The Great Facebook Debate

I was engaged in an interesting Facebook debate about the Massachusetts election yesterday. After some deep, meaningful conversation around why Scott Brown was a great candidate (he was Cosmo’s Sexiest Senator AND his single daughter was on American Idol!!!!) and why Martha Coakley wasn’t (she thought Curt Schilling was a Yankee fan AND she actually supported a healthcare plan in Massachusetts that Scott Brown also supported! The horror). And wait…Martha spelled Massachusetts “Massachusettes” in one of her ads. [Glad the folks that pointed that out are flawless spellers as well]. THAT will teach her to assure every volunteer runs spell check. Although yes, that was pretty dumb. Brought back fond memories of the good ‘ol days…sigh.

But I digress.

I was refreshed to see someone post some questions she had around issues and what these candidates actually stood for.  FINALLY.

In any case, here was the comment that I wanted to respond to:

well.. we have the best healthcare in the world.. why do u think people come here for treatment.. yes we have issues with it.. but we should not demolish all that is good about it .. just so government can control it.. yes it is too expensive.. but why arnt we looking to see why that is and correcting that.. not just saying the gov can do it better… (their track record is not the best .. for instance.. social security was supposed to be saved for only SS but it was used for other things – that is truly why it will not be available when we retire…. Altho we pay into it .. Another one.. I know older people who need help but they cant get it because they are told they make too much pension money or SS and “make to much” for gov help even tho they paid into it all their lives.. and there are others who get it and have not paid in.. at all) – why r prescriptions so expensive.. why do drs practice defensive medicine..why dont we stop all the waste??? I dont know one dr who has said this is a good thing..If we stunt our health care system who will want to be drs.. I certainly want the best dr there is.. Doesnt everyone? I want everyone to have good healthcare but I really dont think either bills that have passed in either the senate or the house will help this country do that…besides all the deals that are being made .. noone truly represents the ave american anymore.. I want our government to stop all the bickering and do the right thing for all of us – it should not matter party affiliation or how much you make or what color you are.. just that we are all Americans.. We should take care of each other .. but it should be fair across the board .. why dont those government officials have the same healthcare we do? .. You know thy get sweet deals and keep it quiet.. right? They wont use the same system they provide to us.. and that is soooo wrong. Maybe if they had to use the system themselves then they might want to do the best thing… I don’t even know Coakley.. but I dont understand why she was telling MA that they should want to support the healthcare bill .. when MA already has it.. and has some budget issues because of it.. maybe they dont think it works that well..

Okay…let’s go one by one…

1. Best Healthcare: I absolutely agree that we have the best MEDICAL care in the world in that our doctors, medicines and facilities are amazing, new, modern, clean, innovative and…accessible to the insured or wealthy. Which leads us to this new phenomenon of medical tourism (seriously…it’s in Wikipedia) which means Americans are going overseas to get medical treatment elsewhere b/c the hoops we need to jump through to access this amazing medical care are too great.
2. Reform: Let’s call it what it is…it’s not about healthcare reform. It’s about insurance reform. Think about it…right now the only source of revenue for either doctors or insurance companies is YOU. So the doctors push through more testing to get more reimbursement and the insurance companies compensate by charging us higher premiums.  Your doctors and your insurance companies are at odds and we are the innocents here. Add lawyers and the threat of malpractice to the mix and phew…you’ve got a real case for reform. I don’t necessarily think the government can do it better but heck, they are the only ones who are coming up with ideas and even admitting it’s a problem, so there ya go.
3. Social Security: There are several reasons one might request social security benefits…either for retirement or disability. Each format has a lot of regulation around it. I have yet to hear of an “old person denied SSI” just because. I’ve heard of folks denied disability for well documented reasons. But I’m with ya. I’d MUCH rather my cash go in to supporting the retired workers who followed the rules over “lending it” to help bail out the banks that caused this mess or support a war that serves no purpose.
4. Prescriptions: That’s a relatively easy one. While I agree they are too expensive, I understand why. The average drug takes 12 to 15 years of hard, non-revenue related effort to come to market. To give you an example, one of the biggest innovations in cancer treatments is based largely on the mass production of Chinese Hamster Ovaries. Seriously. Not kidding. How long do you think it took them to figure that out? In any case, innovation is always the result of a lot of trial and error, usually by incredibly bright, brilliantly educated, focused people. The process is long. It’s frustrating. And it only results in an approved drug coming to market like less than 1% of the time. If we didn’t support this process, cures and innovations would not happen. And without innovation, we wouldn’t be America. That said, there are a gazillion programs pulled together by these drug companies to assure the drugs are more accessible…IF your insurance company lets you.
5. No doctors supporting healthcare reform? The 245,000 members of the American Medical Association actually endorses the more liberal House bill which includes a public option.
6. So the good doctor thing…of COURSE everyone wants a good doctor and I now segment doctors into two categories: doctors who become doctors to get rich and doctors who become doctors to help people. My primary care physician actually won’t deal directly with insurance companies anymore and only takes cash (this happens in South America too) because it’s truly the only way she can “know” her patients. No more :15 appointments. All because over 40% of every $1 spent on primary care traditionally goes toward costs associated with insurance billing and reimbursement. The whole “in or out of network” plus HMO vs. PPO seems much more a barrier to good doctors than not.
7. The Congressional Insurance plan. If they had the plan we have, 15% of them wouldn’t be covered at all. I think the question is why don’t WE have the same plan that THEY DO. Which is essentially what the  House bill was seeking to do. And keep in mind they don’t provide the system to us…which is also what we are trying to fix. I’m all for it. Them providing us with a system that’s good enough for everyone to use.
8. And finally…Coakley. The Massachusetts health plan was SO good that even Brown himself voted it in. I bet he forgot about that. And the resulting budget issues…they are going state to state faster than Swine flu. No vaccine yet.

Sure it’s flawed…but look at my response to drug prices above.

Imagine how much we would learn if no one was willing to take risks and learn from the results. We’d stop progressing. We’d never innovate. We’d learn nothing. Nada. Zilch. And I like learning.

All right…I’m done. Putting my soapbox away. But delighted to finally be discussing issues and not gimmicks. I do say it’s kind of interesting to be having this debate with very people who used to buy me beer when I was underage. Who woulda thunk.

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