Slashdot Mirror
The New National Health Plan Is Texting
theodp writes "With a gushing press release, Federal CTO Aneesh Chopra announced the launch of Text4baby, 'an unprecedented mobile health public-private partnership' designed to promote maternal and child health. Expectant women are instructed to 'Enter the date of the first day of your last menstrual period' to start receiving 'timely and expert health information through SMS text messages' until their child reaches the age of 12 months (limited to 3 free messages/week). The White House Blog has more information on the 'historic collaboration between industry, the health community and government.' Separately, the White House announced plans to spend $3,000 on 'Game-Changing' Solutions to Childhood Obesity. Once again, Dilbert proves to be scarily prescient."
I can maybe answer some of that.
Having lived in countries with national health care systems (someplace in Asia), with private insurance (US), and with no insurance at all but low prices (some other palce in Asia), I have found the highest level of care by far to be in the United States. The worst care, by far, was in the place with no insurance but cheap prices. In most hospitals there, if you're not bribing the staff (and thus raising the price), you'll get almost no care. The place with a national health insurance system was a middle case. Primary care and ob/gyn care is reasonably good (but not as good as the US; our first child was conceived in that country but born in the other place in Asia) and the co-pays were roughly price-equivalent to the US. Hospital stays there, however, fall far short of what you get here. I spend a week in the hospital there, and it was most unpleasant. The national health insurance only paid for a bed in a six-patient room and I was surrounded by people who were far sicker than I, with all the noise, smells, and potential cross-infection that goes with that. The equipment was lousy (I couldn't even get an IV tree with wheels; I had to carry the thing to the communal bathroom; no in-room bathroom or shower). The nursing care was fair, and the food was disgusting. I lived off the convenience store in the basement and a pizza a friend brought me.
Do I want the US health care system to become like the middle case I described? No way. We're way, way better than that now. My wife, who is from one of those other places, agrees that our quality of health care is the best. Going to a national insurance system will probably pull that quality down.
What, then, do we need to fix? A few things:
1) Fix the extremely hostile and litigious malpractice lawsuit industry; it's a major factor in what makes health care and insurance so expensive here. It desperately needs reform. And by "fix" I mean that it needs to be far, far harder to sue someone for malpractice, that you need to really prove they fucked up hugely, along the lines of something that could cause a license suspension or revocation.
2) The way health insurance companies can screw people by doing things like declaring a pre-existing condition uncovered, charging people who actually get sick and use their insurance more money (it's supposed to be a shared risk pool; everyone should pay the same).
3) Get better standardization of forms, etc., so it doesn't cost doctors so much to deal with health insurance. The best thing about the country with national health insurance is that doctors easily knew where they stood and didn't need to employ one or more insurance specialists.
4) Use the forms in points 1-3 to make health insurance cheaper and available to all. Subsidize the cost with tax credits for people who are low income if you have to.
That's how we need to reform health care. What we definitely don't need is national health insurance.
What's so scary about a national health insurance system? To *really* fuck something up requires a government. The US government, in particular is very good at that, and is also very good at ridiculously underestimating what something will cost (or more likely, lying about it). One thing is for certain: spending 100 dollars on government health care will most certainly not get you better health care than spending 100 dollars on private health care. The government never, ever does things better and cheaper. Typically, it's both worse and more expensive.
Government is rarely the solution. More government is even more rarely the solution. Mostly, government is the problem. Sure, we have improvements to be made, but a huge, bloated and expensive government health care bureaucracy isn't the way to do it.