Democrats in 100% control of the country

[hopalong]

It's a tough situation all the way around. So many facets of the problem. We have some amazing technology in this country for medical care. It costs a lot of money to develop and maintain. Training to use that technology is lengthy and labor intensive. No one wants to be on the receiving end of mistakes or oversights in their care and conscientious care givers don't want to make those mistakes. The average individual has no idea how long it takes to become really, truly proficient at a lot of the advanced practice procedures that we perform. This doesn't happen overnight.

It may not be the prime cause for our problems, but the legal climate is not conducive to streamlined care. It's already been mentioned here by others, but the amount of defensive medicine practiced every day is overwhelming in the big picture. If there is any test that can possibly discover a problem and it hasn't been performed, patients and families will be climbing up our ass wondering why we didn't do it. They see this stuff on TV and they think that's the way it always needs to be done. After all, if they do it on 'House", it must be the way we do things for everyone, right?

Workers in the health care field like to be paid for their efforts, training, and expertise. Why not? Banking and insurance execs make some damn fine bonuses; isn't human life worth more than that? From recent events and attitudes, apparently not. I'm not suggesting that workers in health care be given bonuses on that order, or even that bonuses be given at all, but you get the general idea. If my frequent conversations with medical and surgical residents here is any indication, the average physician leaves medical school with approx. $200k in loan debt. Hell, my daughter will be over $100k in debt for her Doctorate in Phys. Therapy when she graduates. (The doctorate is the entry level educational requirement for PT now, BTW, so it's not like she went flying off on a needless paper chase).

Now, do I think everyone should be entitled to basic health care, regardless of ability to pay? Yes, I do. How compassionate would I be if I didn't believe that? How compassionate would an "advanced" society like ours be if it didn't believe that? There's a serious disconnect here if athletes, "celebrities", and industry execs are worth far more than the surgeon who cuts open your brain to remove a tumor or relieve hemorrhaging. Or even the surgeon who removes an inflamed appendix that threatens your life. For that matter, trauma care is horribly manpower intensive, expensive, and lengthy. It consumes a lot of resources.

Do I think that national health care could work? Possibly, but we'd have to remove some pretty major obstacles to get it done. The biggest obstacle is that incredibly manipulative and destructive machine we call Washington, DC, with politicians who seem to be on everybody's payroll but ours, the people they're supposed to be working for. cough -- Arlen Specter -- cough These guys can screw up a one car funeral.

The American people also need an attitude adjustment. Dialysis and open heart surgery for 80-90 year olds is a bad idea. So is keeping obviously terminal patients alive in the ICU for weeks because the family "wants everything done." We also need to develop a healthier attitude towards wellness and prevention, pun intended. We can't just go our merry way and let it become the hospital's problem when we succumb to bad life choices like obesity, substance abuse, or general disregard for healthy living.

Yes, I realize that opens Pandora's box for rationing or denying care for irresponsible behavior or questionable "quality of life" issues, but I never said I had all the answers, just some random thoughts and rants.

[cjbaldw]

The American people also need an attitude adjustment. Dialysis and open heart surgery for 80-90 year olds is a bad idea. So is keeping obviously terminal patients alive in the ICU for weeks because the family "wants everything done." We also need to develop a healthier attitude towards wellness and prevention, pun intended. We can't just go our merry way and let it become the hospital's problem when we succumb to bad life choices like obesity, substance abuse, or general disregard for healthy living.

Yes, I realize that opens Pandora's box for rationing or denying care for irresponsible behavior or questionable "quality of life" issues, but I never said I had all the answers, just some random thoughts and rants.

I hear you, it is tough stuff to be sure. My biggest issue is that many people look at Canada or the EU nations, with almost no real familiarity or experience dealing with socialized medicine - and say - I want what they have! The grass is always greener on the other side of the fence.

I'm not saying that we don't have major problems to solve with our current medical insurance and medical practices - I agree that we do - but I remain opposed to any significant government involvement in medicine. By definition, when government becomes involved in anything - the issue becomes politicized. For all of the problems with the private healthcare system - and as I said there are lots of areas for significant improvement - the system itself works. Not everyone may have access to it - and this is the core problem that needs solving - but I don't want a government run healthcare system personally. My experience is that it may be a very politically expedient solution to entertain - but from a business and healthcare perspective it's not ideal. Just look at the problems with the VA Healthcare system as a great example of government run healthcare - is this what we want nationwide? Because that's what we're going to get folks.

As hopalong outlined, we've got to do something about the liability insurance costs and legal challenges and problems within the healthcare industry. We also have to recognize that at least part of the reason why healthcare costs are increasing is because a lot of the advances in medical technologies are expensive to create and maintain. If we price fix - the innovations will come to a screeching halt. Is that what we want? No innovation in healthcare? We'd all like to believe that people will continue to innovate not for the money but just because it's the right thing to do. My experience is that to believe this is to be naive - but that's just me.

Lastly, we do need a fundamental shift toward prevention and good health. I've read quite a bit of material on the future of the practice of medicine. As technology improves - we will eventually see the use of a combination of extremely high density scanning technologies combined with the use of neural networks for the diagnosis - by the neural network itself mind you - which is pretty amazing when you think about it. This type of technology is already in place and used for breast cancer scans - a neural network was fed some 400,000 scans of mamograms and "taught" to see cancer in breasts. While this technology is still secondary to the humans that also interpret the scans - in the relative near future it will probably become the primary. So, much like technology has helped businesses to become more efficient - technology will do the same thing for medicine. While its not very nice to entertain job losses due to technology improvements in medicine - this is what will drive down costs the most long term - just as technology has driven down costs for businesses significantly over the past 25 years. Silicon Valley is currently investing tens of billions of dollars integrating technology and medicine - and we will reap the rewards in the form of more advances in medicine in the next 20-30 years than we can imagine. I know a number of people working on these types of projects currently. So, for me, I don't want to see changes come along that stifle innovation and prevent capital investments in new medical technologies - and in my view any government run healthcare system that provides no incentive to innovate and politicizes medicine in the process - will do exactly that.