If you are a reader of my blog, you know I have health issues and have been treated effectively within the Penn Health System. I just tried, without any kind of fruition, to get my referrals for specialists released from the order state into "the system." My doctor's appointment with my general physician (GP), who by the way is outstanding, was after normal business hours a couple of nights ago. She gave me two orders for referrals to see two doctors within the Penn Health System. One of the doctors I have been seeing for a couple of years (and he rocks!). The other doctor is new to me and this will be my first appointment.

My GP told me at the end of the visit to call back and have the referrals "released" into "the system." I was thinking this would not be a tough one, sounds easy. Win for me. :-) I just got off of the phone with my GP's administrative folks and I need to get both specialists provider numbers, schedule appointments, and call another number to get the referrals in order. While this is fine and will happen exactly as they directed. I must conform to their system in order to get proper service. I was thinking about how this would work for a customer of Amazon.com...

Let's say that I was buying a new watch through Amazon from a company called Watchzone. The way it works now...

• I found a watch I like on the Amazon site, that happens to be sold by a third party (Watchzone).
• I add the watch to a virtual cart and pay for it using my American Express card.
• The item shows up at my door, delivered by whatever shipment options I chose during checkout.

Let's now apply the business/service model of the Penn Health System to my Amazon purchase...

• I found a watch I like on the Amazon site, that happens to be sold by a third party (Watchzone).
• I add the watch to a virtual cart and try to pay for the watch with my American Express card (without success).
• I call Watchzone and let them know I want the watch.
• I then have to call American Express and tell them to release funds (referral) to Watchzone.
• Amazon and Watchzone communicate somehow and funds (referral) are transferred.
• I get my watch via mail.

The kicker of this whole thing is that in my example of the Penn Health model being applied to Amazon.com... Amazon, Watchzone, and American Express are owned by the same company! Grrr. How should it work? Here is my ideal model...

• I go to my GP and she issues sets of referrals for two specialists.
• I call each specialist within the Penn Health System for appointments and give them the order numbers for the referrals.
• I go to the appointments without hassle.

This ideal model should only function this smoothly *if* all doctors are within the same system. The problem with the Penn Health Systems' business/service model is that there is a separation of systems that cause a series of faults or divisions that disrupts customer services. Their business model and separation of systems create hurdles that the customer has to navigate. Looking at my artificial Amazon/Penn Health mash-up, it illustrates the absurdity of the process and how it would never be accepted in any kind of online business transaction. So why is it standard practice concerning people's lives and welfare?! (Yes, that's a rhetorical question.)

via Patterico.com.

I have no hope for our future as a nation. Seriously.

I have finally come to a conclusion to the healthcare debate. If you were my wife, you would know that I take a long time thinking about stuff. It took me almost two years to come to a conclusion about gay marriage. Also, if you were my wife--you'd be married to me. :-P There are really only two sides to this healthcare thing: either full support of government run healthcare or privatized healthcare as we have it now. Yeah, there are a lot of things that can be changed and regulated, but it still comes out to two sides, more or less. People are all over the place on this issue because of fear and avoidance of reality. Here are my thoughts in some kind of logical order--at least logical in my mind.

Now

Right now we have a privatized healthcare system that has government oversight and regulation that sits side-by-side with three government medical initiatives--for lack of a better term in my limited vocabulary: Medicare, Medicaid, and the Veteran's Health Administration. This is oversimplification, but just go along with it. All of these entities (private and government) work at varying levels of success and failure depending on the multitude of situations. Drugs, procedures, tools, and general advancement happen because of investment of time and money. Someone is paying somewhere and expects a return on investment. It is a market-based economy and a return on investment sounds fair given the climate.

Socialized Medicine

There are a number of folks who think that the government should provide healthcare for "all." All is in quotes because there are different folks that think the definition of all should or shouldn't include a number of paying/un-paying/citizen/non-citizen members. I won't even try to get into that morass of a clusterf*ck, but these folks think that we are a wealthy nation and that people should have adequate healthcare that all of us should be contributing to with tax dollars. Break your arm; go to the hospital and get it photographed, fixed, and casted for no cost. Sounds pretty good. No insurance hassles, no mess, no fuss.

Privatized Healthcare

Most people can agree that the system now is not a great one. The people in a good spot in life have decent care and there are headaches in the system, but they are not totally unacceptable. I would further argue that most folks would like the costs a little lower and a bit more oversight regarding some shady business practices of insurers. The major caveat is that people who have some kind of care, private and/or Medicare, do not want their existing services compromised by the addition of socialized government-run healthcare. Can the people on the socialized medicine side see that people who have decent coverage do not want their coverage f*cked up?

The Problem with Socialized Medicine

I see a number of problems with socialized medicine. The biggest problems are how to pay for it and who gets it? Yeah, folks love to use the post office analogy regarding socialized medicine, but the reality is that the post office loses money every year and we keep sinking money into it. Healthcare will have a much bigger price tag and there is no getting around that fact. As for who gets it? The people that make up the citizenry of the United States should get it, in my humble opinion; but we both know that won't fly. Right now, non-citizens are getting free education and instruction in public schools on the taxpayer dime. When Joe Wilson heckled "You lie!" at President Obama when he said illegals wouldn't get free healthcare, Joe wasn't entirely wrong. Just a little while later, Obama said he would like a path toward amnesty for illegals in place in the near future. So these same illegals today would have free healthcare in the near future if we had socialized medicine right now. So Obama was telling a tiny lie, but we know his heart is in the right place--so we won't penalize him on that one. There are many many more problems, but these two are the ones I hear people screaming about the most.

The Problem with What We have Now

The biggest problems we have with the existing system are predatory practices of insurance companies, trial lawyers that get huge awards in malpractice courts, and the cost of insurance and its impact on business. I will break these three things down and try to relay my thoughts about these problems. Insurance companies are for-profit entities. They are out to turn a profit and are regulated by state governments. They also try to find ways of not providing dollars for healthcare. They do this because some of their clients lie, cheat, and steal. Is it their job to tell the difference between someone who is lying and someone who made a mistake on a form--in a perfect world yes, but we know they really can't discern the difference. Trial lawyers are sharks. They get huge settlements for some clients who are clearly milking the system. I sat in on a clear case of someone who was trying to milk the system. The plaintiff was the stereotypical injured person who needed a cane during the trial, but didn't need it after court. She was looking for millions, but was awarded $2,000 by the jury. She was angered beyond belief when the verdict was read. As for the impact on business, I read a great article (that I can't find any longer) about how money spent on employee healthcare could be used by companies for re-investment if socialized medicine were commonplace in the United States. In my mind, that article was the best argument I have read to date for socialized medicine.

My Opinion

I would totally be for universal healthcare in the United States if the government did a few things. These things would be painful, but ultimately would lead to a fairer system.

• Scrap the existing progressive tax system and institute a flat tax. No deductions, no married/single status, everyone (including corporations) pays an equal percentage of their income.
• Seal the borders and impose heavy fines and/or jail terms on companies that employ illegal aliens.
• Absolutely no services for non-citizens. It wouldn't be that hard to set up a system to bill embassies for injured visitors to our country who have socialized medicine at home.
• Cut spending dramatically and show a clear path toward paying off the deficit. If you don't have the cash to pay for something, you don't get to fund the endeavor on credit and promises.