Sunday, August 02, 2009

Dalai's Opinion of the Health Care Bill

It's very simple.

If the government controls your health, it controls your LIFE.

Are we sure we want to go there? I don't.


David Clunie said...

So you would prefer to have a company whose only motive is maximization of their PROFIT control your health, and hence your life ?

That's where we ARE NOW and many folks want to LEAVE, and go somewhere else.

Not to mention all those who aren't anywhere and have NOWHERE to go right now.


PS. This capitals thing is fun.

Dalai said...

I'm glad you enjoy being a CAPITALIST!

Yes, I'm more comfortable with the PROFIT than the POWER motivation. The desire to make money and DO A GOOD JOB of it is something I understand. The desire to control things is something I fear.

Would you buy a PACS designed by the government, or would you prefer that nasty ol' capitalistic competition assemble the system you would like to see?

David Clunie said...

The problem is that profit motive based system for health care is not working well in this country, if for no other reason than the desire (or ability) to DO A GOOD JOB is no way linked to the MAKING OF MONEY.

And I dare say that the original MDIS PACS, for its day, was a pretty good thing, specified by the government and built to those specifications by a contractor. Not to say that the military procurement system is necessarily ideal either, of course. And the VA's Vista system is held up as an example of electronic medical records working.

Anyway, I am not arguing for or against any particular approach, just trying to make the point that your jumping on the fear mongering bandwagon with exaggerated assertions is pretty lame.

If you want your blog to digress into health care politics, I would be more interested to hear how you would propose to increase accessibility and reduce cost, or why neither of those should be done, rather than just be reminded that you are fairly conservative.


Dalai said...

Fear mongering? Perhaps, but I'm the one who's afraid. If government-run systems worked so well, why do patients who can afford to do so flock to the United States, and not to Canada or England or other places with nationalized care? We still have the best system, with all of its flaws. Do we need reforms? Yes, of course we do. Do the insurance companies need to be curbed? Yes, of course. But do we need to destroy the system to accomplish these goals? No.

What the Democrats have proposed is a power-grab. They will take over the health-care system in the name of those who are underserved. But make no mistake, this is all about power, and owning a large chunk of the US economy. The underserved will still be underserved, and everyone else will have worse service than they did before. Only the politicians (and lawyers) win.

As for my blog, I post what I feel like posting. I would seriously appreciate you posting (on your blog or mine) what you feel to be the solution here. I do hope you have better ideas than I do,and certainly better than our government.

David Clunie said...

Well, I have spent more than half of my life in a country (Australia) which does indeed have a mixture of private and public mechanisms, and offers a pretty good standard of care with very high accessibility but without preventing affluent folks from paying for more care if they want to; I have been away too long to be familiar with the details, and the system has evolved over the years.

And indeed some of those with a high degree of mobility do "flock" to Australia, though more likely for the nice weather and beaches than for health care reasons. If only they had a PACS industry and held DICOM meetings, I would go back there like a shot.

I am glad to see that your conspiracy detector is operating at such high sensitivity, but I really think that you over-simplify by characterizing this as a "power grab", and perhaps have set your operating point on the ROC curve to compromise your specificity.

Of course you post whatever you like; it is your blog, and I certainly didn't intend to imply otherwise. I am just providing some consumer feedback.

I don't claim to have any insight into the complexity of the system, and hence no easy solution to offer, but I believe that mandatory insurance, a proportion of mandatory pro bono care by all providers, prohibition on pre-condition exclusions, decoupling health insurance from employers and employment, tort reform (malpractice liability limitation if not prohibition), no fault compensation, rigorously enforced community outcome driven nationally standard appropriateness criteria, elimination of self-referral, device and drug product and service price control including requirements for economies of scale, elimination of fee-for-service billing, prohibition of balance billing and prohibition of for-profit private payers, would all help.

If the risk pool can be spread sufficiently to still allow for multiple payers and still cover the indigent and the chronically ill, then so much the better, but I am not "afraid" of a single payer system.

After all, we do have a "single payer" "non-profit" defense force, do we not ? And frankly, the health care system has a lot more impact on the lives of most folks in this country than the defense department.

Actually now you come to think of it, maybe we should just militarize every single individual in the country (even if not fit for active duty) and have the DOD run health care :) They could control diet and exercise too and help with the prevention side as well. Maybe the different branches of the services could compete with each other for "members" based on quality of care, to keep the CAPITALISTS amongst us content.


Dalai said...

See, I knew you would have the answer! Indeed, what you propose (except for the DOD thing) is very close to what we need, and very far from what the Democrats are trying to give us. Tort reform? From the Lawyer-In-Chief? NEVER. Mr. Obama has quashed this idea himself. So much for REAL reform. The other points you mention play a peripheral part in the Democrat's program if any at all.

As for pro bono work, we write off at least 10% of our billings as "no pay", which is effectively pro bone. The media never wants to cover the fact that WE, the physicians of the health care system, actually cover the uninsured.

I may be going to RANCZR meeting this year. You should join me!

Anonymous said...

You certainly can post whatever you want on your blog. However, you've been gradually eroding your credibility as a balanced observer of PACS-related issues by going off topic and by being polemical.

The "Dalai" title no longer fits. Not even on PACS. You used to have thoughtful posts about user experience and other matters. Now you have thumbs up and thumbs down. The more often you write, the less you seem to have to say.

I appreciate the industry gossip, some of which doesn't show up on any of my other sources. But your signal-to-noise ratio is not what it used to be.

Anonymous said...

We do not need Health CARE Reform...we need Health INSURANCE reform. Quality of actual CARE in this country is quite good. We are not likely to get INSURANCE reform, as long as special interests and lobbyists are involved.

stacey said...

Free people can treat each other justly, but they can't make life fair. To get rid of the unfairness among individuals, you have to exercise power over them. The more fairness you want, the more power you need. Thus, all dreams of fairness become dreams of tyranny in the end.-Andrew Klavan