Wednesday, March 25, 2009

Government Healthcare: Let's Review.

Sometimes it's good to take a step back when considering a big decision. There are lots of things I would like. I'd love a bigger house, for instance. I imagine how nice it would be. I can see myself entertaining my family for holidays. I picture standing on a big balcony overlooking an enormous yard, walking around in spacious would be great.

Then I have to get real. Sure, a mansion would be nice in a lot of ways. But they cost a lot of money, generally. And sadly, I don't have a lot of money. They require a lot of upkeep. More rooms to live in means more rooms to clean and fill with clutter. I look at my present, more modest house as a way of measuring my capacity to deal with a bigger one. I barely have time to keep my small yard from swallowing us up with weeds. I have a bad habit of cluttering things - the garage, the spare know. So when I look at my history, I realize that a big glorious house probably wouldn't be glorious for long with me living in it. To paraphrase a much more authoritative source, I haven't been faithful in a little, so I probably shouldn't be trusted with more.

So using that model as a backdrop, let's think for a moment about government health care. Government seems to be so incredibly eager to take on this monumental task, and I think it is wise for us (and them) to take a step back:

Medicare. The "safety net" that was instated to ensure that our elder citizens have access to rudimentary health care has now been expanded to the point that it requires three of us working people just to provide the benefit for one of the covered people. The enormous strain on the system has caused the benefits to become insufficient. Many, if not most elders have to take out additional private policies to cover costs not covered by Medicare. It's still not enough, though. Now doctors are faced with the fact that reimbursements for their services are likely to be cut up to 20% in the next few years. This, along with the endlessly changing and massively irritating logistical paperwork nightmare that dealing with the government entails will likely drive most of us out of the Medicare business. Not exactly a great success story by any measurement.

Medicaid. The joint Federal-State program to cover the medically indigent has forever been plagued by problems. It's not just that you get to multiply the problems of dealing with one government agency by 2. They've traditionally been slow to pay doctors, lousy in quality, and lax on regulations. Once again, not much in the way of inspiring confidence.

The V.A. system. Like socialized medicine? Why? Have you seen it in action? If not, try checking out a VA hospital. Every move is regulated - limited medicine choices, waiting lists...all the things that make it the opposite of what most of us have come to expect from our health care.

So which of these models makes government think that it is equipped to handle care for all of us? I suggest that they try to make even one of these things decent before expanding their failure to the masses. In the same way that I can't afford or even deal with the responsibility of having a bigger house, the government has shown conclusively that it is not ready for more right now.