Health Care

“The problem is that our leadership class no longer views Americans as adult constituents capable of making our own decisions: the [sic] view us the way parents view their preschool children.”

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A commenter at the Guardian (!) on the recently passed Senate Health Care bill. The entire thread is worth reading, particularly for her comments:

Maybe I’ll cash in by starting my own insurance company. “Jennifer’s House of Health Insurance and Vintage Clothing.” The premium will be a flat $100 per person per year, with a five-million-dollar deductible. “But Jennifer!” you might protest. “If I have enough money to pay five million dollars a year in health costs, what the hell use is your insurance company to me?”

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Wait, what?

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The Obama administration and congressional Democrats long ago gave up any pretense of working to rationally reform American health care. The exercise now underway in the Senate is a mad dash to get to 60 votes, and nothing more. That’s why some Democratic senators who had no idea exactly what is in the “breakthrough deal” announced by majority leader Harry Reid last week immediately hailed it as a milestone. They’re for anything that creates a sense of “momentum” and “inevitability.” – The Weekly Standard

I’ve given up trying to understand what is going on with the Health Care Bills. The complexity is a feature not a bug for some….

Update: As the commenters remind me, rightly, the sausage-making is never pleasant to watch. I guess I’m expressing frustration. I am trying to be a good citizen and doctor. I just don’t understand the stuff even as I try. Ugh.

Another Update: Commenter Marty writes, “All the talk about mandated coverage, community rating, Medicare buy-in, ‘is it a tax?’ and all the rest is just the topic du jour as the Dems try to glue wings on this dead bird and then pretend it can fly.” (I edited, for clarity, the first update above).

On the changing relationship between doctor and patient and that element of distrust

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Jonathan highlights an Instapundit discussion that caught my eye, too. The discussion is about mammograms and the latest proposed guidelines for screening: do the guidelines represent good science, or are they simply meant to save money (these are not mutually exclusive goals)? I don’t know the science, and don’t have any reason to distrust the health care professionals proposing the guidelines, but I understand that an element of distrust is introduced by the current health care debate.

Anyway, the above linked discussion brings up many interesting points. One is the Public-Health fallacy that Jonathan discusses. Another is the changing relationship between doctor and patient in a system where the federal government intrudes so heavily. Guidelines become suspect. Who is the real beneficiary of the guidelines – the individual patient, or the ‘greater good’ of the population as designated by a government official? The government guidelines, or official, become a third party between the patient and the doctor. The relationship is altered. To some extent, this is already the case with third-party payers and the current level of regulation, but the proposed health care bills take it to another level, entirely.

You see the same phenomenon of distrust when a patient talks about ‘greedy’ doctors and drug companies. I think that distrust will be transferred to Washington under the ‘D.C.-centric’ health-care bills that are being considered. And, in the political fight between constituent groups (patients and others), we may end up with a system where large public health bureaucracies will need to be placated first – a bit like California and the public service unions, or the British NHS*. The entire nature of the doctor-patient relationship will be changed. What do you all think? I’m a physician, and like many physicians, have my own levels of distrust. They are currently being directed at the government takeover of health care.

*I recently watched an old “Yes Minister” (Brit sitcom from the 80s) in which a government minister tries to shut down a hospital with no patients (it has a very large staff). A funny joke, yes? Well, the running joke of the show is that the unions resist by making the following claim – who cares if there are no patients? The greater good is served by all those public sector jobs. So, who “owns” the doctor-patient relationship in that sitcom scenario? Soon, alas, to be ours, perhaps?

Update: Think I used the word distrust enough in the above post? It’s like I’m trying to make a point, or something….
Another Update: Hey, a belated thanks for the link, Instapundit!

“But the Democrats have a policy response: they are about to vote on hundreds of billions in new taxes, a regimen of new fines and mandates for businesses, and a takeover of the health-care industry.”

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Jennifer Rubin at Commentary on the newest unemployment figures and the health care bill.

An unwieldy bill – of truly gargantuan proportions – hastily and stealthily voted on, in the cover of night, er, I mean, on Saturday or Sunday. Sounds prudent. The very picture of competence. The height of clear thinking, modesty and servant-of-the-people servanting! Why worry? What could possibly go wrong?

Update: HEALTHCARE BILL PASSES HOUSE, 220-215. Elections matter. Well, yeah, kinda. Also, please do read Michael Kennedy’s comment in the comments section, below.