Monday, June 20, 2011

Issues regarding our Nation’s Health Care System

We all seem to agree that our health care system needs great improvement.

First of all, it’s way too costly.  It’s ever on the increase, consistently outpacing the normal rate of inflation year to year.  Where is the money going?  Who’s getting it?  Why does it constantly outrun most other industries in terms of cost and inflation?

Secondly, it’s imbalanced.  Some get extraordinary care while others get little or none.  Tons of money is spent on adding a few short months to a life that has already lived seventy, eighty, even ninety years, while little money is available to provide basic health care needs to children who, for lack of it, are constantly sick and may even needlessly die at an early age.

Thirdly, it’s convoluted and opaque, covert and non-transparent.  Have you ever spent time in the hospital and later tried to make sense of the hospital bill?  Did you even get a chance to see the hospital bill’s breakdown?  You asked for an aspirin.  How much did you (i.e., your insurance company) actually pay for it?  You’d be astounded if you knew.  But we’re kept happily in the dark about such details.  The doctor passes by in the hallway; you call out and ask him a simple question.  You discover later that he charged you a $150 consulting fee for that 30 second conversation.  You had simply asked him if you were going to be released from the hospital that afternoon or the next morning.

Fourthly, it’s not about what it’s about.  What is health care?  Regular check-ups for both children and adults are required to treat normal mundane human sicknesses so as to prevent more serious illnesses from spreading.  So, health care is about maintaining a generally healthy population.  There are emergencies, accidents, broken legs, burns, and recoverable illnesses.  So, health care is about providing immediate medical care in a medical emergency.  There are long term and chronic medical needs from birth.  So, health care is about providing sustained medical treatment over a person’s lifetime because of congenital birth defects, deformities, and imperfections.  There are fatal diseases, the big “C” being the most common.  And so, health care is about fighting cancer and other terminal illnesses.

But health care is also a business, BIG business, and profits and losses are a major concern for anyone in the business.  So, we have a contradiction in values.    It’s an industry that capitalizes on people getting sick.  As a business it must make money.  A profit is wanted at the end of the day.  The bottom-line rules!  On the other hand, a family will say, “You can’t put a price tag on Uncle Johnny or Aunt Sally or Grandpa, Grandma, mom, dad, sister, or brother.”  “Do whatever it takes to keep my loved one alive, whatever the cost!” says the family.  Then what?  Then the ghastly medical bills come in, and a family’s home is ruined.  All financial resources are drained.  Meanwhile the loved one is now beyond recovery and dies anyway.  The family can pay no more, will pay no more.  So, who actually benefitted from such care?

Finally, it feeds into human nature’s weakness to want total control and power.  There are couples who very much want their own child but can’t seem to produce one, and there are women who very much do not want the child developing in their womb and want it clinically removed.  Thus, health care is about providing the desired reproductive ends for singles and/or couples who want or do not want “the baby.”  Note: the choice is only available for those who can prove that they have the means to pay.  And then there is the inevitable death and dying process.  Health care is about easing the death and dying process if not indefinitely postponing it for as long as possible.  Exactly how much are you willing to pay to add just a little more time to your life?

We are contradicting ourselves.  On the one hand we have couples who are willing to spend huge amounts of medical money, resources, time, talent, research, and what not in order to keep their “preemie” alive, even if it means that the baby will not have a “normal” life and will require constant medical attention along with its accompanying services (hospital stays, doctors’ visits, pharmaceuticals, nursing care, therapy, special Ed, etc.) for the rest of his/her life.  On the other hand we have those who are desperate to abort their baby, refusing to admit that it is anything near a viable living being.  And still, on the other hand, we have aging parents and grandparents who have lived a good and full life, well into their eighties and nineties, whose family refuses to “let go” demanding they be given the best and most modern medical treatment available in order to keep them here on earth, for what—three, six, perhaps twelve more months at the most?  Is this reasonable?  Is it right?

Who decides and how should such things be decided?  To each his/her own way?  Is it really an individual decision when all of society pays its social and economic consequence in one form or another?  What’s going on here?  As a society we have mixed and conflicting messages as to the definition of life, birth, death, and life’s value.  We want to believe that we can avoid death altogether.  We want to conquer the aging process.  We want modern science and technology to serve our interests, including our decision as to whether or not the next generation shall live—abort or not abort, save the preemie or not save the preemie, no matter the odds against it.  “Don’t pull the plug,” says one couple.  “Get this thing out of me,” says she.

Modern science and technology, especially in the medical field, has caused us to lose sight of two basic truths in life.  (1) We are mortal beings.  Modern medicine has made it more difficult not less, to determine and accept the final step in life—when we have to accept and embrace life’s inevitability—death.  We shall die, all of us.  It seems we won’t accept this.  (2) We are not gods.  The more power a human being wields the more dangerous he/she becomes.  Imagine a typical human with godlike powers.  Scary!  Yet, we are more and more taking it upon ourselves to decide who shall and who shall not live—based on our own selfish interests and desires.  On the aging end, we are artificially keeping loved ones alive by hooking them up to mechanical life support systems, unnecessarily prolonging their passage way to Life after life.  And, on the inception end of things, we are artificially cutting life short by invading the uterus.  We have become our own gods.  This is a very dangerous path to be on.

As to our nation’s health care system, here are some principles we should heed: (1) that which is fair and just is always a good measure for determining whether something is good.  If systems and procedures result in unfair and unjust outcomes, something is wrong.  If we are going to do what’s right for health care in our nation, we need to develop a health care system that is as fair and just for all citizens as can possibly be.  (2) Fairness and justice require truth and transparency.  We need more truth and transparency in our medical health care system.  The right-hand has to know what the left-hand is doing.  We need to understand the who, what, where, when, how, and why of the key players and stakeholders that presently dominate the health care system in order to determine what needs correcting.  I don’t believe that the public is getting the real picture.  Too much is still being hidden from public view.  (3) We need a more consistent and unifying understanding of life/death processes.  “Pulling the plug” is not always a bad thing.  Saving a preemie is not always a good thing.  Yet, I admit, sometimes it seems that you almost have to be God to know how to make that judgment call.

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