A Liberal's Response to Conservative Rants against "Sicko"

One of the arguments made against “sicko” is that it promotes socialized medicine and is just more “liberal whining”. The hard line argument by many conservative critics is that if we go to a system like Canada’s then we will all wait in line for weeks on end and no one will ever get care and then we will all be in the fields harvesting wheat and making substandard toaster ovens in some post-Stalinist nightmare world.

Could it just be that capitalism without checks and balances is fundamentally “different” than what the US once was and the idea of regulatory, best practice oversight is not a bad thing but instead the basis upon which we can make things better?

The health care system in the US is, if not broken, then at least seriously “bent”. I remember being a kid in the 60’s when you could still go to the doctor and not have to sell the house in order to do it. It is certainly not that way any more!!

There are laws and laws should be obeyed equally by all, not just by the poor or powerless. If health care providers are outside of the written legislation then the system does not, in fact, cannot, work.

But the reason we have laws is that it has been shown that not everyone “voluntarily” takes the high noble path. Too often individuals or groups succumb to self-interests and commit deeds that “go against” what is best for the group.

That, on a simplistic level, is why we have a legal system–a codified standard of behavior with “watchers” to help confirm we adhere to those standards and “penalties” to be administered if we don’t.

Health care providers can “stretch” contractual language–your policy–to the point of breaking and that is not fair. All I am asking is that health care providers be held accountable to do what the laws say they should do. Either re-write the laws or do something to hold providers accountable for breaking them. Either or.

Sadly–That is not how it is now. And that is what needs to change.
The concept raised by many Conservatives is that government “involvement” in an issue is analogous to communism. This seems, to me, to be a very weak argument. There is government involvement in every area of our lives–checks and balances is the positive term, government interference is the negative.

Why can’t I drive 90 mph through a school district? Why do I have to have my kids vaccinated just so they can go to 3rd grade? Why do I have confine myself to just one wife; why not three or four or as many as my income will allow?

These are examples of “regulations” (instituted and “controlled” by the government) and I don’t think this is a novel concept that they exist and, hopefully, they are put into place in order to help make the “system” work “better” for the common good.

What is happening, I believe, with health care is that the “idea” of what one gets with insurance turns out to be in variance with what one often times receives. In both socialized medicine countries and the US there is a distinct stratification at work.

Whether one is excluded due to volume or due to income, in both systems there will be those who suffer and those who prosper and there are limitations to both.

If Insurance Companies and other health care providers actually provided the services they “advertise” and contractually agree to then this would just be a question of rich vs poor and a different line of argumentation would likely follow.

But the most important issue (in my opinion) is that health care providers are taking advantage of a system that allows for profit taking (by many that have nothing to do with actually providing care but instead serve only in administrative capacities) to the detriment–in many cases this is life threatening–of the people who pay for their services.

Why, if I am a manufacturer, should I put decent brakes on motorcycles if I can make them at a higher profit with sub-standard ones? Why build the house to code if the likelihood of fire seems so remote? These lines of argumentation are no different than asking “why don’t you provide a level of service that meets acceptable, agreed upon standards?”

The issue is not that Canada is better or worse. The issue is that the system in the US does not work and whether or not one implements “socialized medicine” or not is not nearly as important as making the current system better and providing a level of oversight and control that supports better service to the consumer/patient.

There are many people who feel as if the current healthcare system in America works “just fine”. I disagree. There are methodological imperatives based on both IT infrastructure and clinical processes that are out of control and most of the cost based models underlying health care are at serious odds with accepted best practice models.

Just to put things in perspective, as I do have some first hand experience with health care, on both sides of the curtain, I made about 300,000 a year (as an analyst and manager for Kaiser Permanente–a rather large health care provider and, sadly, a very poor one, as well) and my 300,000 a year salary and my fancy job and title working FOR a hospital did nothing to help me because the hospital I designed business processes and testing methodologies for allowed my child to die.

They were so cost-conscious that they did not “notice” a medical crisis and so now we have no daughter. There are other problems I have experienced with health care as well. One more example (although nothing compared to the loss of our child): I have an arthritic badly damaged shoulder, but the doctors did nothing to help me with that other than confirm that, yes, my shoulder is damaged.

Thanks for the insight. No treatment, no medication, no therapy, nothing. I should “exercise it” and “maybe” it will improve.

As a former athlete I exercise it pretty much all the time. There are horror stories galore I could recite from listening to others talk about their experiences with their health care providers but I think mine should be enough.

And, after allowing our child to die–and trust me, if this happens to you, you may re-think your position on health care–the hospital LOST critical medical records and then, later, inserted false records in their place.

We know these are false because we know EMR (electronic medical record) protocol and the “found” records do not conform to that protocol so they are obviously fakes–and please don’t even ATTEMPT to dispute this because, once again, based on my JOB, I know what these are supposed to look like and these “ain’t it”.

The issue at hand is not one of socialism versus capitalism but rather the implementation of controls and standards that are in closer adherence to standard best practice models in business–the only best practice models anyone in health care pays much attention to are cost reduction models, which is fine provided that frugality does not undercut the efficacy of the service provided.

I am not saying that we need to be Canada or have socialized medicine. What I am saying is this:

1. The health care system does not work as well as it should.

2. Somebody should do something about it. Socialized medicine is not the only answer; but there must be changes, fundamental root cause changes, in order for the health care system to be viable and, well, “healthy”.

To deny that there are “real” problems is, to me, very short-sighted thinking.

Policy always drives process–always–so if the health care providers knew they were expected to conform to a specific level of care or risk being penalized then they would figure it out and the system would change. As long as they can play fast and loose and avoid being penalized nothing will change. That is the issue.

The health care system is based on a big lie–and it is this: we will honor our bargain with you, no matter what.

But what happens is this, if it becomes problematic or expensive later, then the health care providers stop holding up their end of the deal.

When you take your wedding vows, “in sickness and health” there is no fine print that says “unless you get really sick and your illness costs a lot of money to cure.”

With an insurance company you hear the vow but don’t realize the fine print because it is a faint hollow whisper. All I am asking is that the insurance companies honor their vows, their sacred trust, with me and anyone else who signs up for their services. Would you leave your sick wife or child to fend for themselves alone? Is this fair?

SOMETHING has to happen; the status quo is no longer a viable option and if “sicko” brings awareness to this issue and initiates a dialogue and critical assessment of current state, then this, in my opinion, is a positive thing.