Thursday, August 13, 2009

Healthcare Debate

Recently, I went to a Meetup of "Deep-thinkers," who are brave enough to tackle rancorous issues like healthcare reform. I listened carefully to the complaints and compliments that people had for our current system. These individuals, a fairly well-educated, all white, by-and-large believed in our system fundamentally, insofar as it provides the most state-of-the-art diagnoses, procedures, and medications. Perhaps all and certainly most of the eight persons convened were atheists and skeptics, those otherwise known as rational-materialists.

Even though many medical doctors acknowledge emotional, i.e., non-material, factors in health outcomes, ironically emotions are still nevertheless reduced to factors and co-factors, cursors and precursors, meaningless blips of molecules to be manipulated with this pill or that.

One women in the group was very bitter about her insurer. These were individuals who did not belong to insurance covered by an employer. They purchased insurance as individuals. Most of the "healthcare" debate has had nothing to do with healthcare, just the paying for it. Whether the pooling of costs occurs under a private corporation or under a government entity, both are socialist, both recognize that the benefit of the one comes through the contributions of many. At the same time health-access decisions are equally "socialist", i.e., non-democratic. Whether "the government", i.e., some administrator, rejects your claim or Aetna, i.e., an administrator, access to care is not volitional (i.e., I want it. I should have it at any cost personally and even societally) nor is it democratic, evidence-based, or even a "right" owed by virtue of tribute, so-called premiums.

Tribute seems to be the right word because the obeisance paid medicine rather obscures the substantive healthcare issues, like iatrogenic deaths from overdoses and drug cross-reactions, wanton prescription of medications which has rendered valuable tools like antibiotics useless, and patient and family choice to NOT have procedures should they so choose. Even more primary than these issues with regard to true healthcare is food and sleep.

This assertion may seem to run afield from healthcare, but it has everything to do with health. I heard recently that the category of farmer is being removed from the census because the numbers who now claim that occupation have diminished beyond "STATISTICAL SIGNIFICANCE." That booming voice is not my own, rather the invocational resonance of rational-materialism. One nonetheless wonders whether the rocketing rates of obesity and its issuing complications are just a coincidence. True socialist deviants are apt to even draw a connection between an increasing reliance upon agribusiness, its role in the suicides of over 250 thousand Punjabi farmers and its obdurate nontransparency around genetically modified organisms (tm), as part of a rational strategy to create sickness.

Fortunately, the right-minded members of tribute clubs trust The Market's rationality, as a Catholic parent does their child alone with the priest. The tribute member notes that she would not mind having a socialist system like in Sweden, but "they don't have to deal with the ethic complications." At the moment, a tribute club can ensure that at least a modicum of the flotsam and jetsam don't become members. This is known as Tributary Exclusion, see Tribute manual, p. 431, sec. 2, verse 13.

The Tributary Exclusionists, as they've come to be known, are rankled by by the loss of their exclusivity, even though the present reality of 10 minute visits with doctors has done nothing to make them consider how profit compels rationing at every nonprofitable opportunity, i.e., when not administering Lab A,B,C,D,E,F,G, then H, and I. Then the X-rays, then the gizmo a la modismotronic (tm)-- every last bit rituals to gods of techno-mono-particularlism, its priest specialists and specialized technicians, fastidiously coveting their particulation, each modernizing triumph that rolls into "the market" yet another step deeper into the trees of the forest of health we fail to discern.

Health cannot be as simple as broccoli and a binki, not to mention the impact it would have on advertising revenues and "growth" in the healthcare industry. Hmmm. Wouldn't a rational society at least consider that growth in certain sectors of society a particularly bad thing? Is growth in healthcare and military expenditures really what we should be spending our money on when there are perfectly good prisons full of illegal flotsam and jetsam out there waiting for our tax dollars?

Instead of using booming healthcare "success" as a means of criticism, perhaps it is possible to see how their profits reflect something about the value we have for them. After Pasteur, we got rid of the power of genuflection and the power of juju, or so we thought. The same veneration was only projected upon a pill or a procedure that lay so concretely beyond our ken: medicine worship. Such a palpable need is this veneration that diet, sleep, stress, and exercise, things that directly impact health most, get sacrificed before the altar of fear and powerlessness.

Data is starting to show that people are becoming more "syncretic" in their ways, less devout, if you will, searching for solutions that are often articulated as "more natural," "less invasive," and "complementary." The influx of many immigrant peoples who take traditional medicines has had a normalizing effect toward these options in many of the more cosmopolitan parts of the country, and major research institutions like Harvard, UCLA, and the University of Michigan are researching and treating patients using the ancient Chinese medical system extensively.

Somewhere in the healthcare debate account has to made for the individuals who choose not to worship at the alter of medicine. The incident of the Midwestern mother compelled to treat her child's cancer in a manner not of her choosing is a gross violation of parental and individual rights. I cannot help but imagine that given monetary ambitions that something could go horribly wrong with any type of "reform" being discussed presently.

Here's what I think might work. Everybody, that is every legal citizen, annually gets a 5k healthcare account to spend as they wish. The money doesn't roll over. People can spend the money on private or government health insurance, or the can use it to spend on the understanding that waiting till you're sick isn't the best healthcare strategy and that although mamograms and PSA tests may be reasonable diagnostic exams, taking a test does not prevention constitute. So, if an individual feels that spending $3000 on a vacation is best for their health (who knows they might be sleeping), so be it. Others will choose to be proactive with their health, seeking services that directly impact health maintenance and improvement, i.e., dietitians, personal trainers, psychotherapists, and Ayurvedic medicine, which is a lot cheaper than a gastrologist, cardiologist, and the slew of other specialists. If a person feels that getting a carpet pulled up is key to their health, they'll have the latitude to do so. If the person exceeds their $5k then they will enter "the system" of administrative over site. Government or private, the nature of bureaucracy is same.

So how do we pay for a 1.5 trillion dollar healthcare plan? Well, we can use Enron accounting, which we've been doing since the 70s to fuel our military "growth." We can also get 75% of the money by cutting our military and levying a healthcare tariff upon every multinational corporation. Every company that imports that has products sourced or produced abroad would be subject to the tariff. If these companies don't want to pay the tax, they have the ingenious option of actually producing their stuff here. Go figure.

The present breast-beating over healthcare payment has obscured a more substantive discussion about health. Hence, the assumptions that the current debate proceeds upon are unsatisfactory for the non-rational-materialist who chooses not to worship at the temple of modern medicine. By structuring individual healthcare accounts, individuals will be encouraged to be more proactive in their healthcare, while still having the option pay an insurer. Data suggests that more and more people are choosing to broaden their healthcare options, the current debate needs to recognize this growing demand for what it is by ensuring that individuals have full latitude to explore the health options they see fit. Anything less is just another corporate money-grab. In the end, until we start talking about food and sleep, I remain very skeptical.

1 comment:

Unknown said...

Nice work Yang. What you advocate is moving in exactly in the right direction. Push the power to decide down to the actual consumer; reform health care and kill off health insurance. And who knows-- maybe some of those dried up mushrooms and dried out old guys in Chinatown can make somebody feel better--hey, let's leave that up to the person who knows best--each individual citizen.