29 June 2009

health care

I don't pretend to know how to fix the health care system in the US. I agree that there are issues and they need to be addressed. I fear throwing out the existing system and starting from scratch for a lot of reasons - many of them vague and hard for me to articulate. I don't have a lot of knowledge in this area - although I did work for a health insurance company for a while and we had premature twins who exposed us to some of the incredible expenses that come with the extremes of medical care. We were fortunate enough at the time to be on a health plan that essentially covered everything. Had we chosen a different plan option from my employer our personal expenses likely would have been more significant.

Michael Kinsley's column in the Washington Post captures one of my vaguely uneasy fears:
Statistics on life expectancy or infant mortality are averages. The easiest way to raise your averages -- maybe even the best way, if we're being honest -- is to concentrate on the general level of care and not to squander a lot on long-odds cases. But if the long-odds case is you or a family member, you may well feel differently.
Our twins - more accurately, the one who lived for 11 days as opposed to the one who died in utero - was a long-odds case who spent all of his short life in one of the the highest-rent district of the hospital - the neonatal intensive care unit. As his parent I would have been outraged if I'd been told that the odds were such that it didn't make financial sense to treat him.

I've spent a little time with Google tonight and there certainly are statistics to say that England and Canada - two nations with universal coverage - have better longevity rates and better infant mortality rates than we have in the US. Some of the commentary on those statistics, though, suggests that the statistics - as they often do even if they're mathematically correct - fail to encompass the whole story and that there are other factors reflected in those numbers other than just the health care systems of the respective countries.

It is a complex situation that deserves careful, transparent consideration with all parties represented - both private and public. We should not rush this decision to meet any arbitrary deadline.

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