Wednesday, February 11, 2009

The Disposable Society

At the risk of sounding like a political hack, I am compelled to write about a social issue that has long occupied my thoughts and those of this country. I speak here of health care. As a doctor, I was always concerned about getting the best care for everyone, and the cost be damned. In the beginning of my career, I had the option of charging less or nothing to those who could not afford the going rate or didn't have insurance. Once the government entered the picture, such largess became illegal. I had to charge everyone the same thing...or else.

I watched as our neighbors to the north (Canada) went about with a socialized form of care. That is, the government paying the bills and making the rules. It seemed to work. Then I began talking to insurance executives I know who informed me that they did a healthy business selling private health insurance to Canadians. In Florida one winter I met a group of Canadian Orthopedic Surgeons. Why were they there? Seems the system had spent its yearly allowance on elective procedures so enough orthopods were left at home to handle emergencies while the rest went on holiday. The patient (a nuisance in such a system) simply ha to wait until next years crumbs were dolled out.

One day, at my home hospital, I listen as a neurologist talked on the phone to some surgeon in Canada. It seemed that the neurologist's daughter needed a back operation and that, since she lived in Canada with her mother, it would be scheduled in 6-9 weeks. My colleague informed the Canadian doc that the girl was on his private American insurance policy and that his daughter would be covered. The surgery was scheduled for the next morning.

Now, as this country heads toward a similar practice, my greatest fear comes to the fore; the fear I've voiced to confidants for some time. Rationing. A health system run by a business or a government would make decisions based on money rather than compassion. And so it seems. There is already talk about how one would be disqualified for certain (expensive) procedures based solely on their age.

That is sobering to someone like myself who is very active and might have to live with some chronic condition (or die from it) because I am too old to qualify. The government giveth and does so by taking. Had that been in place, the two 90 year olds (that's right) I once sent for bypass surgery would not have not been able to have it. They were having a miserable quality of life until the surgery, and each lived an additional 8-9 years of good quality lives. Worth the expense for 2 ninety year olds to live 9 more years and enjoy life with their famalies? If your answer is no, then what the hell is the point of helping anyone? To make them productive for many more years during which they can earn and pay taxes so that when they become disposable we write them off?

By the way, none of our congressmen or their families would ever be covered by such a plan as they already have their own gold-plated plan. Seems that we have a royal ruling class here with special privileges including the ability to tax the masses. Silly me; I thought that was why we fought the revolutionary war in the first place.

Paddle safe...and you'd better stay well.



Michael said...

Interesting post this morning Dick! I suspect getting medical care that's both affordable and readily available will always be problematic given the high costs these days. I've seen both sides of the system and still have difficulties working out which is the better system. In Canada, everyone gets 'free' care, eventually. In the US those who can afford it go to the head of the line, those who can't pay, can sometimes find themselves in dire straits. I do know that medical people in both countries wring their hands wishing there was a better way to offer their services...

Ron said...

Dick, thanks for writing this ... well said.