Friday, January 29, 2010

A Complex Situation - Part 1: Politics

UPDATE: I really am going to post parts 2/3. I promise. School has just swamped me and I'm not sure when I can sit down and devote the time I want to present everything clearly. Until then: why not leave or check out the comments?

NOTE: T
his discussion will need to be split into multiple blog posts. There's just too much information for a single one. The discussion will most likely be divided into the categories of Politics, Insurance Companies, and Philosophy. Don't worry; I'll cover everything that everyone commented about.

I think that my title pretty much defines the current state of health care. If you're just joining in on this little session, I highly recommend that you read the very different opinions and views expressed in the comments of this post as I'll be summarizing and referencing peoples thoughts here.

Looking at each person's response, the reason for debate/fighting/disagreement pretty much slapped me in the face. Out of the six of my friends that commented, each brought up different issues, concerns, and possible solutions. Now think about how we have 300+ million people in our country . Yikes. No wonder people are heated about things.

The common fact that everyone acknowledged: something needs to change. No one thinks that our status quo should be maintained. Health care needs to change.

So, I've decided to make the discussion more manageable by breaking it down into the subcategories of (I think) Politics, Health Insurance, and Philosophy. I'll try to pull points from each person into the category where it most fits for my discussion/presentation. Don't worry if you think I've missed something right now as I'll likely bring it up in one of the following posts. Where possible I'll link/cite facts that I've learned. Let's go!

First up: Politics.
-Caleb said the predominate issue is the "time in which to revamp" health care and that he thinks Democrats are trying to rush things through to bolster political power. Instead, the process should slow down because it is "affecting everyone...not just the deaf Democrats in power." He thinks "that Obama's tactic of "we must pass everything now, no questions asked" is dishonest and insulting."

-Tyler talked about how the US is behind Europe in health care standards and that if "legislation allows some Americans a higher quality of life, but is an imperfect plan, it is worth it." The final goal and objective should be to "improve quality of life." [Side note: the US ranks 37th in the WHO rankings from 2000 (most current) and yet we by far spend the most money]

-Kevin said the government shouldn't have access to medical records or "the right to determine, based on set criteria and yes/no symptom check sheets, whether or not an individual receives medical care." He also thinks the government should "slow down when developing a new system of health care" because it's often a flawed design and concept of an idea that leads to problems and failure. The role of government, and politicians, is to analyze the situation and revamp healthcare "for the fulfillment and benefit of the majority," because "legislation passed without adequate consideration for the people fails."

-Megh talked about how she thinks health care should be free and paid for through taxes because anyone can get sick at any time, but acknowledged that the US will likely never have this reform due to the financial stakes of large companies. She also linked an article that spoke of the need for Democrats to maintain their push for legislative reform despite the short-term implications it may toward re-election.

My Thoughts?
First, I take issue with the idea that the problems of healthcare reform are somehow the individual fault of either the Democrats, Republicans, or the Obama administration. In my opinion, if blame were to be assigned it would fall at the feet of Congress, both Left and Right alike.

As previously stated, most everyone agrees that the country seriously needs reform. Sadly, the big problem of passing/not passing any legislation is not because of the differing views of the political parties but instead the issue of politicking. Both parties have become so obsessed with winning and being correct that the legislative process has ceased to function. Democrats in Congress, feeling jilted from decades without full political power (holding both Congress and the Presidency), seem to occasionally feel the need to flex their power over the GOP and not compromise. This could be really bad if someone wanted to compromise. Republicans, upset about this and their lack of a cohesive party theme/identity, have essentially stuck their fingers in their ears, tucked their head, and hoped that Democratic failure=Republican success. You have one side attempting to enact some kind of payback and the opposing side trying to not do their job and hope that it leads to being re-elected.

This is no way to run a country.

Kevin said it best in his comment, explaining that we
"elected them [Congresspersons] to make decisions not necessarily based on their goals or ambitions but based on our [the citizens'] situation and needs. It is their job to view the current national and global situation from every possible angle. It is their job to make sense of things and then approach the problem with the goal of improving the lives of those they serve."
I think most everyone in the country would agree with that. We need less politicking, fighting, bickering, partisanship, and worrying about the next election and more cooperation and accomplishment. How does this play out in health care and with the reform that is being debated now?

Like most everything about health care: it's debatable. The current bill is HR 3590- Patient Protection and Affordable Care Act (that's the FULL TEXT- you won't read it). There are also quick summaries from the Democratic and Republican parties. As an overview, the bill would reform/regulate circumstances for physician malpractice, prevent insurance companies from denying coverage to anyone with a preexisting condition, expand health insurance coverage to the ~40-60 million uninsured Americans (I quote a range because we learned how about each year millions of people lose/gain coverage; it's a cycle), offer a federal pool for those without insurance to buy into, and require everyone to have health insurance (much like mandatory auto insurance). This would be paid for through taxes on individuals making more than $500,000 a year (actually repealing an old tax cut), people with really ornate health plans now (I refuse to use the name of a certain car brand), and through cutting/reworking existing programs and funds. It is estimated to cost ~$850 billion total over the next 10 years, but actually result in a ~$150 billion deficit reduction over that time.

Now most people see those things, having heard about them in the news, and go "Whoa, those are all the things the Democrats want. None of the Republicans want that." To that I reply: not exactly. Surprisingly, that reform is actually more of a centrist option. Many people who are far left or far right would prefer something different (a single-payer and completely private system, respectively but they'll be more of that later, under the Philosophy post). HR 3590 actually isn't that different than the current Massachusetts health care system, signed into law in 2006 by Republican then-governor Mitt Romney.

Now, I know that's a lot of information but sadly it's really just a quick overview of the current situation. Don't worry, I'll present a discussion/reasoning of the various different types of health care systems during the Philosophy post while going through more comments. The gist of all this? Congress, meaning both political parties, need to cut the crap, do their jobs (meaning make the necessary changes to fix the country), and stop worrying about their own job security.

Lastly, and this is more of a detail, I don't think Obama can be blamed for allegedly pushing reform through too quickly or- and I'm paraphrasing- for playing the urgency card too much, simply because he does not set the pace. (All of this assumes one thinks things are going too quickly.) The president's role is to set the agenda. A pillar of Obama's campaign message was health care reform; it makes sense to me that he would be calling for Congress to tackle such legislation (not to mention it makes up ~14-17% of our economy). The reform itself and its timing is an issue of Congress and their responsibility to write and pass.

Personally, I don't think that there is ever going to be a "right time" to work on health care reform or any big issue for that matter. Don't get me wrong, I want things to be well thought out and done right, but health care reform is not a new issue. FDR, Truman, Johnson, Nixon and Clinton have all attempted comprehensive health care reform. Only Johnson succeeded (partially) with the creation of Medicare and Medicaid. (Fun fact: FDR was going to propose socialized medicine until a certain country had to go crazy with that whole whacked-out-final-solution-socialism-world war thing. It's in this book which I've recommended before.) With the current political environment of every action being analyzed through the prism of the next election and everyone too worried to simply do the job they were hired for, I'd rather Obama make it a national issue (thereby doing his job) and try to get Congress to finish it.

Still with me? If so: more to come later.

Until next time.



*While I don't think it's a fair way to describe any of my readers, Glenn Beck is probably certifiably insane and terrible for our political process. Regardless of political views.



Thursday, January 28, 2010

A Quick Update

First off:

Thank you so much for the responses on my last post. I really appreciate it and will be parsing through everything and posting a response tomorrow. "Why tomorrow?" you may ask. And I respond: Cardiopulmonary is finished (and has been beaten into submission to be more accurate) and I'll have the time to get everything done the right way.

In the mean time, to hold you over, check out this fantastic little number:

That is wonderful. Want to see it for yourself? Well, check it out here.

Until next time.
(tomorrow)

Tuesday, January 19, 2010

A Delicate Balance and an Open Forum

The beginning of the semester thus far has been pretty interesting. I've found it a bit of a challenge to hit my stride both in the general sense of how my day plays out and with my motivation. Part of it is becoming acclimated to a new schedule (with the addition of our anatomy dissection labs), but another side of it is getting back in the routine of focusing on things that don't necessarily seem relevant right now, namely the physics of air in the lungs.

So how do I solve my dilemma of motivation and focus? By hanging out with my wife and writing on my blog, of course. But let me confess: I may or may not have spent the majority of my not-at-school-time today running the gauntlet of online assignments so all is not lost.

To add to one of my many methods of getting myself refocused and recognizing that there is more to medicine than alveolar gas exchange I offer you, my faithful reader, a question and open forum to speak your opinion. What is your opinion of medicine and healthcare? What's wrong? What's right? What should be done?

I've found myself slightly frustrated and perplexed at others' views of the current state of healthcare in our country and what is or is not being done to remedy any problems. I can't help but wonder, as I think everyone should, if I've become too closed off and set in my ways (or, let me be real, if I need to do a better job of articulating my point and its obvious truth to others).

So let me have it. I'll read them all, mull it over, and post my thoughts/summary/response after a couple of days.

Until next time.

Friday, January 1, 2010

A New Decade

2010, eh? I'm down with that (but really only if we call the 00s the aughts like we're supposed to).

While everyone seems to be excited about the new year (and sure, I'll go along with that), I'm more excited about the prospect of a new official decade. When I look back at the past decade, my mind explodes when I see just how much of my life has changed (and oddly stayed the same)

What changed? During the aughts I:

-cycled through middle school, high school, college, and am now studying medicine.

-have lived in three different towns and progressed from living at home to living "on my own" with people who are essentially brothers (if I didn't already have 3 good ones- that I gained in this past decade) to being wonderfully married.

-went from being an awkward and strange single teen to an awkward and strange (but very lucky) husband.

-became an uncle to not one, not two, but three hilarious boys.

What didn't change? I still:

-read incessantly (but like to think that I read better now thanks to that whole college degree thing)

-play and/or unabashedly enjoy video games/comic books/computers/tv shows/etc. (although I like to think my that tastes have refined)

-maintain a ridiculous competitive streak that school has been kind enough to keep alive.


The point of all this? I don't really know. Perhaps just to stop for a moment and think back at what's happened and changed over the past 10 years. You should, too. This is, after all, your life. Don't forget the immortal words of advice.

Until next time.

Edit: Upon reading this post, my new year resolution will be to slash my use of parenthesis. My bad.