My Bag of Squid

.. to kick down the beach. So stand back.

Wednesday, February 02, 2005

Meat Worth

I'm disgusted.

The American HMO system - everyone in it - need to be rounded up and arrested for slavery. They've attached a dollar figure to a human, and that's abhorrent. What right does a person have to better healthcare, just because he makes more money?

I'm going to leverage a handy abortion argument here. Here it comes: how is the child of a wealthy real estate broker entitled to any better health, dental or eye care than the child of a homeless guy living in a car in the alley? No, they have to be equal if truly people are entitled to life and liberty -- and the drawing of a line anywhere between the amount of personal care either is permitted, itself is an act of assigning a value to people based on social standing.

But how do we do it? The health organizations have shown us not only that they cannot manage our health at all, but that the entire idea of bargaining for the care of people is downright disgusting. If everyone is entitled to the same care, then everyone must have decent access to the same procedures as anyone else. There needs to be one HMO, one organization nationally that decides what procedures or drugs are 'in' and which are out. We need to establish a base line to which everything is moved.

Then we need the ability to manage the decisions of this organization: we need the power to say that oral insulin tablets will be covered by this program, and we need the ability to say cosmetic surgery for the disfigured is covered but for the sagging jowls is not covered. We need the ability to vote, yearly perhaps, on which procedures will become covered and which procedures will no longer be covered. Surgery that is not covered completely will require a percentage to be paid by the patient. Such care, however, is always rendered by the same medical system based on fees and percentage-pay numbers chosen by us in this periodic review.

While we set the percentages and fees for the partially covered (and 0% covered) procedures, we need the ability to set the pay received by our medical practitioners. Our doctors and nurses must receive adequate compensation based on their study years, their experience years, by any accident reports, and by a series of reviews and assessments by patients. Two doctors with the same experience, education and assessments will make the exact same amount of money, always. Doctors performing the 'elective' surgery that's not 100% covered by this medical system receive no extra money. They receive no bonuses. Elective surgery must be performed on a first-come basis, since all elective surgery is by definition non-life-threatening, and must be performed at the same rate - with the same wait time - as essential procedures, to ensure that the wait time for any procedure is based on its severity and not its elective percentage.

Claims must be standardized. Any system involving humans will certainly have a mistake here and there, but our system of malpractice suits is far too draining. Doctors need to be subject to internal review like the police, fire department or any other public service which is at risk of injuring people through poor judgment. Every case receives a triaged investigation, and doctors only gain income-altering experience through years of accident-free work.

Finally, the pay for this must be related to one's income. Unfortunately, it's got to be like income tax, but the taxation format should be a percentage that's voted on like everything else: we decide how much of it is funded by federal property tax (which is a cut of your property tax and hopefully low) and income or sales tax on a chosen class of goods (eg gasoline and tobacco). This unfortunately means we need it to be a government organization, as it is a federal welfare plan. It needs to be subject to organizational review and it needs to be run as an open organization on principles and guidelines as much as possible to reduce the corruption that will undoubtedly occur. It's my firm belief that the waste we will see as a government organization can be reduced through the periodic review of its policies, coverage and income tuning, and that bad administrators will be found and let go with far less damage that would be reaped by profit-concerned HMOs.

Anyone who can ensure equality in health care, access to essential services which we decide are essential, a responsibly well run and funded organization that pays its people a tough but very fair wage is encouraged to revamp this model into something better.

Stop treating people based on their net dollar worth. Humanity is a common resource, and we must not squander it or abuse it.

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