Thursday, July 16, 2009

National Health Care

The other big political story this week has been a push to "reform" the national health care system. By reform, I believe the President and Congress mean "rip out what's in place and put in something else". There's talk about forcing all employers to provide insurance, and giving the unemployed or self-employed money to buy insurance.

And by doing this, they will destroy our health care system.

I'm personally against national, read forced and socialized, health care. I've lived in countries with socialized health care. Junior Bear was born in a German hospital, and while we received adequate care, it was nothing special. If he'd had problems like Little Bear did, we would probably have lost him. When Junior Bear got very ill as an infant, we basically had to give up our baby to the nurses and come back later. He was in a ward, not a neonatal ICU, and it was an open ward at that. Like what you see in the old World War I hospital pictures, but with pictures of the Care Bears on the walls.

I was also subject to a form of socialized medicine when I was in the Army. Yes, I could get sick and get cost-free care, to a point. If the Army couldn't treat me at whatever post I was at, and didn't want to send me to a place where they could treat me for something chronic, I would have been sent to the civilian market to get treated. For my care, it would have been free. For my family, not so much. When you're making less than $15,000 a year, those deductibles and co-pays are pretty harsh.

And care was indeed rationed in the Army. It starts with the gatekeeper for a soldier to go on sick call, the First Sergeant. I avoided going to the clinic like the plague, unless of course they were giving me yet another round of plague vaccine. I did this mainly because I valued the First Sergeant's opinion of me, and First Sergeants are supposed to view anyone who wants to see a doctor without a bone sticking out or blood coming out of at least two orifices as a slacker.

If you were truly ill, you got to wait for at least a few hours while a group of badly overworked and underpaid medics, physicians assistants, and doctors worked their way through the line of sick and injured. This isn't during wartime, it's just normal day to day business. Soldiers live in close proximity to each other, and they do a lot of physical labor and things that tend to injure them. So illness goes though units pretty quickly, and there's almost always a steady stream of minor injuries that need attention.

If you really hurt yourself, then you got some excellent emergency care. If there's something military medicine has concentrated on, it's trauma care. As for follow-up care, well, it depended. When I messed up my ankle doing stupid Army stuff, I was thoroughly examined, x-rayed, poked, and prodded. When the doctor decided I did not need surgery, I was given two crutches, an ACE bandage, enough Motrin to kill a horse, and orders to stay off of it. Imagine my surprise when the next week I was told to sack up and do a ruck march to the range. Massive amounts of Motrin got me through it. But every time I get any kidney pain, I worry that the poor things might just jump out and run away. I've since been advised that Ibuprofen and I shouldn't have anything else to do with one another.

Rehab for my separated shoulder amounted to a rubber band and a doorknob. I'm not exaggerating. Imagine me, a young NCO, a leader of men, tying the end of a piece of rubber tubing to the bathroom door and tugging on it for an hour. Every night. For 3 months. And they wondered why I didn't want to go to the doctor.

With the injuries that have been seen in the War, I understand that such care has gotten a lot better, by the way. I'm not saying that my doctors weren't trying, but they were constrained by the facilities and treatments that were available for them to treat me. There was a limited amount of doctors to go around, and a lot of soldiers who needed treatment. So they went by formulas to treat us. Gastro-intestinal distress? Here's some Immodium and Pepto. Hurt leg/knee/arm/ribs? Here's some Motrin. Cancer? Can't treat you. We'll put you on a bus for a 4 hour ride to a bigger base to get chemo. Take an emesis basin to throw up in for the ride home.

If you had something chronic, like bad knees or back due to all of the running/jumping/lifting/whatever, you were pretty much SOL. If you could get someone to care beyond the "take 8 Motrin and come back when you need more" treatment, you waited for months to see an actual orthopedist. If the ortho thought you needed surgery, you waited even more for a slot to open up to get it. Which meant that you waited months and months to get what I got in 3 weeks when I hurt my back in the civilian world.

If you were really screwed up, you got put out of the Army with a promise of care in the VA system. My brother got well and truly screwed up by military medicine, and has been fighting with the VA for years to get something resembling good ongoing treatment for his condition. The problems above exist, but are compounded by poor funding and the need to treat not only the young and broken, but the old and broken too.

Where am I going with this? Nationalized health care will bring all of these ills to the masses. I have arthritis. For that arthritis there are several options for treatment. They range from the moderately effective and cheap to the extremely effective but expensive. I started out with the cheap, and when it either didn't work or caused problems that were even worse than the arthritis, my doctor and I were able to move into the effective but expensive range. The only limitations were the coverage my insurance company provided and my finances for paying my share. If health care was socialized, most of those options and all of the flexibility would be gone. Some bureaucrat would decide which treatments for my condition could be done, and how much of that treatment could be administered.

When I started treatment, I moved like an elderly man. Now, I'm almost human. (then again, I was never fully human. 3rd generation to walk upright and all that) If my health care had been supervised by someone other than my doctor, I truly believe that I would be unable to enjoy my life as I do today, and I would probably be using a cane to get around.

I'm going to work against socialized health care in our country as much as I can, and I urge each and every one of you to do the same.

If you have your own story to tell, please leave it in the comments.

1 comment:

Inspector Clouseau said...

We have a tendency in America to argue for or against a concept based on our own personal philosophy or view of the world, what advances our personal interests, or the interests of our party, family, organization, or region. Perhaps viewing the issue from a management or systemic perspective might result in innovative approaches to the issue. The American national mindset, citizen philosophy, lack of citizen motivation to be proactively healthy, and governance model make the socialization of health care in America very problematic, particularly at this point in time. A country needs to know its limitations.

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