Friday, September 4, 2009

health care - my 2¢

OK, there's a lot of passionate and emotional discourse going on about health care reform lately. On both sides, all the shouting has been drowning out actual facts, concerns, problems, and solutions.

Personally, I am in favor of universal health care. People in this country shouldn't be going bankrupt because they become sick. I am also in favor of beefed up primary and preventative care. I am in favor of more evidence-based medicine, so that doctors aren't throwing random diagnostic studies at a health problem as if it's a dartboard. And I am also in favor of more transparency in health care costs, which is also W's hoarse-making rallying cry for reform (so that people can make informed decisions about their health care consumption).

(For my medical school course, we try to incorporate how much procedures cost so that the students can include that information into their clinical decision-making. However, I have yet to find a document from our own hospital that outlines itemized procedure costs. We generally fall back on the Medicare fee schedule.)

However, I know that reform will be expensive. The trouble is, no one can seem to figure out how expensive it will be, because different budget offices and committees come up with different figures that contradict other figures put out by various think tanks (estimates range from $150 billion to $2 trillion). The Economix blog over at the NYTimes has tried to break this question down a bit more comprehensively.

For people on the other side, I believe that there may be some good arguments against reform, or for a different type of reform. But it keeps getting drowned out by false hysterics ("death panels" and "Obama lies, Grandma dies" and my absolute favorite, "SOCIALISM!!"). Look people, if you believe that your health care isn't currently being rationed, or that you have the freedom to choose your care or your doctor, you must not have been part of the 20+ year HMO-revolution in this country. And end-of-life decision-making, which is painful and emotional, should be something that is discussed before people are actually in those situations.

Thankfully, I'm glad I can count on the Minnesota State Fair to put forth a bit more civilized discussion about the issues.


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