Tuesday, July 10, 2007

Yes, it's Sicko, but getting better may be no cinch...

I hold no brief for our current health system. Big pharma, big medicine, the profit motive, all well deserving of the many criticisms coming their way.

However, it is extremely naive to believe that nationalized medicine somehow means we have left individualism behind for dedication to community, and now share a commitment to take care of each other. Oh, it may have started that way, and many good people serving in the system still want it to be that way.

But faced by the proliferation of possible and exponentially expensive treatments, the motive of nationalized health services in many countries has become a dedication to care, strangely admixed with, and often trumped by, a governmental demand to cut costs.

It's not a profit motive, but the demand to cut costs can have strangely similar effects to those with which we are familiar in our profit-making system.

(Well, only partly profit-making after all. It is illegal for me to sell my kidney, though everyone else who handles it, from the doctors and nurses who take it out to the folks who carry it, and those who put it in someone else, will happily take their profit. Only I can not. Weird.)

The result for individuals of cost-cutting nationalized systems can be very similar to what we know. And even, perhaps, worse.

I know, I know, we want to keep the argument pure, and not, as someone said, "get bogged down in details of how other systems work", but the devil, as they say, is in those details.

If we still lived in England, my beloved husband would absolutely, certainly be blind, and probably be dead. He would be blind because NICE, the body who decides which drugs, already approved for use by the British equivalent of the FDA, can actually be used by anyone in the NHS. And none of the treatments which have saved my husband's sight are approved for use. It is considered that, since those who would have these treatments are elderly, and they are fairly expensive, it's a waste of money on those who will be dead soon anyway. So no go. There are thousands of people right now going blind in England and Wales for lack of the treatments my husband has been able to have here. And his heart condition was treated aggressively and he was home within 45 hours of diagnosis. This might have happened in Britain, too, though our good friend with a very similar diagnosis had to wait 6 months for treatment and only got it then because the fellow scheduled for that day had died.

Yes, our system needs to change, and yes, this is a religious issue - life and death, hey, isn't that our topic? - but please do not get too dewy eyed that a change will eliminate cost concerns. As I write, in England there is debate over the decision of several regional health authorities not only to have an automatic no resuscitation order on anyone 65 or older regardless of their health otherwise, but to prohibit surgery on all ages of smokers and the obese (as those groups have lower success rates) - again, ignoring the overall health of any individual concerned.

Heaven is harder to get to than one prayer.

1 comment:

Will said...

Very good post, Juffie.

My take has always been that tho we definitely have probs now, I wouldn't want a trip to the doctor to be the same experience I get at the post office or dept of motor vehicles. Or the treatment that victims of Katrina got. Service in the private sector is always better than from a government monopoly.

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