Posted tagged ‘medicine and money’

Healthcare and Populist Backlash

September 16, 2009

        I’ll get back to our left brain/right brain discussion in my next post.  For now though I wanted to digress. 

        Take heart, there are small signs some power might get back to the little guy.  All we gotta do is revolt.

       If you think about it, big ain’t working in modern society.  What went wrong in Health Care is it got too big.  When an Insurance company CEO makes 64 million bucks a year they need to be busted.  

        It happened in sports.  Too many guys who don’t have the skill or passion to learn to shoot, throw, dribble, or hit made a business out of a game.  I’d rather play golf at the local muni on a pretty day than watch the ‘sports’ business.

        The same is true for country music.  Business people who can’t pick ‘The Wildwood Flower’ on the guitar controlled the flow of the money and the art suffered.  It is one reason I love bluegrass music so much.  We don’t care if you are rich or poor.  Anyone can join in.  The only requirement for recognition is dedication, practice and time.  You can not create a market image and package a  picker.  The music is too hard to learn to play and can not be faked.    

         In medicine you can make far more money by denying care than providing it, at least at the primary care level.  Greedy people who report to stockholders rather than patients brought the system to its knees.  I don’t want the Government plan to get too big either, but I would like to see it position the other players where they have no choice but to do right.  (Against their will for some of them, by the way.) 

        A model which creates true competition would help.  Every day when I go to work I need to understand someone younger, smarter, and better looking than me (ie a heck of lot of people) would like to have my job.  I do my best for my people ’cause that’s the way my mama taught me.  (in the South you never go against mama)  For the ones who aren’t natured or trained that way, I’ve found they can learn fast if they are forced to.  It should stay that way too.  (In reality no one wants my job right now.  Primary care is now a hopeless quagmire.  Big insurance makes it as difficult to help people as possible, at least as far as daily grunt work.)

        No doctor needs to survive because of political favor.  I know some who do.  They couldn’t pass Boards on a day of divine inspiration, but are protected because of their alliances.  Trust me, you don’t want them as your doc.  I’ll take one like legendary Dr. Jess every time.  He’s a surgeon at a major medical center, plays the fiddle and wears string ties.  He has no use for administrative fools.  They’d get shed of him, but the guy is too dang smart and good to patients for the political types to take him on.  They are at least bright enough to understand there’d be a populist backlash.  It amuses me to know how they lay awake at night and worry about maverick docs like Dr. Jess.  Indie was that way, as you will see in ‘The Mandolin Case.’  (Still slated for a 2010 release).     

         Here in Harvey County, true competition salvaged some hope for our little medical landscape.  (I plan to show you how in a second novel.)  It’s like George Bailey said in ‘A Wonderful Life.’  “This town needs the measly Building and Loan, Potter; if for no other reason so everyone doesn’t have to crawl to you.”  (paraphrased)  Monopolies, be they business or government always get bloated.  I never dealt with a bureaucrat with a heart.

         According to Newsweek, “the Founder’s vision was a republic of self reliant farmers and small town tradesmen.”  The article referred to banking, but the same principle applies to medicine.  It was better off in the hands of patients and providers.  Now it is controlled by very large institutions whose ‘important’ people often can’t distinguish gas from a heart attack, nor do they care or realize why this might be an important skill.  As one industry insider wag told me, “When I got into health care I thought we’d be talking about germs.  All we talk about is money.”  

         Niall Ferguson wrote in Newweek that the Founding Fathers had a significant mistrust of big.  There isn’t much new.  Maybe history will just recyle.   He recalled there has been more than one backlash against big in the past.  President Andrew Jackson used to say about the central second Bank of the United States, ‘The Bank is trying to kill me, but I will kill it.”

          Large institutions, be they banks, sports, country music, newspapers, publishing houses, government, political groups, or health care conglomerates need to heed history.  The privileged few depend on the daily toil and drudgery of ordinary folks to sustain their good fortune.  When they forget where they came from and get above their raising, a populist backlash awaits.

        Oh, by the way, you might note there is no longer a second Bank of the United States.  It went out in 1832. Old Hickory was  a stubborn man, and he prevailed.

Dr. B