Good musings. I don't have the answers, just more questions... and I'm not trying to inflame people, but I chose the below quotes just because they got me thinking about the fact that nothing is ever as simple as a + b = c in the real world.
Quote:
Originally Posted by DixieGal
... What differentiates the US med care system from NHS is competitiveness. The better the care that you deliver, the more your reputation grows, and the more research dollars you are awarded. The more research experience you gain, the more pharmaceutical money you are offered. Competition drives the medical field as much as it drive retail. Sure, you can call us greedy, but that drive to acquire the most has driven medicine to the heights it now occupies.
|
Competitiveness is often laudable, but an interesting issue here concerning health care is how success is to be measured? In the rush to collect those research grant and pharmaceutical dollars, what statistics are gathered to support your position as a worthy medical institute? Patients treated versus cost of treatment? Ratio of private versus Medicaid patients? And do those statistics benefit the patients?
Often the kinds of statistics collected to demonstrate a business case to a pharmaceutical mega-corp interested in developing AIDS treatments to sell for profits to famine-ravaged third-world communities may not actually translate to the best treatment for the middle and lower income patients coming to your clinic seeking help. In fact, losing money because you provide the best possible treatment to people who are only covered through the Medicaid payments is probably a negative selling point to many potential investors looking at the bottom line.
Then you start performing cost-benefit analysis on treatments to try to curb your expenses, and suddenly you have to ask how much is a person's life worth in dollar terms? Or how much is the relief of their suffering allowed to cost? These kinds of questions are impossible to quantify in terms of dollars, and dehumanising when we try to do so.
But back in the real world, everything costs. Clinics, whether government or private, need to manage their budgets. But social services such as education and health care, where human lives and quality of life is at stake, need some kind of reality check against an assembly line mode of thinking, where the human being becomes just another cost factor of production, just another component in the great machine of industry.
That's why some kind of independent oversight is necessary, whether that means government provided services that aren't profit driven, or government regulation that curbs the temptation to increase profits at patient expense. It seems government may have some useful role to play in these situations on both sides of the ocean.
Of course, who watches the watchers becomes the next conundrum to deal with... see, nothing is ever simple.
Quote:
Originally Posted by DixieGal
... I believe our American way of wanting the mostest biggest flashiest of everything is what made us rich. Why would we want to change that? There's no reason to feel guilty, and I am proud of the fact that anyone who wants to compete be rich in the US can be. Like RSE said, it's a big country, and if you fail, then it's easy to move and start fresh again.
|
I'm not sure we can simplify the real world this way. There are no easy answers, and looking for them, or worse, believing you've found them, just helps hide the real issues.
Believing that "anyone who wants to be rich in the US can be" is fine but not accurate. Does that mean if you're not rich you just don't want it? Or if you're poor it's because you're not trying hard enough? Like that other ol' chestnut that your daddy probably espoused, "work hard and you'll get ahead!"
Getting rich usually involves something beyond the standard job + home + car scenario, which in turn involves something outside normal opportunities many people have. You always read about the rags to riches success stories, but for every one of them who makes it there are another 50 guys 'n' gals who took their shot and missed - you rarely read about them.
I'm more interested in the "not rich" side of the equation. Everyone loves success, and success breeds success. But what about helping those less fortunate and being part of a community. Because one quite common attitude to the poor in America is that it's their own fault. This is not unanimous, but more oft-expressed than I think it should be. The rationale is, if the poor wanted to be part of society or get help, then they could. Clearly they're poor and homeless, not from circumstances beyond their control or problems within the system, but because they don't want to help themselves out. They don't want to work. They failed, so too bad, so sad. This is the flipside of the "anyone can be rich" falacy - if you're poor, you're not trying hard enough.
Call me pessimistic, but it's probably more realistic. I'm not saying don't try, don't compete. Just the opposite. But I'm also saying, to paraphrase the Rolling Stones, you can't always get what you want.