Last night we had a theme dinner party at our apartment with my cousin Ashley and her kids, Zandt and Lexi. We all wore PJs and had a yummy breakfast dinner of chocolate chip banana pancakes, sausages, scrambled eggs, and fruit salad! We watched my favorite animated movie- 101 Dalmatians. Last month they had us over for a beach party dinner, complete with a hotdog stand, meal tickets, and a lifeguard (Lexi) on duty. Their dinner was much more creative than mine! I think we will continue the theme dinners. Let me know if you have any good ideas!
Here are some thoughts on healthcare from my brilliant hubby, Mark. He posted this on the blog http://bejohngalt.com/2009/07/massachusetts-in-suit-over-universal-healthcare/#comments. I encourage you to read it and leave your comments!
I just began my surgical internship, so I obviously have a vested interest in paying attention to the medical environment these people are trying to create. Some of my thoughts:
-What’s happening to Boston Medical Center will be duplicated hundreds of times around the country. Doctors, nurses, etc. are generally in medicine because they want to practice health care, but hospitals are run by businessmen, and they WILL shut down if the hospital’s not profitable.
-”47 million uninsured” as an impetus for “health care reform” is rubbish. First, that number’s dubious at best. Second, the vast majority of the uninsured fall into one of three categories: 1. Young, healthy people who don’t think they need it (and usually don’t); 2. the American “poor” (usually overweight smokers) who are simply too lazy to enroll in Medicaid; and 3. illegals. The sob story is always the hard-working blue-collar worker who forgoes common luxuries while making just enough to be ineligible for gov’t assistance, but still just can’t find the dough for health insurance. In my experience, this patient does not exist. Even folks on Medicaid have cable, bluetooth, and a car, and can apparently afford two packs a day and enough food to weigh 300 lbs. Bottom line: health insurance just isn’t a priority for most people who don’t have it.
-No politician or talking head is talking about the real problems facing medicine. Here’s a list - the bottom three aren’t in any strict order, but number one is set in stone.
TOP FOUR PROBLEMS WITH AMERICAN MEDICINE
1. THE AMERICAN POPULACE - A JAMA editorial last spring broke down the costs of personal behavior. Here’s how it goes: around 16% of the U.S. GDP, total ~$14 trillion, is spent in medicine. 75% of that, or %12 overall, is spent on medical costs directly related to smoking, alcohol, and obesity. That’s $1.5 trillion dollars. Thomas Sowell writes about the conflation of “health care” with “medical care.” The medical care of the U.S. is by far the best in the world. Hospital stays of a day here would be a week in Japan, and our cancer survival rates are far superior to anyone else’s. If it’s independent of patient behavior, America is the best. The reason, however, that our life expectancy is lower than it should be is that patient behavior usually trumps medical treatment. Whether it’s the lady with COPD on two liters of oxygen who shows up to the ER to be admitted every other week, but isn’t there during rounds because she’s outside smoking, or it’s the guy with cirrhosis who comes in with ascites, completely demented from encephalopathy, every three days to get his belly tapped, but every time he goes home he doesn’t take his meds and drinks beer until he’s back in the hospital, the typical American patient behaves in a way that is completely refractory to medical care. And if you add other substance abuse (much of psychiatry) and irresponsible sexual behavior (much of ob-gyn) to smoking, alcohol, and obesity, that $1.5 trillion becomes higher. So why isn’t this talked about? Because personal responsibility can’t be legislated, and it doesn’t win you votes.
2. ECONOMIC DISCONNECT BETWEEN CONSUMER AND PAYER - It’s simple. If you’re not paying for something, you don’t have an incentive to behave responsibly or carefully. This was seen in TennCare, and it’ll be seen everywhere if Obama has his way. Costs will skyrocket; why get over-the-counter meds and be out ten bucks when you can go to your doctor at no cost to you? Most consumers of medical care aren’t paying for it, and most payers aren’t receiving it. This is also why a general sense of entitlement has infected much of the populace - the least appreciative and most noncompliant patients are those who don’t pay for their care.
3. TORT LAW - I’m glad I’m in Texas. Doctors’ (justified) fear of litigation drives “unnecessary” procedures (they’re necessary, all right - to CYA) and (in some places) outrageous malpractice insurance costs. Tort reform would go a long way towards lowering the costs and letting physicians focus more on patient care rather than getting sued.
4. ILLEGAL IMMIGRANTS - they’re leeches in the ER, sucking down your tax dollars. Enough said.
So here I am, six figures in debt and staring at the possibility of a career of decreasing compensation (which has been stagnant for twenty years anyway) to work for the government and take care of lousy patients. I have a finance degree; I promise you, I could have a much less stressful job and be making plenty of dough right now, but like the vast majority of physicians, I find medicine a noble calling. I guarantee, though, that if Obama has his way, I’m off to Costa Rica to do medical missions. Oh, and those smart kids you’d like to have spend from 7 to 11 post-college years training to be good doctors? Yeah, they’re going to do something else.
That’s all from me. My only hope is that Obama’s utter lack of executive experience in any field will result in spectacular failure.
