Archive for July 2012

The Healthcare Debate Is More About Magic Than Substance

Most people inherently know that magic is based on making you believe not only what cannot be true but not possible.  The magician makes grand gestures that direct your attention away from reality so you do not see what is really going on.  But when we discuss paying for our healthcare under all the confusion (and magic) are some basic truths in life:

1.)  Money you get must always be more than money you spend.

2.)  Sick people have more medical expenses than healthy people.

3.)  Making almost anything  “free” will draw a crowd.

When we talk about healthcare we need to understand people get sick or injured and then they have medical expenses.  Their treatment costs money and lots of treatment costs lots of money.  Insurance does not make them sick, and does not make them healthy either.  Insurance pays for the treatment that “may” restore them to health.  Insurance cost is a symptom, it is not the problem!

The discussion needs be directed to the causes of the real problem and those are:

1.) People do not generally care for themselves and they get sick and injured.

2.) People who get sick are compelled to spend money and that money attracts an ever increasingly more expensive treatment system.

3.) Cost sharing (insurance) is the most effective way to spread the cost of care but that cost is driven by rising medical costs and has become unaffordable on any scale.

Treatment of the problem goes to the core of what being an “American” means. As a people we are independent, as a country we venerate the underdog and the ability to rise from obscurity to greatness. We do not like being told what to do and we object to regulation of our lives.

When it comes to our healthcare though we run up against the facts of being human. We are biologic systems and as miraculous as we may seem we wear out, we get sick, we get injured, and we eventually die. That reality does not go well with our desire to be independent, to do what we want no matter what and to live forever.

In addition when we get sick or injured it is painful and the worse the affliction the worse the pain is.  We just want the pain to go away and we do not care what it costs, whose fault it is, or what may have prevented the pain. We want the best treatment money can buy and we want it now! And that is the real crux of the issue.

Demand for treatment creates a bigger and bigger treatment system.  That treatment system delivers all that we ask for but it also needs more and more money to continue.  The most viable long term solution is to be more healthy as individuals and as a people.  Simple, isn’t it?  Well it looks good but is also requires a paradigm shift in American thinking. 

In our current healthcare system, there are few incentives for people to lead a healthy lifestyle and take responsibility for their own health and well being.  Our current healthcare system centers on disease, not on health, treatment or prevention.  Americans have to be invested in their own health.

As Americans, we do not like to be told what to do but we will be led by persuasion and incentives.  We must change the healthcare system to one that reinforces people to be healthy and rewards people for making good lifestyle choices.  We must be willing participants in our own health.  No healthcare system can bear the costs for individuals who neglect themselves and are unwilling to make good decisions about their health.

Isn’t this where the debate about health care should really start?






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