Sunday, March 14, 2010

Weighing in on Health Care: Rationing & Increasing Health

The last thing the world really needs is one more person sharing their thoughts on health care.

America's health care reform effort, led primarily under the White House initiative of Barack Obama will certainly be the discussion of text book authors and college political science classes for ages.

Not just for the initiative and the results (whatever those may be) but because of the process, the successes, the failures, and the politics behind a health care bill that's page count grows by the month.

Yet for all the talk, the summits, and the discussion I continue to feel after well over a year of talk that the point of it all has been missed.

Health Care Rationing.

Whether we like the idea or not, health care is rationed. There is only so much health care that is available.

In some countries health care is rationed by money, if you have a lot of money you can get the health care you need, while the poor are without. In other places, government health care is provided, but certain services are excluded and only certain procedures are available to the general public, perhaps those deemed most medically accessory and involving life sustainability. And in other places, health care is rationed by systems that involve long waits in health clinics or on waiting lists to receive the prescribed services as available.

The fact of the matter is that health care like everything else is a limited resource, not a finite resource and the government wants to play a role in determining how health care will be divided out in a way that does not exclude people from the system simply due to market forces.

Of course, there in lies the debate. Most people are somewhere on the spectrum that would deny someone basic medical care because they have limited financial resources, but how does the system accommodate for this? What care should be provided to those who can't afford it, and how will it get paid for.

My thoughts, Increasing Health

Yet, here is were to me, the conversation has continued to get bogged down. When discussing policy (which is only part of the conversation, as so much of the conversation is about the process of passing the bill, rather than the policy that it will implement) the discussion focus on the what is distributed and how it will get paid for, operating under the mindset that health care is a fixed resource, not with the ability to increase or decrease.

Thinking economically, I wish that instead of just determining how to ration health that the conversation instead would focus more on how to increase health.

If there was more doctors, more medicine, more health care facilities, more nurses, more intellectual capital, then there would be more health, and the cost of health care could potentially decrease and be increasingly available so their would be a decreased need to ration and a decreased bottom line to cover the cost of insuring more people.

In my mind some of the key ways of increasing health would include making it more affordable for individuals to enter the medical field and to practice medicine. What if there were more scholarships at public universities that would allow people to get their degree in medicine to provide medicine in rural and economically depressed communities. If physicians didn't enter the field with thousands of dollars of medical debt they might be willing to work in less profitable fields for lower wages.

What if medical malpractice insurance was less expensive, and there was better caps on what doctors could be sued for? The cost of medicine would decrease dramatically.

Sure these are not final solutions, and there are aspects about the health debate that are messy but good conversations to have, but I think this component of the discussion is grossly ignored.

Instead of just looking to insurance companies, dollars and cents, who's covered, what's covered, and how's it covered, let's look beyond that. Let's look at how we can increase health, not just how we can divvy it out.

1 comment:

Dad said...

Random thoughts on this post.

Will students be willing to go through med school for lower pay even if it is more affordable?

What incentive can we replace the money with for doctors? If they get less money could we get them more fame or respect or something?

How about investing more into nurse and nurse practitioners. What if a company found a way to market DIY home care on a budget? What if the revolution in American cooking happened with home health care? Could there be a Home Remedy Network (HoRN) on cable? Celebrity Dr's? Wait that's already happening. Dr. Oz and the Dr's are the beginning of something that I think will be big.