What do American Health Care and Soviet Fire Fighters have in common?

I am getting a lot of messages with polarized opinions about the health care reform. I want to point out one of the reasons why the current "system" is ridiculous and unsustainable.

Doctors are paid more to do procedures, and significantly less to just use their brain power for a diagnosis. (Granted, there is also at least one malpractice attorney behind every bush waiting to see you NOT do something which might have helped the patient.) Therefore, the more procedures they do, the higher their pay. Do you see anything wrong with this picture?

Once upon a time, Russian fire fighters were paid by the hour for the time they spent extinguishing fires. And - surprise, surprise - fires became a lot longer and more devastating. Hope you see the analogy here.

I think in the argument about health care we forget that the goal of a good health care system is not to provide people with unlimited and immediate access to all available tests and procedures, not to spend the most money for treatments, but to provide better quality of life, and to increase life expectancy of the citizens. Yes, Americans get the most tests, heart catheterizations, colonoscopies, elective surgeries, etc., but they still live less than people in Europe do, and outcomes of most diseases are worse over here than over there. We are behind every developed European country in those two respects. End of story.

The myth of American superiority in health care is greatly exaggerated. Tough pill to swallow, my fellow Americans, I am sure. But once you get it down, you will feel better.

(By the way, a common misconception also is that doctors somehow benefit financially from the drugs they prescribe - that is, a doctor gets a higher kick-back for prescribing name brand drugs, and a lower one for generics. This is absolutely not true. Unless your doctor is also your pharmacist, he or she is not materially interested in how many and which drugs you get.)

Manufactured anger

Fox news reports today: "The White House said Tuesday that some of the anger that Democratic lawmakers have encountered at town hall meetings over the past several days is "manufactured." They proceed to ridicule that notion implying that people are genuinely angry at the politicians' attempts to reform our health care system and to introduce universal health care which we alone do not have in the developed world.

As a private individual, not a liberal, and not a Democrat, I will confirm that from my personal experience I believe there is a concentrated effort behind fueling that anger and organizing those "protesting crowds". Over the weekend I received a pre-recorded phone call inviting me to come to such a meeting and "scaring" me with all the horrible things which would happen should the government succeed in their reform plans. You better believe that it cost somebody some serious money to record the message and call thousands of households. Follow the money, and you will know who organized the protests. Maybe it was financed by the Republican Party - I don't know. But it was some special groups' money which financed it anyway. My guess is that the insurance companies, and possibly the big pharma are behind the finances for such protests.

I hang up on them. As a person who originally came from the Soviet Union, and a person who has been married to a physician for a quarter of a century, I can tell them a lot myself about what the consequences will be. However, I know that the current system is deeply corrupted and inefficient. I do believe we as a nation should be able to make some basic health care guarantees to our citizens. I am not familiar with the details of the government plan - I am sure they will screw up the reform, but what we have now is not sustainable and we have no moral right to perpetuate it. The system we have now is wasteful, and it still limits people's access to health care. Your claims processor at the insurance company who may be a high school dropout has the power to deny the doctor prescribed necessary diagnostic procedure or treatment because that processor is charged with the sacred mission of guarding the bonus size for the insurance company's CEO. Don't kid yourselves! We do not have the best health care system in the world. Don't look at how much money we spend on healthcare. Look at the outcomes of teh treatment. We are far from the top of the industrialized nations in the results of all our very technological treatment. And what is important, too, I do not know a single primary care doctor who wishes their children would become primary care doctors in their turn. Reform or no reform, who are you going to have to treat you?

I will be writing more on the subject.