Friday, June 19, 2009

Parenting Our Government: The Cost of Giving In

My three year old has mastered the concept of verbal assault like a professional special interest lobbyist. She lurks in a room, just long enough to take stock of the situation. Once she sees an opportunity, she pounces like a lionness. The attack is swift, and I rarely have time to think, much less consider her demands. "What is that? Why are you doing that? What is that thing for? Can I have that? I want that...can I have it? I want that NOW! Mom, can I have it? MOOOOOMMMMM! I want that NOW!!!"

After ten minutes, the neural synapses fire simultaneously, driving me to acquiesce, in order to stop the hammering in my head caused by her incessant begging. Half the time, she gets what she wants and simply starts asking for something else. Like any pre-schooler, the power and control isn't in the getting, it is in the demanding after being refused, and THEN the getting. In a way, she could mentor a Washington lobbyist in methodology. Moreso, if what she wants isn't possible, she just demands louder and screams until every nerve in my body is raw. I become willing to give her ANYTHING, just to preserve my sanity. Just shut the kid UP!

As a parent, I know to give into her rants and demands are only going to successfully create a monster. I have to be firm in my parenting and nip the manipulation in the bud by putting her in another room as soon as the pitch on her whining reaches a certain decibel level.

Special interest groups operate in much the same way in our country. They scream and kick until they get their way, or they simply bombard us until we grow so weary, we just want to shut them up. And much like my three year old, they are never satisfied when they achieve their objective. They just change the demand. As long as their demands are being heard and eventually met, they are in control. That is really all they want.

Those special interest groups represent the business people whining about the cost of health insurance, insurance companies complaining they can't control the costs of medical care and medical care providers complaining too many people are showing up for care that don't have insurance, forcing them to increase the costs of health care to the patients. The funny thing in all this is one simple reality: In the early eighties, the government gave into fear mongering (by hospitals) that the baby boom generation was going to meet untimely deaths unless they had government health insurance. Medicare and Medicaid were born.

But by placing a third party between the producer (physician/hospital) and the consumer (patient), we unwittingly created a delayed reaction in the supply/demand cycle. Throw licensing boards into the equation, and the ugly truth is, we were better off 30 years ago when the average person didn't have medical insurance, and simply paid out of pocket to see a doctor or go to the hospital. If you examine the cost of inflation rate to the rate of medical care costs, you will be able to pinpoint exactly when the government got their grubby little hands involved in healthcare the LAST time:

The perceptive person will notice the dramatic increase of costs just in the last two years when the discussion for government sponsored healthcare for all reached a fevered pitch in the last few months. Coincidence? I doubt it. You'll notice a dramatic increase in medical care inflation right about the time Billary were introducing their idea for socialized medicine in the early 90's. Wow...what a real coincidence! Talk about frothing at the mouth!

You see, there was a time when the cost of medical care rose only as high as the cost of inflation. It changed when the Medicare program was introduced, along with Medicaid. The 'costs' were suddenly through the roof when hospitals and doctors noticed there was an open ended check from the government. They found it was very lucrative to buy up hospitals, make major corporations out of them, and bill up the wazoo to get every dime out of the government. Of course, after the government realized the stupidity of care without cost controls, they introduced Diagnosis Related Groups (DRG's to those of us who have spent too much time in the Medical industry.) This meant, if a patient showed up with a diagnosis of heart attack, the government estimated the average amount of time for being in the hospital, bypass surgery and recovery time, and paid only the average, regardless of where the care was given, who gave it or how long the actual recovery rate was. The flat rate was born, and hospitals now had an incentive to push people out of the hospital before they were ready to go, if they had exceeded their max number of allowed days in the hospital. Add to that the need to deal with a new onslaught of patients who now 'bought into' the Medicare system and you have a nice little nightmare just waiting to be experienced.

Now Pres. Obama (PO as in, I'm PISSED OFF, from now on) wants to take over the current medical care system to "reduce costs." Um...maybe he hasn't noticed, but that was the objective the LAST time they did this, and it only drove the costs UP. Now, if PO doesn't want to force his plan on every tax payer, he won't be able to afford it. If he does, he hasn't fully understood the definition of socialized medicine. And the concept hasn't really been presented honestly to him. If he wants that, he wants to destroy the medical industry in the U.S.

That is because socialized medicine in every country that has it does two things: It drives up the cost of medical care for everyone, and it reduces the quality of that care. Rationing isn't a 'fear mongering' concept. It is real, here in socialized medicine Ireland. Ask anyone who gets cancer. They must wait in line to get surgery (12 months in some areas.) They must wait in line to see specialists. (It has taken me two full years to get an appointment with a neurologist for my M.S.) A psychologist's evaluation for my autistic son is still a pending issue, and it took over 18 months to get occupational therapy for his care. This is AFTER having a diagnosis (which takes a psychologist AND a neurologist.) Ireland does boast the lowest rate of a lot of conditions, but then again, noone bothers to get diagnosed, because it takes so long.

Now understand, I appreciate the care I have gotten. Our GP is very kind, and the nursing care is very good. But overall, it isn't top of the line. The structure discourages the best from getting the best appointments, and the appointments to the highest positions are very politicized. Imagine Barney Frank appointing the Department Head for Dietary Nutrition...or Nancy Pelosi selecting the Head of Psychiatry. Better yet, imagine Katherine Sebilius appointing the Head of Obstetrics. We would all have dead babies.

There aren't any socialized medicine systems that have a single payer system and advanced quality medical care. I believe it will never work in the U.S. Our culture in the U.S. is too conditioned to demand the best. But they can't hold up to the bureaucracy of the Federal Government. It will drive us back into non-participating physicians who only want cash for care. We will be forced to select from a small minority of doctors, and we will be locked into paying for a government system that is ineffective, administration heavy and not cost contained. Either that, or they will be something reminiscent of Logan's Run.

My point is, be careful about giving into the whining on this one. It is like the constant badgering from my three year old. She begs, whines and screams for a piece of cheese, but within an hour, the cheese causes her to develop asthma that chokes her airway almost to the point of suffocation. I can't give in on the cheese, so she will survive, and thrive. It is the same with the healthcare system. It simply takes looking at other models for socialized medicine and evaluating THEIR success. (Yes, Ireland has a two payer system too...doesn't mean a damned thing except the wait for a neurologist is shaved down to 12 months.)

It may be better to just return to the direct payment system, where doctors and hospitals have to set their prices based on the amount people can reasonably pay. We can always go back to paying for major medical insurance. Insurance should be insurance for the unlikely eventuality that we are hit with a catastrophic situation...not a common cold.

Otherwise, the whining is just going to intensify, only it will be coming out of our own mouths, in order to just get in for a test or for a visit with a specialist.

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