage (it is actually part of our earned wages taken from us and delivered in a different form than fungible cash), we believe that health care is handed down on high from the crown, and that its quality and quantity is subject to begging, influence, and political power.

God help us and our country, and God forgive the poor innocents willing to fritter away their own power and all the benefits of a market economy taken for granted and unremembered, all for the promise of a unrealizable free lunch (or "free" restful hospital stay paid for by--whom??) "given" to them as a pretty gift by politicians only too glad to masquerade as beneficent heroes with other people's money. They will be happy to act as another layer of middleman taking their own slick payoffs.

As Neal Boortz has said many times,

Socialized medicine. It's just this simple: If the government controls your health care, the government controls you. The true path to reform of our health care system lies in the private sector, not government. But if people are in charge of their own health care, how can politicians use the threatened loss of that health care as a scare tactic in elections?

The game here is simple. Work tirelessly to make Americans more and more dependent on government. Destroy their individuality and their sense of self worth. Make them believe, as Democrats do, that American is great because of government, not because of the dynamic of free people working together in a system based on economic liberty and the rule of law. Make government the most important institution in the lives of every American -- every voter --- even more important than the Church or the family.

Once you've created a dependency on government all you have to do is threaten the voters with the loss of their government-provided security blanket and they'll follow you anywhere ... all the way to the destruction of the American dream.

Sorry, my friend. I appreciate your emotions, but I cannot follow your policy prescription.

UPDATE: Consider this thought experiment. If an additional 48 hours of a hospital stay will cost, say, $2,000 to 6,000 and it is YOU, the mastectomy patient and your family who will have to pay for it, do you feel any more inclined to try going home, as your doctor (in the face of a malpractice suit) allows you to, and have your family monitor and assist you as you recover, to save that $2,00 to 6,000? If it is your own money on the line paying the medical costs instead of manna from heaven being dropped in your lap to pay for it, do you still want to purchase the additional 48 hours of intensive hospital care?

This example highlights how much more careful we are with purchases and choices when it is our own hard-earned resources on the line. But too many of us feel we are owed services and resources by and from others without ever considering the fact that those resources are equally precious to someone else. All the women who have signed this petition: just where do they think the money will come from to pay for the 48-hour mandated hospital stay, including paying for the additional hospital bed space this would require?

I'm afraid the answer is: they don't know and they don't care. They feel someone else (who?) owes them this money they are unwilling to pay for themselves because....?

Here's an idea I offer as a possible better suggestion:

As hospitals necessarily provide more and better (and more costly) services per hour (and are subject to ever more regulatory and litigation costs and the costs of subsidizing nonpaying patients) so that overnight and extended stays become astronomically expensive, new minimal-service "rest centers" can be opened nearby where patients recovering from "drive-by mastectomies" and other outpatient procedures can choose to rest and recover for 48 hours under a monitoring nurse's care, at much less cost than for a full-blown hospital stay. In fact, the highest costs of this alternate solution would really be due to regulations, licensing, mandates, and paying for the medical malpractice insurance of the monitoring medical personnel. So maybe, to make this even more affordable for more women, it would be best to allow the patient to choose to go home or to a motel nearby to the hospital (in case of problems) and hire a nurse to stay with her for 48 hours.

Wait, don't we allow this already? Or are patients unwilling to pay anything for their own health care beyond what their insurance premiums cost them (and sometimes not even that much)?

An obvious and simple solution here is for women to ask their doctors to better inform mastectomy patients of what to expect after surgery, and how to find affordable access to aftercare resources, including rent-a-nurses.

If there is a demand for niche and alternative medical services, someone recognizing a profit-making opportunity will step up and satisfy the demand with a good, workable solution. But not if the government steps in and distorts incentives and the market. There has already been too much of that in the healthcare field.

Hang onto your choices, people. Don't go running to the politicians to pass more draconian and stupid laws limiting choices and confiscating money to be wasted through bureaucracy, bloat, and corruption. Don't give away your freedoms or take away the choices of others. Let the market do what it does best: respond, innovate and offer a range of new solutions. It is government that fences us in.

Think through all of the consequences of your actions when you appeal to politicians to interfere. Think beyond stage one.

FURTHER: Bookworm examines bad medicine and uninsured people.

Andrew Klavan shares feeling bad about having to be an impolite conservative.

Thomas Lifson: The U.S. subsidizes Canada's unworkable "universal health care."



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