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Health Care Basics: To Use, Rub Gently Into Noggin
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| Copyright: | Unknown | | Source: | Lewiston Morning Tribune (ID) | | Wordcount: | |
Jul. 2--Effective health care reform begins with a good moisturizing cream.
President Obama may never utter those words, but the truth was revealed to me while hiking up to the Clarkston "C" this weekend.
I had a number of health-related thoughts during the hike. I wondered if I'd lost my mind. I wondered how many heart attacks it's possible to have without actually dying. I considered hacking up a lung, and wondered if my health insurance covered hillside rescues or if I would have to roll all the way back to the bottom before getting any medical attention.
The moisturizer revelation came later that afternoon, when I crawled home and noticed a lobster in the mirror.
Sunscreen certainly falls into the category of preventative medicine -- and I admit, a dab or two before the death march may have been wise. But it's so unmanly. It's like asking for directions. You completely miss out on the sense of accomplishment that comes from doing things the hard way.
Moisturizer, on the other hand, shows just how confident you are in your manhood. When you're young and insecure, you wouldn't be caught dead using the stuff. You'd rather peel and look like a freaking lizard shedding its skin. A few decades of that, though, and you realize a cool, soothing lotion won't make you forget the proper position of a toilet seat. It should be a standard part of every guy's do-it-yourself medical kit, along with bourbon, aspirin and monofilament fishing line.
Modern health care has advanced far beyond the do-it-yourself stage, of course. Now, health care is a public endeavor. The industry, like your mother, encourages you to exercise and eat right, get enough sleep and make healthy choices -- but once you get sick, doctors will do everything they can to help, no matter how much of a booby you've been. Moral judgments about your lifestyle seem to take a back seat. They may lecture you about the dangers of obesity or smoking, but they don't restrict treatment just because you were irresponsible or made bad decisions.
Years ago I had a co-worker whose father died while waiting for a liver transplant, in part because there were too many people ahead of him on the transplant list. Some of those were heavy drinkers who destroyed their own livers, but doctors didn't take that into consideration when deciding who was most in need. I'm OK with that. I think I'd be OK with it even if it were me or my father waiting for a liver. I don't want doctors pronouncing judgment on my life before deciding the best treatment option.
But when it comes to paying for those treatments, should personal responsibility or cost-benefit play a greater role?
Congress is currently debating several health care reform bills. It's unlikely any of them will reduce taxpayer support for programs like Medicare and Medicaid. Most will increase the overall public cost, possibly by $1 trillion or more over the next decade.
If that's the case, should taxpayers demand that their dollars not be "wasted" on people who don't take responsibility for their own health? If we're picking up the tab, should we cap benefits for people who don't eat their vegetables or go to the gym, who think pizza is health food and whose idea of aerobic exercise is blowing smoke rings? While we're at it, should we reconsider elder care? My 86-year-old aunt broke her back and ankle in a car accident while driving herself to dialysis treatment. She had surgery to fix her ankle the day before she died. Taxpayers paid the bill. No one wants their loved ones to suffer, but was that the wisest use of public dollars?
These are uncomfortable questions and I don't have the answers, but it disturbs me that Congress is ducking this issue rather than making it the core of the reform debate. If we cannot say no, if we provide unlimited treatment even for people who make bad choices or when it won't improve someone's quality of life, how can we ever bring rising health care costs under control?
The capitalist system functions as it does because consumers are free to allocate their financial resources as they see best; fewer resources result in fewer choices and/or more efficient spending in other categories. Yet to a large extent, Americans have been unwilling to use this model for health care -- we don't want to deny someone treatment simply because they can't afford it.
But with health care reform, we're now talking an expanded cost to taxpayers. If we are unwilling to limit expenditures because people can't afford treatment, or because treatment is "wasted" on them, or because they're too old to benefit, then what's left? Without some boundaries to what the public will pay for, why would anyone think Congress can fix this problem?
Skin lotion seems a much easier solution.
Spence covers politics for the Tribune. He may be contacted at bspence@lmtribune.com or (208) 848-2274.
This is a news service of Thomson Business Intelligence Service ©2006. This content is for your personal use only, subject to Terms and Conditions. No redistribution allowed.
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