Healthcare: Effectiveness vs Socialism and Communism
A lot of people like to label me anything from a "hairy liberal" to a "socialist" or "communist" because I question the viability of "for profit" healthcare as it is delivered here in the US of A.
In a community like Steemit, that's perhaps not surprising, given the number of generally conservative, free-thinking, anarcho-capitalist, libertarian leanings I encounter here.
Politics vs. Practicality
My opinion, however, has a lot less to do with political leanings than with simple practicality.
Buddha in the sun
Consider, for a moment, what the function of "health care" is. Isn't the primary function of health care and medicine to create a world in which people are healthy enough that they have only minimal need of health care and medicine?
If we take that one step further, doesn't it follow that "success" of the industry under such a paradigm actually constitutes reaching a point where the services provided are barely needed, at all? What's more, the objective when a person presents with a "health issue" is to HEAL that person so they never have to come back?
That's just common sense, right? Regardless of where on the political spectrum you fall.
With this in mind, let's examine the capitalist free enterprise system: At its foundation, the profit motive: to maximize profit. Adjunct to that, the metric of GROWTH as a measure of success. When your business is growing, and your profit is growing, it means you're successful.
Peaceful lilypond
So then comes the $64-million question:
How do you reconcile a system whose primary edict and measure of success is profit maximization and growth to an industry whose primary measure of success and efficacy is — in essence — minimizing the need for itself?
Now before you go all stone age on me here, let me repeat that what I am NOT doing here is making a pitch for socialized medicine!
What I am making a pitch for is an entirely new approach, because clearly what we have isn't working, and socialized medicine is typically also less than ideal.
If anything, I'm making a pitch for healthcare and medicine as a "zero sum game" rather than a "for profit" game. A "game" in which the primary objective is a healthy and happy healthcare recipient, not a bunch of "happy investors."
Decentralized Blockchain Healthcare?
Last time I had this discussion with a friend, we ended up somewhere back in the region of something that has always made sense to me: A healthcare system run along the lines of a mutual insurance company, a co-op, or a credit union.
Colorful flowers
Perhaps the service providers and the service recipients all "own" the network they are part of. Perhaps it can all be a decentralized network running on tradeable tokens, much like Bitcoin or Steem; where you can earn tokens by taking care of yourself and doing healthy things; pay for your healthcare with tokens at the provider of your choice; "investors" (and philanthropists) can invest in tokens that are part of a pool to fund major emergencies; people can "buy" tokens to keep their won equivalent of a "Health Savings Account" and employers can even offer health tokens as benefits and incentives when hiring.
That's just one possibility... I'm sure there are dozens more.
It's not exactly "socialized" (and yet potentially "national"), while there are millions of independent contributors, and yet there's a standardized "web structure" that holds all the bits together... your tokens spend exactly the same at a chiropractor in Maine, as they do at a podiatrist's in San Diego.
Of course, it would require "Those Who Would Control Everything" to step out of the way... a tall order.
Just some ideas I have been tossing around in my mind, as a result of recently spending a lot of time considering the "predatory" nature of most economics; particularly "predatory capitalism."
How about YOU? Do you think the USA (or your country, for that matter) needs a new healthcare system? What are our biggest problems? Is "for profit" medicine a contradiction of the idea that we are trying to minimize healthcare needs? Or does it encourage "ongoing treatment" rather than "healing" because of the profit motive? What do you think is the best solution to the global idea of "healthcare for all?" Leave a comment-- share your experiences-- be part of the conversation!
created by @zord189
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Created at 180824 15:19 PDT
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Hi @denmarkguy! We are @steem-ua, a new Steem dApp, computing UserAuthority for all accounts on Steem. Starting from the witnesses, UA propagates from user to user based on its followers until equilibrium is reached. We are currently in test mode upvoting quality contributions with a high UA value (UA_author + UA_post)!
howdy this fine Friday night sir denmarkguy! well sir..you're thinking deeper than I can think right now but I wanted to stop in and show my support!
Darn and I was really looking forward to a more in depth response from you.
Can't get to the top of the engagement league posting long replies XD
I know, right. lol. It may have went above his head but I was ribbing him...lol.
some thoughts
Note: my 'personal physician of many years...quit. He changed his practice from general medicine to trauma. Emergency room and 'after hours'.
Guess why?
If you said 'too many rules' you'd be right.
Funbobby's been wondering where you've been, he's was speculating on who may have powered down during the down turn of steem.
I have been otherwise occupied.
It's merely coincidental that while I was busy doing other stuff the 'down turn' happened.
I suppose Steemit just can't get along without me?
well....at least funbobby...lol, better give him a holler your back.
I would like to chime in on your third bullet point: specialization. Not just in the specialty of the doctor, but also in the vast amount of medical equipment. Your distributed solution is a good starting point, but without central hubs for specialists and advanced equipment, we are going to go back 80 years in technology. No doctor would be able to afford a CT Scan, MRI, or operating room in their offices. No doctor can be expected to be an expert on every field of medicine.
So, you start building those centralized places, and all the expensive big ticket consults and procedures move there. Everything will inevitably follow the money to these profit centers and away from your family doctor's office until you're stuck with... something that looks a lot like what we have today.
People want 2018 healthcare at 1968 prices. Sure we can cut some red tape here and there, but that's never going to appreciably change a thing.
how much does an MRI machine cost today?
how much did one cost ten years ago?
I tried to look this up but the pricing info (as with most major capital expenditures) is very difficult to find and MSRP info isn’t generally published.
That said, I did find this, which is quite interesting and enlightening. http://time.com/money/2995166/why-does-mri-cost-so-much/
The biggest takeaway is that regardless of the model you buy, you’d still need to spend hundreds of thousands of dollars on the room to house it in. Not to mention the salary of the staff to run the machine.
MRI prices fall sharply in markets outside U.S.
odd that..
A lot has changed since 1991, but that is interesting that even back then the US was more expensive than elsewhere in the world.
The health care facilities in our area have teamed up with the county and they run health clinic's together on a sliding scale basis. If your income is to low you don't get charged. They worked together because it was advantageous to both of them, it helped alleviate people using the emergency room for non emergency illnesses and gave the health department a edge on expanding health care with less cost by combining both systems. The system also allows them to share resources available through the health care system to provide low to no cost pharmaceuticals and extensive medical care some people need. From what I have seen from a friend who developed breast cancer who had no insurance the resources provided provided her with a complete recovery and reconstructive surgery of her breast. We now have these clinics on every side of town, pretty much the health department pays for the structure and some support staff while the hospital provides for the health care providers.
This is an interesting approach. The problem with Emergency Rooms being used as primary care facilities is huge, especially among the impoverished. If you don't mind me asking, what country/what part of the country are you living?
Kent county in Michigan. Those clinics are listed under Cherry Street Health Services, they also provide dental care to children and a walk in emergency basis for adults. The adults usually have to show up early, depending on the severity they will be seen if someone doesn't show up for their appointment or by the end of the day or they will get scheduled to come in and take care of whatever the dental emergency is. When I read some of the stuff I read I often think I should write a post about how unique our city really is, there's medical care, dental care, a kitchen where three meals a day are served to the homeless, we have homeless shelters...if it's sub zero freezing outside they make it a priority for cops to go get all the homeless and bring them in, we have several homeless coffee shops that the homeless can sit in during the day and they will provide coffee and donuts, sometimes meals and picnics, we have a mission store if you bring in proof that you receive government assistance you can get a free bag of clothes once a month and they even have a place inside one of the coffee houses that lets the homeless do their laundry.
Heya Denmarkguy, great blog. I made a rebuttal here: https://steemit.com/capitalism/@alex.utopium/economics-of-healthcare
Oh no, how did I miss this post? Healthcare is my absolute favorite public policy topic, and I've given it a ton of thought.
I will save the comment space since I'm late to the and just boil everything down to the two alternatives I have come up with:
Automatic (but optional) enrollment in a public option for Medicare at 18, where insureds pay the full premiums. This is nothing extremely new or original, but I also propose a system of graduated subsidies which ramp up between the ages of 18 and 72, covering 0-95% of the cost of coverage. There could also be a supplemental subsidy that scaled with income or disability. The first two years you come on the plan, you pay full price for your premiums. This would discourage gaming the system.
Universal (free) public coverage for preventative, chronic, and catastrophic care, with a very limited and well-defined list of covered conditions and reimbursement amounts. Optional un-subsidized private coverage market for acute care.
Though if you post again on healthcare, I'll be quicker on the trigger next time!