27 August 2009
Overusing Medical Care
Indeed, most Americans would probably insist on focusing medical practices on their own or their loved ones’ needs rather than on serving the greater good of society, as states Betsy McCaughey in her Op-ed article in the August 27, 2009 Wall Street Journal. It’s that self-interest that exemplifies many human endeavors and that has led us into a number of dilemmas besides bankrupting health care costs, including global warming, international financial recession, and criminal behavior, to name a few.
Societies have learned to deal progressively with these threats to improvement of their welfare through regulation in recognition of their common interest in establishing and maintaining order and preserving a livable environment. In Darwinian terms, the driver has been the survival of the species. But survival requires a certain measure of altruism in any species, i.e. sacrificing an individual’s apparent welfare for the long-term benefit of everyone. It is shortsighted to step away from that need for social engineering when we have taken control to do so away from the Invisible Hand of evolution.
Dr. Ezekiel Emanuel has a point when he blames simplistic faithfulness to the Hippocratic Oath for the exploding cost of health care in the U.S. Somehow, the contradiction between serving each patient’s needs and serving the greater good does get resolved by the use of triage to manage emergency situations. The combination of our extended life expectancy and our expectation of cutting-edge therapies is leading our civilization’s finances into an emergency condition where choices have to be made between prolonging individual lives and improving the general quality of life.
Indeed, most Americans would probably insist on focusing medical practices on their own or their loved ones’ needs rather than on serving the greater good of society, as states Betsy McCaughey in her Op-ed article in the August 27, 2009 Wall Street Journal. It’s that self-interest that exemplifies many human endeavors and that has led us into a number of dilemmas besides bankrupting health care costs, including global warming, international financial recession, and criminal behavior, to name a few.
Societies have learned to deal progressively with these threats to improvement of their welfare through regulation in recognition of their common interest in establishing and maintaining order and preserving a livable environment. In Darwinian terms, the driver has been the survival of the species. But survival requires a certain measure of altruism in any species, i.e. sacrificing an individual’s apparent welfare for the long-term benefit of everyone. It is shortsighted to step away from that need for social engineering when we have taken control to do so away from the Invisible Hand of evolution.
Dr. Ezekiel Emanuel has a point when he blames simplistic faithfulness to the Hippocratic Oath for the exploding cost of health care in the U.S. Somehow, the contradiction between serving each patient’s needs and serving the greater good does get resolved by the use of triage to manage emergency situations. The combination of our extended life expectancy and our expectation of cutting-edge therapies is leading our civilization’s finances into an emergency condition where choices have to be made between prolonging individual lives and improving the general quality of life.
25 August 2009
Americans Think They Can Fix Anything
Just as in the case of Global Warming, most Americans think they will eventually, and soon enough, find a solution to any problem. That is an essential part of the optimism, the self-confidence that characterizes the American spirit.
We live our lives in reckless disregard of the consequences of our bad eating, escapist, substance abuse, and sedentary lifestyle habits in the belief that ingenuity will resolve their ill effects.
Earth will be around far beyond any of our lifetimes, so there is plenty of time left to correct carbon build-up in the atmosphere. When it comes to health care, however, each of us is confined to a limited physical existence.
Much of mankind has traditionally dealt with this sad truth by craving escape to the rewards of spiritual life. Americans in the health care industry and the Democratic Party believe that paying to cure everyone’s illnesses will only take a little bit more money. Americans like Dr. Frank Lipman (in the August 24, 2009 Huffington Post) believe they can create a heaven on earth by changing human nature. We’ll see which of them bankrupts the nation.
Just as in the case of Global Warming, most Americans think they will eventually, and soon enough, find a solution to any problem. That is an essential part of the optimism, the self-confidence that characterizes the American spirit.
We live our lives in reckless disregard of the consequences of our bad eating, escapist, substance abuse, and sedentary lifestyle habits in the belief that ingenuity will resolve their ill effects.
Earth will be around far beyond any of our lifetimes, so there is plenty of time left to correct carbon build-up in the atmosphere. When it comes to health care, however, each of us is confined to a limited physical existence.
Much of mankind has traditionally dealt with this sad truth by craving escape to the rewards of spiritual life. Americans in the health care industry and the Democratic Party believe that paying to cure everyone’s illnesses will only take a little bit more money. Americans like Dr. Frank Lipman (in the August 24, 2009 Huffington Post) believe they can create a heaven on earth by changing human nature. We’ll see which of them bankrupts the nation.
20 August 2009
Hiring Discrimination and Health
Preferring to hire a skinny bimbo for personal reasons, as recently reported on AlterNet, is grounds for a discrimination suit. However a corporation may certainly weigh the cost of subsidizing health insurance for an obese employee against the benefit to it of the skills and performance of that employee.
It's not the responsibility of that corporation to counsel its current or prospective employees on lifestyle changes. That is the kind of service that should be required and paid for in the program that results from reform of our national health care insurance. It would end up saving us money as well as improving our quality of life.
Preferring to hire a skinny bimbo for personal reasons, as recently reported on AlterNet, is grounds for a discrimination suit. However a corporation may certainly weigh the cost of subsidizing health insurance for an obese employee against the benefit to it of the skills and performance of that employee.
It's not the responsibility of that corporation to counsel its current or prospective employees on lifestyle changes. That is the kind of service that should be required and paid for in the program that results from reform of our national health care insurance. It would end up saving us money as well as improving our quality of life.
17 August 2009
You Can Always Spend More on Health Care
Is there no expense too large when it comes to prolonging the life of a loved one? That is what “living wills” are all about. Would we have the option to extend those lives as long as we do now without a health care insurance system that pays for it beyond the unexpressed desires of often uncommunicative patients? And would the 400,000 foreign non-residents who come to the U.S. every year for exceptional medical care have that option if it were not subsidized by a health care system that consumes over 16% of our GDP?
It may be possible to avoid spending as much as we do on health care, despite Craig S. Karpel’s opinion in the August 17, 2009 Wall Street Journal, and still permit the medical and pharmaceutical industries to profit from their widely recognized excellence in research and therapy development. They can continue to act as engines of economic growth without bankrupting the nation. The key to such a transformation would be to shift their return on investment from a serendipitous result of health care overspending to the intended outcome of a carefully planned business model.
Let us not throw everything we have at the health care problems caused by our aging population. Let us, like Jack Benny, instead carefully think it over.
Is there no expense too large when it comes to prolonging the life of a loved one? That is what “living wills” are all about. Would we have the option to extend those lives as long as we do now without a health care insurance system that pays for it beyond the unexpressed desires of often uncommunicative patients? And would the 400,000 foreign non-residents who come to the U.S. every year for exceptional medical care have that option if it were not subsidized by a health care system that consumes over 16% of our GDP?
It may be possible to avoid spending as much as we do on health care, despite Craig S. Karpel’s opinion in the August 17, 2009 Wall Street Journal, and still permit the medical and pharmaceutical industries to profit from their widely recognized excellence in research and therapy development. They can continue to act as engines of economic growth without bankrupting the nation. The key to such a transformation would be to shift their return on investment from a serendipitous result of health care overspending to the intended outcome of a carefully planned business model.
Let us not throw everything we have at the health care problems caused by our aging population. Let us, like Jack Benny, instead carefully think it over.
12 August 2009
Diagnosing Our Healthcare System’s Faults
A major fault of the U.S. healthcare system is that it fools consumers into believing that their health is best cared for when the most expensive diagnostic tests and therapies are devoted to curing their illnesses. It’s a false analogy to buying an expensive automobile in order to avoid early obsolescence or wearing away. Every American should have the right, this model posits, to have the longest life possible (whatever the quality of that life), no matter what it costs.
Dr. Andrew Weil, in his August 9, 2009, Huffington Post article, “The Wrong Diagnosis,” pointed out that the Obama Administration may be misdiagnosing our system’s faults as owing to the high prices charged by pharmaceutical, testing and treatment suppliers instead of to the selection of the solutions appropriate to specific health conditions. That may be the result of the cost of defending doctors against their legal liability for the medical consequences of failing to recognize the symptoms of a remotely possible accurate diagnosis. The romance of this perception of the medical profession is depicted in the popular TV series, “House, MD.”
The media has wondered about the supposed alignment of the pharmaceutical industry behind the Obama healthcare insurance reform plan. It may be because the industry has decided that any plan that assumes that money is the solution to the problem can’t help but line their pockets. The fault of the U.S. healthcare system is not that it costs individuals too much, but that in aggregate it costs the entire economy too much. If we were able to correct the incentives that lead to selecting the most expensive solution to each health care need, we might bring down the overall cost of ameliorating our longer and longer lives.
A major fault of the U.S. healthcare system is that it fools consumers into believing that their health is best cared for when the most expensive diagnostic tests and therapies are devoted to curing their illnesses. It’s a false analogy to buying an expensive automobile in order to avoid early obsolescence or wearing away. Every American should have the right, this model posits, to have the longest life possible (whatever the quality of that life), no matter what it costs.
Dr. Andrew Weil, in his August 9, 2009, Huffington Post article, “The Wrong Diagnosis,” pointed out that the Obama Administration may be misdiagnosing our system’s faults as owing to the high prices charged by pharmaceutical, testing and treatment suppliers instead of to the selection of the solutions appropriate to specific health conditions. That may be the result of the cost of defending doctors against their legal liability for the medical consequences of failing to recognize the symptoms of a remotely possible accurate diagnosis. The romance of this perception of the medical profession is depicted in the popular TV series, “House, MD.”
The media has wondered about the supposed alignment of the pharmaceutical industry behind the Obama healthcare insurance reform plan. It may be because the industry has decided that any plan that assumes that money is the solution to the problem can’t help but line their pockets. The fault of the U.S. healthcare system is not that it costs individuals too much, but that in aggregate it costs the entire economy too much. If we were able to correct the incentives that lead to selecting the most expensive solution to each health care need, we might bring down the overall cost of ameliorating our longer and longer lives.
07 August 2009
The Prognosis for National Health Insurance
Arthur Laffer’s report on National Health Insurance makes a good argument in favor of a system that is similar to the one adopted by the government of Singapore. Both systems rely on the consumer to control the cost of health care by placing responsibility for paying for it in their hands through medical savings accounts that they dispense and contribute to in whole or in part.
However, owing to the dominance in American values of monetary gain as the measure of professional fulfillment, there is a basic contradiction between the profit-maximization goals of many health care providers in the U.S. and the cost-minimization goals of their patients. Although this contradiction may only apply to a minority of health care providers (and to not all health insurers either) its distortions have infected our entire health care system. The process has certainly been abetted by the America’s medical liability practices.
The weakest solution to our health care system’s faults stated by Mr. Laffer is “Reduce the number of mandated benefits that insurers are required to cover.” It’s not insurers (private or public), or consumers for that matter, who should determine which health care procedures are needed and, therefore, should be paid for by an ideal health insurance system. That is the job of a dedicated profession of health care providers, who are in some way released from the encumbrances of a perverse legal system and an ambivalent societal structure that separates material reward from professional competence.
As our population ages, thanks in great measure to advances in our medical therapies, it will become more and more essential that our society compensate the developers and practitioners of those therapies according to their great value to each of us. A political decision must be made to designate that profession as a kind of priesthood so that it and our common health are not contaminated by a striving for material gain.
Arthur Laffer’s report on National Health Insurance makes a good argument in favor of a system that is similar to the one adopted by the government of Singapore. Both systems rely on the consumer to control the cost of health care by placing responsibility for paying for it in their hands through medical savings accounts that they dispense and contribute to in whole or in part.
However, owing to the dominance in American values of monetary gain as the measure of professional fulfillment, there is a basic contradiction between the profit-maximization goals of many health care providers in the U.S. and the cost-minimization goals of their patients. Although this contradiction may only apply to a minority of health care providers (and to not all health insurers either) its distortions have infected our entire health care system. The process has certainly been abetted by the America’s medical liability practices.
The weakest solution to our health care system’s faults stated by Mr. Laffer is “Reduce the number of mandated benefits that insurers are required to cover.” It’s not insurers (private or public), or consumers for that matter, who should determine which health care procedures are needed and, therefore, should be paid for by an ideal health insurance system. That is the job of a dedicated profession of health care providers, who are in some way released from the encumbrances of a perverse legal system and an ambivalent societal structure that separates material reward from professional competence.
As our population ages, thanks in great measure to advances in our medical therapies, it will become more and more essential that our society compensate the developers and practitioners of those therapies according to their great value to each of us. A political decision must be made to designate that profession as a kind of priesthood so that it and our common health are not contaminated by a striving for material gain.
03 August 2009
Health Reform Is No Cancer
The difference in cancer survival rates between Britain or Canada and the U.S. has less to do with the structure of their health insurance systems than with the disparity of national personal incomes. Income inequality in the U.S. economy permits there to be proportionally a more numerous group of wealthy cancer sufferers than in either of the other two countries cited by Myrna Ulfik in her Op-Ed article, “Health Reform and Cancer,” in the July 31, 2009, Wall Street Journal. Patients like Ms. Ulfik can afford to pay the expense of “gold-plated” health insurance plans similar to the one that members of Congress opt for instead of the public plan.
Cancer survival rates in the U.S. will continue to exceed those in Britain and Canada in spite of reform of our health care insurance system as long as our economy creates disparate wealth to sustain demand for expensive therapies and diagnostic scans. The objective of the Obama health insurance reform must be to make that level of care, for all chronic and emergency illnesses, more equitably available to the population at large without bankrupting the country.
The difference in cancer survival rates between Britain or Canada and the U.S. has less to do with the structure of their health insurance systems than with the disparity of national personal incomes. Income inequality in the U.S. economy permits there to be proportionally a more numerous group of wealthy cancer sufferers than in either of the other two countries cited by Myrna Ulfik in her Op-Ed article, “Health Reform and Cancer,” in the July 31, 2009, Wall Street Journal. Patients like Ms. Ulfik can afford to pay the expense of “gold-plated” health insurance plans similar to the one that members of Congress opt for instead of the public plan.
Cancer survival rates in the U.S. will continue to exceed those in Britain and Canada in spite of reform of our health care insurance system as long as our economy creates disparate wealth to sustain demand for expensive therapies and diagnostic scans. The objective of the Obama health insurance reform must be to make that level of care, for all chronic and emergency illnesses, more equitably available to the population at large without bankrupting the country.
02 August 2009
Demanding Boards’ Diligence
In his Op-Ed article in the August 1-2, 2009 Wall Street Journal, “The Schumer Proxy,” Thomas J. Donohue distorts the likely consequence of the Shareholder Bill of Rights. Although union pension funds, hedge funds, and corporate raiders are likely to be the initial beneficiaries of its enlargement of participation in corporate governance, the burden of its provisions will fall heavily on corporate boards, which will no longer be the public relations tools of top management.
Not only would directors have to contend with more and more proxy battles, as activist groups master the art of marshalling one-percent minimum holdings, but they would have to stand for reelection every year, select a chairman from outside management and, who knows, become a professional class of business governors. It sounds like a more “European” system, unlike the typical boom and bust economy of the U.S. that has driven the world into unprecedented wealth in recent years and dashed some of its hopes last September.
In his Op-Ed article in the August 1-2, 2009 Wall Street Journal, “The Schumer Proxy,” Thomas J. Donohue distorts the likely consequence of the Shareholder Bill of Rights. Although union pension funds, hedge funds, and corporate raiders are likely to be the initial beneficiaries of its enlargement of participation in corporate governance, the burden of its provisions will fall heavily on corporate boards, which will no longer be the public relations tools of top management.
Not only would directors have to contend with more and more proxy battles, as activist groups master the art of marshalling one-percent minimum holdings, but they would have to stand for reelection every year, select a chairman from outside management and, who knows, become a professional class of business governors. It sounds like a more “European” system, unlike the typical boom and bust economy of the U.S. that has driven the world into unprecedented wealth in recent years and dashed some of its hopes last September.
