Thoughts on states’ rights, resource allocation, and why Iowa is a little slice of heaven.
If government is the answer, just imagine how stupid the question is. George Orwell was correct when he commented: “In a time of universal deceit, telling the truth is a revolutionary act.” Disinformation – or non-information – is everywhere. Most 24-hour news is 24 hours of crap.
Last week, in American Medical News (a well-known radical journal), a report was published that looked over the health statistics of the “Gang of Seventeen.” These are the seventeen Western democracies that we tend to view as the “civilized world,” and with whom we are constantly comparing ourselves. Get the piece. Read it. Study it. It is both frightening and illuminating. Not only do we have the most expensive healthcare in the world by more than double our nearest competitor, but also the worst results. Male longevity: 17th of the 17 countries. Female longevity: 17th of the 17 countries – although women do live slightly longer than men. Infant mortality? Again, we’ve taken the bottom of the barrel. Need we go on here? We are led by people who think that by calling it the “Affordable Care Act” we would all be dumb enough to think it had something to do with health or care. Nothing could be farther from the truth. This is a massive effort to avoid looking at the causes of life, death and transfiguration. This is political-speak in the extreme. It’s like Stalin telling his people they were building the Great Society. Or was that Lyndon Johnson? Geeze, I’ve forgotten.
So, who is leading this peripatetic healthcare parade? What are the harbingers of collapse, and how do we now move to rectify the problem? First, we need to ask where this problem has come from. Most who have recently held or now hold leadership positions are the descendants of the “greatest generation.” Remember those poor people who lived through the Great Depression and fought the Second World War and built the country? They gave to their children everything but poverty. And that’s too bad because they needed a little poverty desperately. They are the snot-nosed kids who got everything they wanted – like top flight educations – and never really asked where the money came from. Most of them couldn’t use a wrench or a screwdriver if their life depended on it. So, now the progeny of the Greatest Generation – which has taken the field and believes it’s running things – want to “do what they think is right.” You mean we have to make choices? You mean we can’t create our own reality? You mean we can’t get a degree in primal scream masturbation and its influence on progressive deconstructionism and expect to get a job on the way out the Ivy-shrouded doors?
Our generation – and I include myself – really only had one motto: Nothing succeeds like excess. The concept of being concerned about caring for the young in a realistic, substantial way and caring for the old by taking them back into our homes never really dawned on anyone until now. Funny thing: If you hang around long enough, you get old. Now these issues are staring us in the face. We are looking down the barrel of policies and concepts which substantially have forced those of us in the United States to deal with one factor: The dependency ratio. The relationship between those pulling the wagon and those sitting in the wagon of economic recovery has now fallen to below two. This is a number which economists have long anticipated would precipitate some serious calamity. The real question we are asking as we consider these numbers is: Can they actually be correct? Who’s going to take care of us, and why can’t we have all the healthcare we want, even if most of it doesn’t work? Americans have been cowed and manipulated by meaningless non-science. If we can put men on the moon, why can’t we fix grandma? Oh, if only it were that simple.
As an aside, I would like the readers to now take one minute and decide how they want to die. This is an important question since you are going to die at some point in time. How much should it cost and who should pay the bill? None of these issues were contemplated in the Affordable Care Act, and now it’s coming home to roost. We are now told, the way the Act it is currently constituted, the cost was underestimated by at least 40%. What are we going to do about this? There seems to be a total abandonment of the entrepreneurial spirit that says: “We can do it better, cheaper, faster and smarter.” As soon as “big government” gets involved, no one seems to care. Backing up the report in the American Medical News was the March 2012 publication by the Commonwealth Fund. For those of you unaware of the Commonwealth Fund, understand that its only job is looking at what can make this a better country and world. Get a copy of this report and study it carefully; it is the principle basis on which healthcare will go forward over the next few years. They have rated healthcare in America by 43 different aspects. They’ve divided the country into 306 regions (i.e. groups of populations) for study purposes.
Let’s take a look at the study. It’s amazing how often Dubuque, Mason City and Iowa City come to the top of the list. They are almost the lowest in cost and best in outcomes in healthcare in the United States. Of the big cities, why should Minneapolis and St. Paul be so high in both quality and low in cost while Miami is exactly the opposite? Why should it cost three times as much for a senior to get healthcare in Miami, Florida? No one raised these issues during the healthcare debate, and quite frankly, it is not only killing our seniors, it is killing our children and their future. Top of the list for quality? Green Bay, Wisconsin. Down at the bottom? Houston, Texas. And Houston has a lot more doctors per person than Green Bay. Maybe it’s the cold weather in Green Bay. All the bugs are killed in the winter so you don’t need antibiotics. It’s hard to know, isn’t it?
The Congress of the United States is afraid to turn things back to the states. America is not a homogenous culture. We have regional differences. Why do you think that hardworking, fiscally responsible and healthy citizens of South Dakota should sub-fund the non-intelligent and nonproductive healthcare of Miami, Florida? If Miami actually had to pay its own healthcare bills instead of stealing money from Montana, they would be forced to raise the amount they pay or look for some innovative way to change their behaviors.
In 1960, when I was in 8th grade, I took my first combination economics and government course. I remember vividly the pie chart on federal spending for the year 1960. Defense constituted 52 percent of all federal spending. Today, that number is between 19 and 20 percent, depending on what you count. Defense will be number three this year in the federal budget for the first time in the history of the United States. Entitlement programs, which include Medicare, Medicaid and Social Security (not including federal retirement benefits) will be number one. Close behind, at 20 percent, will be the interest on the national debt. That’s right. For the first time in our history, since the first shot of the Revolutionary War, we as a people will be spending more on the interest of our largess than in defense of these shores.
Doctors were once known as “can do” people. We are now known as “can’t do unless we have fifty more tests” people. Physicians have the destiny of the union in their hands. We are the big ticket item and we need the moral fortitude and courage to occasionally say “no more” to minimally effective medications and useless end-of-life therapies.
I know that you’re thinking: “I’ll do the right thing when they put the lawyers in cages.” Is the current medical/mal system broken? Yes. Move on. Does that mean we can blame everything on the lawyers? No. We are complicit in this problem and must accept the fact that we have totally disregarded our job and stewardship of the resources of the United States. Until we get the system we need, just remember that we win most of the time in court. If you’re going to get sued, at least get sued for doing what’s right.
Pro bono publico