Sunday, November 29, 2009

A Personal Perspective on Health Care

10 days ago, my mother fell while visiting her primary care physician. He had to put three stitches in the back of her head. Last Monday, she fell in the porch outside her house, and it was necessary for her to have surgery on her arm, which was broken in two places and the elbow was dislocated. The hospital did the surgery Wednesday and kept her overnight for observation. She was released Thanksgiving morning and my brother and I drove her home. I went to my home where my wife was preparing Thanksgiving dinner, and received a call from my brother around 345 PM; Mom had fallen yet again and hit her head.

Mom spent the rest of Thursday in the Emergency Room at Memorial Hermann Hospital, and she was admitted into the NTICU around 1 AM Friday morning. Her vital signs were unstable and the tests showed a possible aneurism. Fortunately, her condition improved over the next couple days and today Mom is being transferred to a different ICU. She has insurance through Medicare and a supplemental provider. The costs of the multiple stays will be expensive, but for the most part Mom’s costs will be controlled. On the one hand, my Mom paid for many years on insurance she never had to use, but now it is an invaluable resource. Overall, in my Mom’s case the system seems to work the way it is meant to do.

Health Care needs reform; there is no serious argument on that point. The rules can be burdensome, the costs rise more quickly than anyone can really afford, and there is real concern that a large segment of the population is underserved. The solution, however, cannot be found through simple application of a mathematical formula, or any political theory. Medicine, first and foremost, is about people. The patients and their families, the doctors, nurses and other providers, and the general public all have authentic interests in health care and how it is provided.

There are economic and political reasons why I do not like the reform plan proposed by the Obama Administration and the Democrats in Congress. But the main reason is far more personal – the Democrats make a lot of promises, in general and lacking substance, about access and choice, but they refuse to have a serious debate about the cost, effects, and conditions of their proposed changes. I need to know what the changes will mean to a 76-year-old woman who needs multiple trips to ICU. I need to know what the changes will do to my continuing treatment for cancer, a type which at this time has no known cure. I need to know what the changes will do for my other relatives, including my wife and daughter. The proposed plans seem focused only on cost reductions, with no protections for significant demographics, like seniors, people with chronic and incurable conditions, or people who are healthy now but face a history of serious problems. The problem is not that these questions have not been answered yet, it’s that the Democrats refuse to even admit those problems exist, that they have to address them in public discussions. Debate and disagreement have been suppressed and punished, with constituents locked out of allegedly public meetings, with alternative proposals by Republicans denied consideration and debate. The only plan offered to the public is the Democrats’ plan, with no serious attention given to flaws.

Until the Congress listens to the people who are affected by this plan, and serious effort is made to improve the plan to create an effective, functional plan, I cannot support it on any rational basis. Nor do I think that anyone who lives in the real world will find the proposed plan acceptable when they understand how it works, or more to the point, will not work.