Insurance and Medicine for the Future

So far, we don't have much detail about the plans for changing our medical (health care) system. From the liberal side of political discourse, we keep hearing how horrible everything is, and how difficult it will be to make changes, and all of us will have to give up something to make the system work. From the conservative side, we hear how bad socialized medicine will be, that the government-run medical system will be hopelessly expensive and inefficient and that people will die from the reduction in care.

Here's what I know: so far, when the feds say that are going to do something, the result is quite often the opposite of the published purpose, and that they are pretty bad at creating anything of value in our society. When they talk about tinkering with the medical system, I shudder, because they can do so much harm in such a short time. The medical systems in Europe largely act under a socialistic framework, and they make decisions that we in the U. S. find repugnant. For instance, years ago in Great Britain, if a person was over 65 years of age, they could not have cardiac bypass surgery. They were old, the thinking went, and so should go ahead and die. As I understand it, the policy changed eventually, but that sort of mindset would never have made it to the starting point in policy-making for American insurance systems.

I really expect not much to change, because there are powerful forces aligned against such change. Large employers don't want people to be able to get insurance outside their employ, as that lessens their hold on good workers. The insurance industry doesn't want change, as their profits are likely to drop, or they might cease to exist entirely if the feds take over. The pharmaceutical industry does not want change of any sort, because all the plans discussed so far involve reducing cost of medications, and choices of medicines to take. The government is not likely to allow real change because, like it or not, many of the lawmakers owe too much in favors for the support of insurers and drug companies, so even if our president wants change, there will likely be extreme opposition to that change.

If we could just see some real discussions about this without politicians trying to demagogue the issues for their own personal benefit, then I think we could see real change. But we're kept in the dark with pseudofacts and hyperbole, designed to scare people into accepting laws and policies they would never allow if they knew what was really in them. I just hope that we physicians will be able to continue to keep our offices open and to see patients without the feds or insurers getting in the way too much.