I have to confess that I have severe doubts as to some of the proposals being made in here, to reduce health care costs.
Many of them seem too simplistic, if not outright impossible. "Just mandate that insurance companies must charge lower premiums, and pay a higher share of the costs, without reducing coverage."
Now, I do have a feeling that there may be ways to reduce at least some costs. but I feel like some of them will require huge attitude shifts. on society as a whole.
A decade or two ago, I head a report about a study somebody had dome. I'm going strictly by memory, and have no link to any such study whatsoever. So let's just call it a hypothetical, and pretend that I'm making it up. Just assume that what I remember, is true.
The study looked at four expensive but common medical procedures. One of them was cardiac bypass surgery, I forget the other three. They took all of the patients who's doctor recommended cardiac bypass surgery, and divided them into two groups: Those who had the procedure, and those who chose not to have it.
And they looked at their survival rates, which the study defined as "how many of the people, in each group, are still alive, five years later?"
And in three of the four procedures they looked at, having the procedure did not increase the odds of the patient being alive, five years down the road. Their odds of dying were the same, whether they had the procedure or not.
So, let's just assume that what I remember is actually true. Let's assume that cardiac bypass surgery does not actually improve the patient's odds of being alive, five years from now.
Should we, as a society, at least consider the possibility that maybe we shouldn't have a system where other people pay for that procedure?
I know, it's certainly easy to demonize a decision of "well, Uncle Joe needs cardiac bypass surgery, or else the odds are he may have another heart attack. but this big entity (government or an insurance company) isn't going to pay for it. And you can't. So, you're not going to get it."
What about the patient who's been in a nursing home for the last two years? She can't speak a complete sentence. (Although does sometimes appear to understand sentences.) Can't stand. Can't feed herself. Has to be changed, every few hours.
Does it really benefit society (or the individual, for that matter) to pay for her to live in a nursing home for five years, waiting for some medical condition to come along that will eventually end this? What is anybody actually getting, for that money?
But what's the alternative? Kick her out and let her die in the street? 'Good morning, Mrs. Smith. you've been here nine months, today. The nurser will be in shortly with your ,mandatory euthanasia."?
The current system, I feel like, isn't right. But I'm not at all sure that I see a path to a better one. How do you get to a better world? (Especially when I'm not at all sure that I can even say what that better world is.)
Part of me really wishes that we, as a society, would decide that maybe we need to relax some of the phobias we have against things like hospice, and I think things like suicide, and even physician-assisted euthanasia.
Apologies for the probably morbid view.