Universal health care

Would it not be great to have free health care? What's not to like! Free? Health? Care? So, what is the problem?

Here are some of the problems

1. FREE: Health care providers will not work for free, so it really won't be free, just redistributed costs. So, again, from those who have to those who need will be the way the money will flow. If you are in the middle class, it will be just about the same cost as it is now; if you are in a higher class, it will be more expensive than it is now.
2. HEALTH: Health is like anything else in this world...you must work for it. If you are blessed with a normal anatomy and a normal psyche, you start with an edge. If you are lucky enough not to acquire a chronic progressive disorder or be involved in a freak, debilitating accident, even more to your advantage. Yet, even if you are doubly cursed, with congenital abnormalities and acquired diseases or injuries, your health still is mainly in your own hands. You must take care of yourself. See a prior post for more information. Not even the USA government can guarantee your health.
3. CARE: Here's a quarter... Health care will be run by a national bureaucracy. Bureaucrats are in the business of keeping their jobs, not in caring. That is the problem with managed care, and they are run by companies competing for your business!

You want the truth? Can you handle it? OK, here it is from the inside.

1. Autonomy and informed consent are BS. There is no way a lay person can learn all that needs to be known to know the right thing to do. The best a lay person can do is to choose from a few options or choose to opt out. Medical science is very evolved. Think about it. After 4 years of medical school, a physician is still incompetent to treat you without supervision and on the job training. And you are going to figure out what to do with a few hours or days of thought while being emotionally distraught by the knowledge that you have something bad? This is one of the craziest ideas I have ever heard of! The answer is trust. You must have a provider that you trust. People who don't go to doctors don't go out of fear and lack of trust.
2. Get the lawyers out of health care. Except for profound misconduct, such as intentional harming of a patient, adverse outcomes generally are due to either bad luck or bad communication of information. Bad communication is a system problem that has been entrenched by tradition and sustained by legal action that makes people defend rather than correct. In the name of privacy, we limit some information distribution. Bad luck occurs when you have something that the doctor did not expect or a reaction to treatment that was unanticipated. Unless profound misconduct, this is due to the fact that health care is an evolving industry. You want to save some money? Then, let doctors decide what needs to be done. Here is an example. A patient thinks she has a brain tumor. The doctor examines the patient and is quite sure that there is no brain tumor. If the doctor does not do a MRI scan, and if there is a brain tumor, the doctor will lose in court. If the doctor does the MRI scan and it is normal, money has been wasted. Now, imagine that patient comes back one month later with the same concerns. Same thing again. This is a tiny example of how patient-legal driven health care costs drive up health care. Here is another example. An inexpensive medication has a 1% risk of a seriously bad outcome and an expensive medication has a 0.5% risk of a seriously bad outcome. What one would you want? What should the doctor do? Should whatever you choose be "free" to you?
3. Smarter systems. We have regulations concerning the use of microwaves in hospitals to make popcorn, but no regulations on the speed of delivery of antibiotics to a patient. Regulations don't help. Smart systems do. Let's get more IT into health care. Even today, it is the rare situation where a doctor can pull up the latest medical information about your problem at your bedside or at the nurses station. When asked why there was no documentation of the results of a test on a patient's chart last week, DocBrain was told that he could log on to the hospital computer system and look it up. But, if I want the patient's vital signs or the nurses impression of what is going on, I cannot find that out by logging on, only by looking at the chart. This fragmentation of information is unacceptable in the information age.

Universal health care is not the answer. It is a rope-a-dope for the outsiders, those not in the know about health care delivery and decision making. It sounds good. It diverts from the true problems: demands for unnecessary care; legal bludgeoning of health care providers; bureaucracy; lack of adequate information systems; and lack of trust in the health care system.