No Free Lunch in Health Care

There can be no debate that universal health care is a necessity for the United States if we are to survive economically and as a healthy nation. Nevertheless all sides in the argument for how it should be enacted are guilty of misleading statements and inuendos that relegate universal health care in the United States to an unfulfilled dream.
The President: President Obama is protecting his cronies: the Trial Lawyers Association, political hacks, the Democratic Party liberal coalition, the senior citizen vote. Specifically he refuses to acknowledge the huge toll punitive damages takes on the cost of providing health care. His Trial Lawyer Association friends who contribute so heavily to his campaign take 33% of every dollar they get in the courts from malpractice awards. They add millions to the tolls by forcing care providers to defend themselves against frivolous law suits which amount to about 80% of all of the cases filed. They use juvenile arguments to defend their behavior when they sacrifice the health of the majority for the windfall of an unfortunate few.
The President also curries favor with his liberal Democratic faction by promoting unrealistic policies at enormous expense to the American working population. He does not acknowledge that there are only 3 nations in the industrialized western world that pay more taxes than Americans yet he wishes to saddle American citizens with yet another tax without providing for cost savings.
The President allows the Congress to exempt themselves from any bill they pass and he likewise exempts senior citizens from the consequences of any bill he signs despite the fact that he knows that 90% of an individual’s health care costs are spent in the last year of life.
Senior Citizens: 90% of health care costs are spent in the last year of life yet senior citizens continue to demand that they receive any and all health care available even if it means the care provided will only prolong their life for a short duration and even if their quality of life cannot be maintained. These citizens enjoy the greatest prosperity experienced in the world during retirement yet they feel they have no obligation to promote the common good.
The American Medical Association: The AMA endorsed the President’s proposal even though he would not endorse any of the popular physician promoted initiatives because he took the time to address their national meeting. They have only about 1/3 of the American physicians as members yet they purported to speak for physicians and they blatantly ignored the wishes of the majority of physicians. Both they and the President ignore the fact that physician compensation makes up approximately 3% of the health care budget even though every proposal we have read includes reducing physician compensation.
The old adage that you make the bed you sleep in applies.

Mortality of Malignant Melanoma in Europe is 2X United States

I attended the joint meeting of the American Academy of Dermatology and the European Academy of Dermatology last month. The meeting was the first of its kind and the quality was excellent. The setting was Munich, Germany about which I will write in another blog. Suffice it to say that Munich is a beautiful city and the Bavarian people were charming and hospitable.
To me the most startling information that was presented at the meeting was the mortality rate of malignant melanoma in Europe and the United States. Specifically, twice as many people in Europe die after contracting this cancer as compared to the United States. Let me restate this: the death rate from malignant melanoma in Europe is double that in the United States. I sought out Professor Andreas Katsambas, Professor of Dermatology from Athens, Greece for more information. I suggested that the only explanation I could conceive is that malignant melanoma is diagnosed at a later stage in Europe than in the United States. You see, the disease is curable when caught early. And the reason for the delay in diagnosis is that in many European countries socialized medicine does not promote preventive care or even consultations when a patient is concerned with a “changing mole”. This is more of a problem in the Eastern Block countries.
Before you accuse me of being a self-serving wealth-seeking physician consider that: 1) I am a supporter of universal health care, 2) I recognize that the health care system in the United States is broken and often functions below the standards of the industrialized world, and 3) I regard Denmark and France as having arguably the 2 best health care systems in the world. However, I have also experience health care in Sweden; or shall I call it non-health care. I have had 2 close Swedish friends wait up to 18 months for diagnosis and treatment of bone pain which would have been fatal had the diagnosis been bone cancer. I have seen what apathy and antipathy in the medical community does to patient care. And I have heard countless stories of patient complaints being ignored. I have heard from Canadian doctors telling of their dissatisfaction (subject of another blog) and been told of countless Canadians going to Washington and Minnesota for health care.
In short, when the economics of health care is more important than diagnosis, patients get hurt and some of them die. As the United States writhes through its debate on repairing the health care system, availability of diagnostic care should not be debated. When politicians talk citizens lose. The American system suffers from one major abuse that paralyzes the system. Administrative costs are twice that of the rest of the world. Simple as that. Money that should go toward availability of health care goes to bureaucrats. And political bureaucrats are the ones who are going to try to repair the system. I hope they learn from the rest of the world. Reduce administrative costs and universal health care is realistic and preferable as in Denmark and France. Ignore reality, increase costs, relegate providers of care to status below bureaucrats and diseases such as malignant melanoma have an increasing mortality.