August 21, 2007

(Kind of) Political Commentary

Posted in Commentary at 3:52 am by Iram

I have been struck once again by a lapse in productivity, and my personal muse is begging me to release some of the mental writing that I sporadically compose without any form of audience or springboard. Nothing incredibly creative comes to mind though, and I find myself focusing on some of the more disturbing events I have been following in recent news, both local and international. Thus, I shall spend a few moments declaring my personal thoughts on some of the more prevalent issues, in no particular order.

1.Iraqi Women Forced into Prostitution
CNN published an interesting piece a few days ago regarding Iraqi women who are being forced by poverty and starvation to sell their bodies as their only means of providing a household income by which they can feed their children. There are probably many opposing views out there when it comes to what can be considered ‘forced.’ I have already heard some individuals argue that even though these women may have been provoked to take such extreme steps they are, in the end, acting of their own free will and thus cannot be considered forced in any way. On the other hand, many of these women were originally forced or coerced into performing sexual acts against their own free will, and after that initial incident have felt that sex-work is the only type of work of which they are worthy. Whatever your views on this issue, I think that everybody would be hard pressed to argue the fact that this war has simply taken too many lives. Too many innocents are being affected by the ongoing dispute in Iraq (and let’s not forget Afghanistan): widows, orphans, parents who have lost their children, civilians who are now unemployed and unfed. Unfortunately, all of these categories apply not only to the countries that hold the battlefields but also to our own great nation. There is no end in site, and nobody has been able to provide a feasible strategy by which guns can be lain aside and diplomatic reasoning can preside. I am personally familiar with many of the problems that will prevent countries such as these from establishing democratic states that meet the criterion of the United States, and I can only hope and pray that there is enough tolerance and understanding on both sides of the bargaining table when the time comes so that this series of unfortunate incidents can end in a peaceful negotiation, and soon.

2. Access to Healthcare in America
Healthcare has been a headlining topic over the past few months, from Michael Moore’s notoriously illegal stint in Cuba while filming his documentary ‘Sicko,’ to the raising of the issue in recent political debates for the upcoming presidential elections, to a recent news article detailing the plight of an elderly man who killed his wife because his pension and social security payments could no longer cover her increasingly costly healthcare expenses. As a future physician, healthcare is an issue that is very close to my heart, and one that I have studied exuberantly through various medically-focused sociology and economics courses. I am very proud of the fact that in the US those individuals who have sufficient resources have access to the best and most innovative medical treatment available across the globe. Our system of internal competition in addition to rewards for creativity and ingenuity have allowed research and development in both the basic and clinical sciences to flourish, creating a foundation for experimental medicine and ongoing discovery of new treatments and approaches to diagnoses. At the same time, however, the fact that most healthcare is in the hands of private companies has raised prices exorbitantly as these entities understandably function as big businesses that care about one thing and one thing only: the bottom line. The worst part of this situation is that it is hurting those who are already less fortunate; the people teetering at the edge of the poverty line are in double jeopardy, because not only can they not afford healthcare but they also constitute the population that is most at risk for many of the health problems pervading common society today.

We are currently sitting at a very interesting cross-roads, where we can choose to pull healthcare under the wing of the public sector and make it more affordable – but in the process inevitably lose much of the incentive for growth in the field – or we can choose to ‘subsidize’ the private sector in order to defray some of the costs from the consumer. I personally believe that the latter is the better choice for this nation. Providing universal free health care like many of the European Countries and our Northern neighbor introduces too many problems to an already troubled system, including the economic issue of Moral Hazard, the question of how our already overburdened and disorganized public management system will be able to handle such a drastic addition to its priority list, and the ever-important issue of who will pay for the inclusion. On the other hand, if the government were to create its own insurance company that could in a sense compete with the existing private insurance companies, the bulk buying power would allow the governmental institution to negotiate with healthcare providers and lower the price of healthcare paid by consumers, while in addition inducing the downstream affect of lowering insurance premiums and incidental costs incurred by those who elect to maintain coverage by private companies. I envision this as being structurally similar to the way that the U.S. Postal Service competes with UPS and FedEX. This way, the private companies still exist, and they maintain their ability to generate profits as long as they maintain the desire and the drive to develop innovative methods of management and structure that would allow them to cut costs and remain competitive with the governmental agency (I believe I read somewhere that more than half of the check you hand to your doctor funds bureaucracy and red-tape). As long as the private companies, which will always function as private independent businesses, exist, there will always be incentive for growth in the healthcare field that will keep our R&D department at the top of the world.

I originally started with a list of 5 issues that I planned to discuss in this post, but I have already dedicated numerous keyboard strokes to these first two issues and it is time for me to return back to my neuroanatomy atlas. Perhaps at the next bout of cerebral exhaustion I can give my right brain a bit more exercise.

1 Comment »

  1. Whichever path the country takes it is faced with the same issues: Inappropriate Utilization of Healthcare Services and Substandard Quality of Care. The two are strongly linked. When you factor in the impact of Medical Errors and Medication Errors, you will see prolonged length of stay in the hospital, increased use of ancillary services and expensive diagnostic testing, greater medication and supply costs, and a greater number of physicians to be reimbursed to name a few,

    Reducing the reimbursement to physicians does nothing to reduce cost. Quite often it results in more procedures performed which may or not be medically necessary, more testing, more self-referrals to physician-owned physician facilities, more office visits – all done to make up the difference in payer reimbursement, federal funded and private insurance.

    No matter how the payer system is structured, the only way to conserve healthcare dollars so there will be no one going without adequate care is to make the caregivers accountable for the service they render – that includes all providers of health care. Can it be done? Sure…if they are not paid if they abuse the system.

    http://www.charlesclarknovels.com


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