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Saturday, August 15, 2009

Blah Blah Blah Health Care Blah Blah Blah

I read a post over at BayouRenaissanceMan about "socialized" health care and had so many thoughts about his post that his comment box laughed at me when I tried to publish. So....I will post my thoughts here:

I didn't read the original article or Roberta's rant yet (see bayou's post for links to both), but I wanted to make a few comments while they're in my head...

If I read Bayou's post correctly, he states that there are some people who have health issues because of their lifestyle (smokers get cancer, etc.) and not just because of chance, and he asks how much care should be given to these people and for how long? Here's what came to mind for me:

If I get sick and need care and the care provider can make a decision as to the amount or quality of care I receive based on his/her own judgment of my morals or the circumstances of my illness, then my health care turns into a crap shoot. Who knows what mood the care giver is in, or what their belief system is or what their prejudices are (we are all prejudiced to some degree, if we are honest) at what might be a critical time for me. I think it's problematic to base the availability, quality or duration of care on the subjective judgment of individual humans or institutions. Because, it inevitably ends up with somebody playing God, if the decisions can impact whether a person lives or dies or they rebound to full productivity or just drool in a chair the rest of their life.

So I think it is best if health care (whether public or private) treats the illness objectively - such-and-such symptom requires such-and-such treatment - without the invasion of moralistic or other subjective judgment criteria.

Discarding, dismissing or withholding care from people because of their waywardness is not a very, um, Christian thing to do. There are some very brave people out there who work with rapists and murderers (i.e. "bad" people) to try and help them, because these care givers or religious people have compassion for all living beings, and because they know that many victimizers were victims of violence themselves. If one of those criminals can be helped, it is a good thing. I think it's problematic to say that because so-and-so did these bad things, that they deserve less care, or no care at all. If I was a foolish American who got caught protesting the regime in Iran (or was just hiking in the wrong place or stepped over the border into North Korea) and got injured while being arrested or in jail, I wouldn't want my health care determined by the judgments of Iranian doctors or jailers as to whether or not this infidel deserves care. I know this seems like an extreme example, but we have just recently seen two reporters arrested in North Korea and hikers arrested in Iran, so this is a very real possibility.

If Mary Magdalen got syphilis and was dying, I don't know if Jesus would have patted her on the head and said, "Well Mary, now you know the consequences of your sinful whore life! I'll pray while you suffer and die, that you might be lucky enough to be forgiven by my father and allowed to enter the gates of heaven. Other than that, see ya!"

I live in France where there is a combination of public and private health care, and there is nobody making a decision about my worthiness for care. You just get sick and then you get care, whether you can afford it or not. I just read recently over at TPMCafe from another American girl who lives in France and just got diagnosed with breast cancer, that the French have a review board who will review more complex cases (long-term diabetes or cancer care) and determine if the patient receives 100% state coverage or the regular 70% that all citizens get. Most long-term care cases receive the 100% coverage. You don't have to wait for care during this review. You just pay the 30% you normally pay and if you receive the 100% coverage, it's retroactive and covers past bills.

So, I'm not sure that providing care for anyone who needs it, through objective medical decision making, versus subjective judgment about a patient's worthiness is what Bayou man would call "one size fits all" "socialized" medicine. But it's what I prefer. And I believe a public, government-funded health program (with all its inherant beurocratic bullshit) has more of a chance of delivering objective care, than a profit-motivated insurance company who WILL and constantly DOES make decisions about whether or not you qualify for coverage.

Another thought before I go - There will always be people who are not so much unfortunate as they are manipulative, cunning and who take advantage of anything and anybody. There will always be people who figure out how to "game" the system and get stuff without working for it. I believe (and have no facts to back it up) that the percentage of those types of people is low and I also believe that we can't make a decision to implement or not implement something, based on those people. We just have to figure them into the overall cost, just like restaurant owners figure in a general cost for employee theft and dishware breakage.

I've paid into the US tax and Social Security system for more than 30 years, and although I've lost several jobs during the dot bomb, I only collected unemployment once for a few weeks until I got pissed off at what a big hassle it was. I realized that if I accepted my $750 a month from unemployment, if I got three little jobs (which is what I eventually did) that added another $2000 a month to that $750, I would come closer to the $3500 per month overhead I had created when I had those high-paying corporate jobs. But I wasn't allowed to do that. I had to only accept the $750 and make no extra money, or not take the $750 at all. So I either had to game the system and collect unemployment and do the little jobs under the table, or not take the unemployment. I'm a lousy liar, so I chose to not take the unemployment, and take my chances with waitressing, driving a van for a trail riding company and babysitting an art gallery.

But the thing about unemployment is that they told me I had paid so much into the system that I had hundreds of weeks available to me. I could have just surfed on those many weeks until I used them all up. After all, It's MY money. But, I don't mind if somebody else less fortunate, whether they are gaming the system or not, gets that money instead of me. At the same time, me and my various employers have paid thousands and thousands of dollars into the coffers of private insurance companies, and I have rarely gone to the doctor and have had no major or lingering health care needs during the last 30 years of employment. It DOES piss me off that all that money went into the pockets of insurance company executives. I would MUCH RATHER know that the money I paid in for health care but didn't use, went towards helping somebody else in need.

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