Saturday, August 15, 2009

Uncle SamCare

End-of-life consultations. Apparently Sarah Palin's "death panels" worried congress sufficiently enough that the end-of-life chitchat has been removed from the Obama health care plan. The consultations, supposedly, were to pay physicians who "provide information about living wills, health care proxies, pain medication and hospice." Don't we already do this? For years, everyone I know who lived on borrowed time, was offered, or their family members offered, info on all of the above.

I don't think Obama's end-of-life consults are about euthanasia per se - they may be close. But why pay a physician to provide end of life information he should be providing already? Under such a health care clause I'm sure every nursing home resident will have a consultation charged to the taxpayer. The number of institutionalized patients grows as the baby boomers age. Alternatives to nursing homes are booming industries - the assisted living and/or supervised adult day care, although these seem to be only delaying the inevitable ride to the nursing home, if and when 24/7 care is needed.

As the obesity epidemic continues, and its subsequent health problems, patients needing end-of-life consults will be younger and sicker. Remember too, anytime the government pays for a service, we see more "need" for that service. The "plan" may not encourage "euthanasia" but I would bet many of the methods/procedures that keep semi-comatose pain-wracked patients breathing will eventually be strongly discouraged by medical professionals and institutes; it's happening already.

Personally, I don't have a problem with euthanasia for myself, as I prefer quality of life over quantity. If anyone ever has to change my diaper and turn me over - shoot me, call it mercy, enroll me in the Hemlock Society End-of-Life Choices, an organization originally formed in 1980. Hmmm... end of life consultations ... end of life choices ... are there hemlockers in this administration?

One good thing that might come out of BarryCare is "rationing." Rationing is adamantly denied by supporters but anytime anything is distributed equitably - it has to be rationed, unless you have an endless supply of geese laying golden eggs. It's Biblical to believe you can take a certain number of loaves and provide equally to all. "Rationing" could be a good thing in that most folks will be forced to stop trips to emergency rooms and doctor offices for the common cold and headache, demanding antibiotics and pain pills. And if there's a god perhaps all those lazyass parents with badass kids will be forced to parent rather than doping Little Johnny to sit still and focus.

And all you fakers - your days are numbered. No more OxyContin for "chronic pain" or benzodiazepines for anxiety - getting buzzed at taxpayer expense may finally be curtailed - or you'll have to buy them on the street. But then again maybe not - a buzzed populace is more docile and PhRMA is backing BarryCare. In their own words, with everyone covered, there will be more sales "volume." And according to PhRMA's main man "... we’ve been able to add nearly 10 years to the average American life over the last 50 years ... we’re doing better at turning once-deadly conditions into medically manageable, chronic conditions.

Chronically ill for at least another decade - woo hoo. Reality check: Our lifespan will drop, is dropping, as obesity and sedentary lifestyles create major health problems at a younger age. Obesity is the new disability.

Where is Obama on better nutrition and preventative care? Absent. Current thinking considers screening and vaccinations as "preventative." It's not. And with 60+% of America obese or overweight it's obvious nutrition and prevention have never been major players in health care reform. Nutritionists are available now, but a trip to Wal-mart will show folks are not looking to nutrition and exercise to reduce those aisle-wide lumbering butts in stretch pants, or spilling over the seat of a motorized shopping cart.

Obama swears we have the money to cover all Americans. No one seems to have a concise idea of where the money will come from, other than rationing and cuts in other programs, but these ideas are pooh-poohed as irrational fears.

Savings could be found in doing away with defensive medicine, which some cite is as much as 10% of medical care, or $240 billion a year. Defensive medicine, the billions wasted on tests and procedures, is done primarily to protect Dr. Quackendamage against liability. But then "trial lawyers" might have a say about any legislation to do with liability caps, or have spoken already as there is no tort reform mentioned in Obama's 1000 page health care reform. Some states are enacting laws on this - so if you make your living from medical lawsuits you'll have to shop for which state is best suited for suers. And I hope you don't mind another deduction from your paycheck, or reduction in that tax refund to cover your share of Uncle Sam Care.

Women may find ObamaCare a plus - if the US follows the path of the old USSR health care. Under the structure of the USSR's medical-coverage-for-all, the majority of physicians were female.

Medical technology and hospital conditions under Soviet collectivism were wretched and doctors did not have the exalted status in Russia that they enjoyed elsewhere; to be a doctor in the USSR was largely perceived as drudgework. Job openings for physicians tended to be filled by women because, frankly comrade, men didn't want the job.

Nor is Michael Moore's Cuba a healthcare utopia. Haven't seen Sicko but Cuba's health care system is a disaster for patients and physicians. Earning an average 400 pesos per month (equivalent to $20USD), many doctors quit the profession and seek jobs in the only industry that offers any chance for economic opportunity and access to dollars - ­ the tourism industry. Doctors can be found driving ragged taxis, acting as tour guides, or working in family restaurants as waiters and cooks. Or they volunteer to work in Venezuela, Nicaragua, Bolivia and promptly seek asylum to the US. Like I said, I don't know if Moore showed the downside of Cuban health care - but bet he didn't. Did he mention that most physicians in Cuba offer treatments and drugs under the table? (Don't accept a B12 feel-good injection in Cuba, it's much more than a vitamin.)

Seems the M.O. for left/progressives these days is replacing a flawed system with a failed one.

Not to worry though - if the government has its way with us and can stop those townhall mobs, we're going to get all the "reform" we can stand and then some. Reform will widen the class division even more - the wealthy will buy the best care in the world if they want. Federal and state employees, congress, pols, and such will continue their preferred health care at our expense, and corporations who can will use private healthcare packages to attract the best and brightest - honest to god I remember this being practiced in the 1960s, '70s, and early '80s - it was called company provided workers benefits - that was before Big Business had a bottom-line lightbulb moment whereby Big Government could cover the medical costs of the peasantry. Big Business has accomplished much of that in the last 25 years.

But, aside from all that, don't we want to keep up with Beijing? "The Chinese government is hoping that if the country's social safety net is stronger, its people will feel secure enough to spend more, which is badly needed to help offset the global demand slump. Beijing wants to expand basic health coverage to most of the population by 2011 and it is willing to spend the billions needed to do so. Leaders are betting that the ambitious program will help stave off social unrest, as the country slows to its weakest pace of growth in seven years."

You see Bubba? The Government is betting on it. Finally, we will feel secure, spend more, cure global slumps, and Government can stave us off - better living through better chemistry. Hooyah.

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