Sole Morality

What's good for the goose...

I posted on a disgusting policy of Oregon's state run health care back in June. I'm not saying I have all the answers to the health care issues, but putting it in the hands of the government still doesn't seem to be the best idea to me.

A prime example comes out of England with their National Health Service (NHS) that "provides healthcare to all UK permanent residents that is free at the point of need and paid for from general taxation" (Wikipedia on Healthcare in England). One would think that after 60 years of providing the bulk of healthcare for the nation that the NHS would have all the kinks worked out and the system would be running smoothly. That's not what the Telegraph has to say though.

An October 14 article on Telegraph.co.uk reports that many NHS employees have been receiving "physiotherapy" appointments through private insurance paid for by NHS in order to help them "return to work more quickly." Apparently the services offered by NHS aren't quick enough. That should tell you something.

The article doesn't say how slow was too slow for NHS, but to get an idea, let's check with the BBC. In a 2005 article, they note that waiting times were on average 95 days. That's right, over three months to see a specialist. How did they remedy the long wait times? By contracting out to the private sector. Hardly a triumph for socialized medicine.

What about in the states though. We shook off British despite inferior tactics and numbers, surely we can triumph again the health care arena, right?

Well, let's take a look at Massachusetts. Massachusetts has state funded healthcare for those who cannot afford private insurance. In fact, it is state mandated, meaning if you don't have private health care, you are required to get the state healthcare or pay a penalty. Recently the Boston Globe ran an article about health care waiting times with the new health care system in place. Can you guess what things look like?

The article notes doctors working 60 hour work weeks handling increased patient loads. One new practitioner had to stop accepting new patients after only six weeks. Many internists have stopped accepting new patients altogether. And waiting times? The standard wait for a standard appointment with your physician is between 2-4 months.

If England is running anything like that, no wonder NHS is sending their own staff to private physicians.

One wonders though, if even England's NHS admits that socialized medicine takes so long, why is it still being pushed? If private physicians are good enough for NHS, shouldn't they be good enough for the rest of England to use? And if we see that England is having these kinds of problems, why are we pushing that way and being pushed that direction by some prominent political hopefuls?

I'm not saying the current system is perfect, but it seems a shame to address a problem by making it worse.

The dangers of state run health care

While many people tout the advantages of nationalized health care, government run health care isn't always all people make it out to be. For Barbara Wagner, it was quite a bit less.

Barbara is on the Oregon Health Plan (OHP), a state run health care plan. Suffering from lung cancer, Barbara sought treatment from a physician who prescribed a medication that would slow the growth of her cancer and consequently extend her life.

So, like any one of us would do, she wanted to fill her prescription and start taking the medications. And that is what she would have done, except her insurance said no.

OHP came back and said that they weren't willing to pay for her medications.

"We can't cover everything for everyone," Dr. Walter Shaffer, medical director of the state Division of Medical Assistance Programs said. "We try to come up with polices that provide the most good for the most people."

Lest you think OHP is heartless and doesn't care about members of their health plan, they didn't leave Barbara without any options. They did leave her one that they would pay for: doctor-assisted suicide.

Oregon is the only state that allows physician-assisted suicide. Apparently it is the preferred alternative if the state doesn't feel that your treatment for a terminal illness will be of "enough benefit."

[Dr.] Shaffer then addressed a priority list that had been developed to ration health care. "There's some desire on the part of the framers of this list to not cover treatments that are futile," he said, "or where the potential benefit to the patient is minimal in relation to the expense of providing the care."

Minimal. The problem is that minimal is a rather subjective term when you are talking about life.

Thankfully, the company that makes the drug that Barbara was prescribed has stepped up and is providing it to her at no cost.

I personally think that OHP was flat out of line for indicating that they would pay for the suicide option but not her meds. Right or wrong on their refusal to pay for meds, offering the alternative was just plain wrong. Let her doctor bring up the assisted suicide option.

“To say to someone, we’ll pay for you to die, but not pay for you to live, it’s cruel,” [Barbara] said.

I couldn't agree more.