Sunday, September 28, 2008

Debate... give me my 97 minutes back please.

Did anyone else think that watching the debate Friday was a HUGE waste of time. McCain is creepy with his slow-progressing points and awkward facial expressions. It pained me deeply every time I had to watch him try to hold in laughter while Obama was speaking. Then there's Obama who kept on going "" like some doofus (isn't he supposed to be the literate one?). McCain should have blown Obama out of the water being the self-proclaimed foreign affairs specialist and Obama was weak as heck on the economy something I was led to believe he was strong in (I guess that's the problem with "believing" in a candidate). Now I am no political genius, just your average schmuck, but I am embarrased to say that those were our best two candidates Friday. Neither one was impressive and neither one has won my vote yet.

Leia Mais…

Friday, September 26, 2008

Meditation XVII by John Donne

PERCHANCE he for whom this bell tolls may be so ill as that he knows not it tolls for him. And perchance I may think myself so much better than I am, as that they who are about me, and see my state, may have caused it to toll for me, and I know not that. The church is catholic, universal, so are all her actions; all that she does, belongs to all. When she baptizes a child, that action concerns me; for that child is thereby connected to that head which is my head too, and ingraffed into that body, whereof I am a member. And when she buries a man, that action concerns me; all mankind is of one author, and is one volume; when one man dies, one chapter is not torn out of the book, but translated into a better language; and every chapter must be so translated; God employs several translators; some pieces are translated by age, some by sickness, some by war, some by justice; but God's hand is in every translation, and his hand shall bind up all our scattered leaves again, for that library where every book shall lie open to one another; as therefore the bell that rings to a sermon, calls not upon the preacher only, but upon the congregation to come; so this bell calls us all: but how much more me, who am brought so near the door by this sickness.

There was a contention as far as a suit (in which, piety and dignity, religion and estimation, were mingled) which of the religious orders should ring to prayers first in the morning; and it was determined, that they should ring first that rose earliest. If we understand aright the dignity of this bell, that tolls for our evening prayer, we would be glad to make it ours, by rising early, in that application, that it might be ours as well as his, whose indeed it is. The bell doth toll for him, that thinks it doth; and though it intermit again, yet from that minute, that that occasion wrought upon him, he is united to God. Who casts not up his eye to the sun when it rises? But who takes off his eye from a comet, when that breaks out? who bends not his ear to any bell, which upon any occasion rings? But who can remove it from that bell, which is passing a piece of himself out of this world?

No man is an island. entire of itself; every man is a piece of the continent, a part of the main; if a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friend's or of thine own were; any man's death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bell tolls; it tolls for thee.

Neither can we call this a begging of misery, or a borrowing of misery, as though we were not miserable enough of ourselves, but must fetch in more from the next house, in taking upon us the misery of our neighbors. Truly it were an excusable covetousness if we did; for affliction is a treasure, and scarce any man hath enough of it. No man hath afflicion enough, that is not matured and ripened by it, and made fit for God by that affliction. If a man carry treasure in bullion or in a wedge of gold, and have none coined into current moneys, his treasure will not defray him as he travels. Tribulation is treasure in the nature of it, but it is not current money in the use of it, except we get nearer and nearer our home, heaven, by it. Another may be sick too, and sick to death, and this affliction may lie in his bowels, as gold in a mine, and be of no use to him; but this bell that tells me of his affliction, digs out, and applies that gold to me: if by this consideration of another's danger, I take mine own into contemplation, and so secure myself, by making my recourse to my God, who is our only security.

Leia Mais…

Monday, September 8, 2008

A Different Shade of Gladwell

So I decided since the last article I posted was 8 years old that I would see if Malcolm Gladwell has written more recently in regards to health care. He has and he's flip-flopped! He decided that his previous arguments made with Adam Gopnik were based on the money put into the health care system, i.e. funding problems rather than systemic problems. I really respect Malcolm Gladwell's opinion because his book The Tipping Point really changed the way I think. I want to post a link to his blog stating his current (still 3 years old) opinion on this issue. He says our government blocks any attempt to socialize our health care system (there have been about 6 attempts so far) because of what is called "moral hazard." The idea here is that if people have insurance for something they tend to use it more frivolously thereby adding inefficiency and waste to the current system. He disputes moral hazard using logic, case studies, and statistics. Here is a link to the post: The Moral Hazard Myth

Also, in response to my first post on SiCKO, my cousin Brad proposed the possibility of using an actuarial system analogous to car insurance to help move past our current dilemma. I thought that was a very novel idea. Gladwell addresses this idea. I thought what he said was interesting so I'll cut and paste it here:

"There is another way to organize insurance, however, and that is to make it actuarial. Car insurance, for instance, is actuarial. How much you pay is in large part a function of your individual situation and history: someone who drives a sports car and has received twenty speeding tickets in the past two years pays a much higher annual premium than a soccer mom with a minivan. In recent years, the private insurance industry in the United States has been moving toward the actuarial model, with profound consequences. The triumph of the actuarial model over the social-insurance model is the reason that companies unlucky enough to employ older, high-cost employees—like United Airlines—have run into such financial difficulty. It's the reason that automakers are increasingly moving their operations to Canada. It's the reason that small businesses that have one or two employees with serious illnesses suddenly face unmanageably high health-insurance premiums, and it's the reason that, in many states, people suffering from a potentially high-cost medical condition can't get anyone to insure them at all.

Health Savings Accounts represent the final, irrevocable step in the actuarial direction. If you are preoccupied with moral hazard, then you want people to pay for care with their own money, and, when you do that, the sick inevitably end up paying more than the healthy. And when you make people choose an insurance plan that fits their individual needs, those with significant medical problems will choose expensive health plans that cover lots of things, while those with few health problems will choose cheaper, bare-bones plans. The more expensive the comprehensive plans become, and the less expensive the bare-bones plans become, the more the very sick will cluster together at one end of the insurance spectrum, and the more the well will cluster together at the low-cost end. The days when the healthy twenty-five-year-old subsidizes the sixty-year-old with heart disease or diabetes are coming to an end. "The main effect of putting more of it on the consumer is to reduce the social redistributive element of insurance," the Stanford economist Victor Fuchs says. Health Savings Accounts are not a variant of universal health care. In their governing assumptions, they are the antithesis of universal health care.

The issue about what to do with the health-care system is sometimes presented as a technical argument about the merits of one kind of coverage over another or as an ideological argument about socialized versus private medicine. It is, instead, about a few very simple questions. Do you think that this kind of redistribution of risk is a good idea? Do you think that people whose genes predispose them to depression or cancer, or whose poverty complicates asthma or diabetes, or who get hit by a drunk driver, or who have to keep their mouths closed because their teeth are rotting ought to bear a greater share of the costs of their health care than those of us who are lucky enough to escape such misfortunes? In the rest of the industrialized world, it is assumed that the more equally and widely the burdens of illness are shared, the better off the population as a whole is likely to be. The reason the United States has forty-five million people without coverage is that its health-care policy is in the hands of people who disagree, and who regard health insurance not as the solution but as the problem."

Please respond with any additional insights, any differences in opinion, etc. and help move this discussion forward. I am still far from coming to any sort of conclusion on the matter.

Leia Mais…

Sunday, September 7, 2008

Positives of Our Health Care System

I just read a debate between Malcolm Gladwell (Tipping Point, Blink) and Adam Gopnik., both are writers for The New Yorker. Each has lived in Canada giving them first-hand experience with the system put in place there. I sided with Gladwell in this debate. He favors our system. This may seem inconsistent with my previous posts, but keep in mind I'm still molding my opinion. How I start thinking isn't always how I end up, I love that about learning :-). Anyway I'll cut and paste my favorite point Malcolm Gladwell made and link you all to the article which shows up in Washinton Monthly published in 2000 (sorry it's a little old, but still very relevant and insightful).

said Gladwell:
"If you look at the level of medical innovation in the world in the last 25 years, virtually everything comes from America. Absent America, medicine in the world is in the dark; it is retarded; it is at a level that all of us would find unacceptable. What is happening right now is that all these cheap single-payer systems are essentially poaching. They are cherry-picking off the American system. The American system is pumping money into research, has got this free market system which is incredibly dynamic and incredibly innovative. Everyone else just sits back and cherry picks all of the things we come up with. What happens if there's no America tomorrow? What happens if we junk our system? Where does medical progress come from? "

"I would like to say as my closing comment that what impresses me most about health care is the extent to which more is going to change around in medicine and health care in the next 15 years than changed in the last hundred. I think, for example, the hospital as we know it is dead. I think that drugs become infinitely more important in the next 10 years than they've been previously. All kinds of diseases are going to be transferred from the surgeon to the pharmacist. What I'm most concerned about is what kind of health-care system is the most flexible, the most willing to deal with these changes, the quickest to adapt to them, the most innovative. To me, it's an open and shut case that single-payer systems are extremely inflexible. That is a great cost. The Canadian system has been very slow even to catch up with the change in the last 20 years. And I worry that if we were to move in this country towards piecemeal social engineering we would in some way compromise the system's flexibility at a time when, to me, the most important thing in the next 15 years is going to be flexibility.

We're about to figure out the human genome, for God's sake. Everything hinges on the speed at which we are able to adapt and bring to market that sort of knowledge base. I'm just terrified of tinkering with such an extraordinarily dynamic system at a time when dynamism is, to me, the paramount. I mean, this is the crux of our disagreement. You're impressed with what the medical system is now capable of providing. I am, on the contrary, impressed by what the medical system has not yet provided. And that's why I favor a system that is, for all its faults, incredibly dynamic; and you favor a system that, for all its faults, is incredibly good at delivering the status quo."

Read the complete article (it's lengthy): Canada Vs. U.S.

Leia Mais…

Friday, September 5, 2008

Follow Up On Universal Health Care

I decided to post a few clips from SiCKO that I found particularly moving and thought provoking. I still suggest watching the documentary in its entirety to get the full effect that moved me. I want to make it clear however that I am not an advocate of universal health care. I am simply an interested citizen, curious about what the future of health care can potentially become here in the U.S. My opinions are still undeveloped. These posts are simply thoughts to put on the table. Your feedback is very helpful if not critical to helping me see both sides and form an opinion.

Here's a doctor in London who is extremely satisfied with their system.

Here's an interesting confession .

Interesting words of Tony Benn

There's a few other concepts portrayed in Moore's film but I can't find them on youtube. One is an interview with a room of Americans living in France talking about how they almost feel guilty that they enjoy benefits (5 weeks payed vacation a year, 6mos paid maternal leave, health care, etc.) that their parents in the U.S. have worked their entire lives and have yet to attain completely.

These clips and the movie overall was persuasive, BUT it so so obviously bias that it almost makes a thinker like myself sick. It shows the worst sides of american health care and portrays a utopia-type atmosphere elsewhere. I'm positive that universal health care has its flaws just like any other man-made system (man-controlled) and I intend to do more research. I just want more substantial/reputable sources, right now its just Michael Moore v. Fox News.

Here's two clips opposing Moore's video:

Also here's a speech by President Ezra Taft Benson on Socialism which my cousin Brad sent to me which I found to be extremely insightful. I STRONGLY suggest reading it:

Leia Mais…

Tuesday, September 2, 2008

Universal Health Care

My wife and I watched Sicko yesterday. As many of you know I am a year and a half away from starting medical school, so the state of our health care here in America is of utmost importance in my mind. Michael Moore presents a very bias documentary of health care horror stories here in America and the lack problems with foreign health care systems, everywhere from Canada to Cuba (he didn't seem to show lower class citizens in other countries). Despite the obvious flaws and holes in Moore's reasoning and research, I was left wishing we had universal health care here in the states. The doctor's in France seemed well off (one of my worries is working for the gov't), happy, and successfull overall. They couldn't dream of working in a system where they would have to turn away sick people because they didn't have insurance to cover the cost. I shudder at the thought of myself in the future being forced to stay my hand in healing those I would be capable of healing, in Christian terms burying my talents. The driving force behind my career path is service, to be a self-less physician. Will insurance companies and hospital administrations deny me of this goal? Is the only reason we don't have universal health care here in America because, as Moore said, propaganda against other countries (the French) and fear of change, fear of socialism? Is the idea of a self-less physician the core principle of social healthcare and an impossibility in the U.S.? Maybe I should move to France.

I guess the purpose of this post is to get more of the story. After watching Sicko I am ery moved. Anybody with any other insights on the matter wither for or against universal health care (especially the plans of Hillary or Obama), your thoughts are encouraged.

Leia Mais…