I wish I was a writer. Sadly, I’m not. I pretend with this blog, but I write this blog in the same way I have always done my homework throughout all my years of school: I think and ponder and put off until the very-last-minute then I purge my system of my cluttered thoughts, let it sit for an hour, reread, and then publish. Not the best way for making good, well researched arguments, I’ll definitely concede.
We bailed out the banks. We are funding a war on three fronts now: Afganistan, Pakistan, and Iraq. We are bailing out the car companies. We have sent all our manufacturing overseas. Our infrastructure is crumbling.
We can’t afford healthcare now. If indeed we ever could, as it is defined presently.
I made a post on Automatic Earth yesterday in response to someone who claims to be an anesthesiologist in the Dallas area…quite interesting to see the responses. People really do have a faith in the medical profession’s abilities and skills that appears to border on the mystical. And most scary, several people who claim to also be in the medical field ALSO appear to have a faith in their own abilities and skills that appears to border on the mystical.
To me, although I’m not a Christian, I do think that the sacred books of the world contain much good sense. For me, the line ‘to whom much is given, much is expected’ resonates as though it was written 2000 years ago especially knowing I would end up being born and needing to read it, to understand it, and to live each day knowing I will be held accountable in some karmic way to that statement. I was born in a family where intelligence is the norm, and being a complete screwball is also the norm…as is not living up to one’s potential. I am still, to this day, a disappointment to my family in that I did not finish becoming a doctor (I started on that path several times and each time I ended up saying ‘whoa, this is a lot of work for a slacker like me’)
Another line that really resonates with me is this: ‘he who would be master of all, would be servant of all’ Now I have misplaced pride just like the next person, but I really think this is true of my profession like perhaps no other. I really have to be of service to humanity. It’s part of my ‘lot’ in life. I’m in a helping profession.
Where the problem comes is that my profession, like the medical industry generally, is just that: an industry. We are glorified factory workers with a never ending conveyor belt in front of us, trying our best to slap bandaids on broken human beings as they move down the line. When did this happen? How did it happen? How can we fix it? I wake up at night more nights than not with those questions hanging like a sword over my head. I don’t know the answers and it bugs me that the only solutions I can think of aren’t palatable options at all.
Several people have posited that the true solution to our problems lies in simply going back to plain ole’ fee for service, direct pay. I simply don’t know how that can possibly work. Physicians have worked very hard since the Puritan days to achieve that mystical status and prestige. When someone lays claim to an exclusive status and is able to enforce that legally, it automatically becomes only the province of those who can afford it. I don’t think we want that to continue. I don’t think it’s in anyone’s best interests. Including the physicians.
As part of that, some think that negotiating with the hospitals will mean you will get a better deal. Not so, at least in my experience. My youngest son was hospitalized with pneumonia when he was 15, on a monitored floor, for several days. Not only would they not negotiate price with me, they also insisted on $500/month payments or they would (and did) turn me over to a collection agency. I tried repeatedly to explain to them that if I could afford $500 a month I would have had insurance for him in the first place, as that is what my employer sponsored insurance wanted for me to get the family plan. They didn’t care, so I have this hospital bill on my credit rating, and probably will for the rest of my life. I pay them anywhere from $25 to $50 per month, and I still owe well over $5500 on a nearly $10,000 bill. I can’t for the life of me understand why they were willing to sell the debt to a company for pennies on the dollar but they weren’t willing to negotiate a payment plan we both could live with directly with me.
If we are to accept a direct pay plan, it will mean the costs must come down drastically and immediately, which I don’t see happening. I can’t afford it. I incurred tens of thousands of dollars of student loan debt that I must pay off, as well as a mortgage and a car. If the price is to come down, my pay scale must also come down. The only way I can afford that is if the government forgives my debt ($500 a month to those alone). Now, I’m willing for that to happen, but I’m not sure my colleagues would be as willing. For me, it would mean dropping to a lower tax bracket to take a $500 per month hit — which would add up to less taxes overall at the present rates. Some of my colleagues have contracted with our employer in return for employment commitments to pay their student loan debt…I’m simply not willing to bind myself to any company for that amount of time in order to have someone peruse my every bank statement under the guise of making sure I’ve paid my loans myself (for purposes of reimbursement, of course — also taxable as income).
So, so far, in order to get a more affordable health care system, we must take away prestige, reduce wages, and remove it from industry status. I really don’t know how that will ever happen except that we are going to get very very poor in the waiting time. It will happen, I just don’t think it will happen in my lifetime. What I do think will happen is that it will become the province of those who can afford to pay cash, as much of our elective stuff (like plastic surgery and dental care) is now. Not a palatable thought. But one that keeps me up at night none the less.
One of my friends suggested that Mr. Tin Foil and I begin learning ‘forbidden’ skills to our certification/license levels, as we could end up being the community ‘go to’ resource for under the table medical care. That frightens me on a level you can have no understanding of. I have done many hours of research into the demonization and marginalization of midwives for example; I don’t want to go to jail, nor do I want to be hung, nor do I want my land and home taken from me as punishment for serving my neighbors with something that others view as their rightful province. Is that what it will come to? Not a palatable thought either. One that also keeps me up at night. Especially when I know how much I DON’T know and probably never will.
How much we owe to the simple existence of antibiotics is incalculable. And you can’t stockpile those. Will there be a black market trade in those and other medicines for those who can afford them?
Oy. I think too much. I wish I could think of solutions as much as the causes and the problems. Well, I can, but I don’t like the answers. I really think that provision of preventative care, and some access to affordable illness care when necessary, is absolutely the responsibility of us all in civilized society. The problem is that we are becoming less and less civilized, and more and more unwilling/unable to even listen to each other. Or to work together.