Thursday, June 4, 2009

Healthcare Reform: Where's The Unemotional Fact Analysis?

I'm in Arizona right now, visiting with family and friends and taking care of some bidness. It's a vacation for me, after an intense final push to finish up two writing contracts I had at the same time. I don't turn away work, but the result of all that intensity is that the left side of my body is pretty much numb. I sit in bed and write on my computer, because when I sit at a desk I always slump, which caused back problems. But now I guess I need to also pay attention to how I work sitting up in my bed too.

So...I went to my brother's massage therapist for some relief, but it looks like I might have a pinched nerve somewhere, so I have an appointment Monday with the chiropractic neurologist in the same office as the massage therapist. As I was sitting in the waiting room, I started chatting with the doctor's mother, who is the receptionist. She's Canadian, with an American green card. Here's how our conversation went:

Canadian: You don't want socialized medicine.
Me: Yes, I do.
Canadian: No, you don't.
Me: Yes, I do.
Canadian: No, you don't.
Me: Yes, I do.

She gave up, because she's nicer than me. Then...

Canadian: But I've experienced socialized medicine in Canada and it's terrible. Long waits for appointments and in the doctor's office.
Me: I've experienced socialized medicine in France and it's great.
Canadian: Well, ok, but in Canada, even somebody with throat cancer has to wait six months just to get in to see the doctor.
Me: That sounds like a Republican fear mongering talking point.
Canadian: No. That's my story. I had throat cancer and I couldn't get to a doctor for six months.
Me: ...


This repartee underlines what I've been thinking about recently. In a land of sound bites, "socialized medicine" is a huge sweeping general term that is loaded with emotion but, like most sound bites, is a quickie phrase that inadequately sums up a very complex issue. When the Republicans utilize this phrase, they distract all of us from really discussing the nuances of worldwide health care practices and their underlying values, and coming up with viable solutions. It just becomes a hot potato that politicians throw at each other, while the American people suffer the inadequacies of the system first-hand but have very little data to help their elected representatives come up with a solution.

What the generic term doesn't cover is the fact that all health care systems are run by people and processes, whether they be people within the government, people within insurance companies or healthcare providers or healthcare consumers. And something I discovered when working for the government (contractor to the marine corps) and inside corporate America, is that people are fallible and processes can be overly complicated, completely inadequate or amazingly smart. It just depends on the skills and foresight of the fallible people who define the processes. So, it's not a surprise that the efficacy of healthcare in different countries differs.

I have British friends who say that healthcare in Britain is terrible. When I lived near London twenty-five years ago, I experienced it first-hand. All I had was a cough and sinus infection that wouldn't go away, and when I arrived at the doctor's office I had to take a number from one of those dispensers you see in American grocery stores at the meat or deli departments. Then I waited forever until I could go into the doc's office. He was a grumpy old geezer who listened to my symptoms and then made me take off my shirt AND my bra, so he could listen to my chest, supposedly. There was no reason at all for me to take off my bra, but he was probably bored to death and decided it would be fun to see young American girl breasts. In the end, he told me to go to a pharmacy and buy cough syrup. Needless to say, I was underimpressed.

My current British friends say they come to France to get better health care. I have some friends who are Canadians and they tell me they like their healthcare system, but the first-hand stories I heard at the chiropractor's office yesterday indicate that the system is not so great. The receptionist's son, with whom I will visit on Monday, is also a Canadian, but he struggles to make money as a doctor in the American system. Because of the insurance companies, he can only make money if he limits each patient appointment to a maximum of 15 minutes, but he doesn't believe in that.

Who or what is the culprit here? I don't know enough to say at this point. My brother asked me, "What do the French do differently than the British or Canadians that make their healthcare better?" I don't know the answer to that. I think Denmark was recently listed as one of the best countries to live in, and that their socialized medical system is wonderful. If that's true, I wonder what the differences are? While American politicians run around yelling emotionally-charged sound bites at each other, is ANYBODY analyzing the structures and processes of successful socialized healthcare systems and using that hard data to define America's new and amazing approach? I sincerely doubt it. That approach makes too much sense and doesn't get your political mug on the news, doesn't get you vilified by Rush Limbaugh so you can get MORE news coverage of your shocked and outraged defense against his vilification. That's the game that's being played here, instead of people working together to create a solution that works. What a shame.

My gut tells me that the insurance and pharmaceutical companies are at the root of the American problem. There's a commercial greed factor that can't be denied. It's built into the system because both are for-profit entities. And Americans go to Canada to buy their drugs, the very same drugs they get in the states, but at a fraction of the cost. How does that happen?

Do you or should you profit from healthcare? Is healthcare a basic human right? I believe it is. Then, how do the pharmaceutical companies fund the many-year drug development process required to bring drug solutions to the market, if they don't reinvest profits? In my mind, drug development should not be in the private sector, but should be done in the universities using government money.

I see my right-wing brethren rolling their eyes at the last statement, touting the overused hype, "Oh Lisa, government money is the tax payer's money, don't you know that?" No, actually, I'm a fucking moron and have no idea that when the government pays for something, it's using my tax dollars. (snark) I pay taxes happily. It's my privilege as a citizen. But I don't always agree with how our tax money is spent. I'd be much happier if my taxes funded drug research in the universities and I could buy drugs at a reasonable price, than if my tax dollars are paying off the loans that BushCo took from the Chinese to fund an illegal and immoral war in Iraq, kill American soldiers for NO good reason and kill, maim and displace MILLIONS of Iraqis. Or I'd much prefer my government tax dollars went towards insuring America's children rather than giving billions in no-bid contracts to murderous Blackwater/Xe and incompetent and greedy Halliburton/Dick Cheney.

So, fuck you, Republicans, every time you start that cheap-shot, intellectually bereft Government-Tit talk.

The doctor's mom/receptionist and my right-wing brother both agreed with me that the insurance and pharma companies are a big problem. As Obama has been saying recently, let's focus on what we can agree on, and this seems to be a shared value. But there's way too much industry lobby money flowing into politicians' pockets on both sides of the aisle, to ever see the end of insurance/pharma in America.

Is there any effort out there to do what I'm suggesting and unemotionally analyze and compare successful and unsuccessful healthcare systems and construct a new way? If you know of any, let me know. THAT's a productive discussion I'd like to be a part of. All the rest is political pandering and obfuscation.

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