12/01/99

A HMOdest proposal

Health care is just too important to be left to the free market.

How did it get that way? Centuries of medical progress have led us to the point where modern medicine can, given the time and resources, cure, prevent, or mitigate most of the maladies known to mankind. During the Civil War, our idea of surgery meant a saw for a scalpel and a bullet for anesthesia. At the close of the 20th century, surgeons can remove your gallbladder though a narrow metal tube, using two or three incisions of a few centimeters each, and have you home the next day. We can replace entire joints with man-made metal and plastic substitutes. X-rays, CAT scans, MRI's, and other wondrous devices can look right through you to detect mechanical or biological malfunction. We have capabilities never dreamed of by doctors even twenty years ago.

Of course, these gigantic strides in medical capabilities naturally raise moral issues. If modern medicine can treat a disease or injury, why should anyone have to do without? The fact that these diagnostic tests and treatments cost resources, usually in the form of money, should be no hindrance in the face of an obvious moral imperative.

So I have a solution: let's turn it all over to the government. In keeping with the fine democratic (big and little "d") tradition, when the citizens want something for nothing, they can get it, and have Uncle Sugar pay for it. It's the perfect solution, really, if you think about it. Every citizen knows the government has unlimited resources, and failing that, they can always levy some tax on the rich, since every citizen knows the rich don't pay their fair share. This plan would also have many advantages.

First, think of the service. Once all medical professionals work for the government, service will me much improved over that offered by HMO's. We've all been exposed to government employees, whether they be LAPD, IRS, or DMV. Remember the last time you had to get your drivers' license renewed? Remember the smiling, intelligent, and helpful person behind the counter? Now imagine that person is your gynecologist. Or the surgeon operating on your brain aneurysm. Aren't you excited?

Second, think of the immediate cost savings. Once health care has been co-opted by the government, waste, fraud, and inefficiency will be virtually eliminated. Those same government employees who bring government construction projects in on-budget and on-time can join with the folks at the Pentagon in the Hammer and Toilet Seat Procurement Department to deliver medical goods and services quickly and cheaply. These savings, in turn, can be used to offset raids from the Social Security Trust Fund.

Third, government involvement will virtually halt the upward spiral of medical costs, because researchers will stop looking for those expensive new treatments. What if we discovered a cure for cancer? Everyone would demand entitlement to it, and then how would we pay for everything? But once government is involved, greedy pharmaceutical companies, driven only by profit, will stop throwing billions of dollars researching new drugs and devices, since they will have no hope of recouping their costs. This will also have an added collateral benefit, since the resultant slowdown at the Patent Office will allow drastic staff cuts and operational savings. We'll also cut off the diversion of our health care services to wealthy foreigners. Privileged Brits and Canadians who can't get health care from their government-run systems at home will stop taking up our doctors' valuable time, since they won't be able to get quality health care here either.

Finally, government provision of health care means that our government not only foots the bill, but regulates health care as well. Instead of medical professionals making medical decisions about who gets medical care, how about that helpful and well-informed bureaucrat from the DMV we mentioned earlier? Or even better, since funding and oversight for federal agencies ultimately comes from Congress, we'll have our Senators and Representatives making the rules about who can have a replacement kidney, and the proper method for lancing a boil. Oh, and don't forget - they'll also make the rules on abortion procedures and availability of birth control pills.

Now, if you were feeling sick before, don't you feel better already?

All blatherings copyright 1999 by the author. All rights reserved. You can look, but don't touch. Thou shalt not covet thy neighbor's blatherings.

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