The Balancing Act of Health Care Reform and the Reality of Profit.

First let me say that I am really proud to be an American. And I believe that America is about initiative. It really is a country for people who want to get somewhere. It is also the most generous country on earth. The recent numbers of individual giving are staggering. All given to get work done through the non-profit and church sector. The system works beautifully. And for the reward for giving, not only do you get some self-satisfaction, but also you get a tax write off. The government itself is not great at giving- because your congressmen just can't do it unless it means they will get votes. Dems, Repubs- doesn't matter. If it doesn't get them votes, or allow them to trade votes for add ons for bills, then they don't care. It's their job to get votes and they take it very seriously. As for health care- if one is to be completely honest, Hillary made this mess. And for that alone, she deserves not to run. She wasn't doing anything but getting in over her head and getting the support of such academics as Uwe Reinhardt to make it all look sound. Mr Reinhardt has now become the ultimate capitalist using speaking fees to denounce all sorts of current medical care. I actually had a letter published once in the Wall Street Journal- it was quite long and they did not edit it but allowed me to vent a bit. Mr Reinhardt has become my "one eyebrowed baby". He is an expert of complaint. I remember that my kids once had an AP Biology teacher who was openly distainful of physicians (though they paid tuition in full at that private school)- she often told her kids that doctors earned too much money. But do they? How do you compensate physicians who take incredible legal risk just by opening their doors? After all, there are hungry malpractice lawyers to feed. Like John Edwards, who almost single handedly put obstetricians out of work in this country over the most debatable of issues- that of whether or not an obstetrician is actually responsible for all cases of cerebral palsy. Now, with decades of fetal monitoring, we know that infants are born with cerebral palsy even after normal deliveries. Of course, with very little thought one can deduce that during 9 months in utero, a developing fetus can encounter many episodes of hypoxia- twisted cord, compression of the cord near term, low blood pressure in the mother just from postural events- none of which have anything to do with the obstetrician. But with vultures like John Edwards practising to put obstetricians out of business, why would anyone even want to be a physician? So IF you take away the financial rewards, or what is left of financial rewards, what exactly IS the incentive for a bright (and believe me, stupid doesn't DO med school) student to do 4 years of college, 4 years or more of expensive medical education, 4 or more years of post doctoral training, and themn years of debt repayment? No other position requires such intelligence, and such dedication and sacrifice of home life. NOT ONE. So here we go again. Health care has become very expensive. Most of the expense comes from the two ends of the spectrum- the immense cost of keeping immature neonates alive and the immense cost of prolonging life that is soon to be lost. The cost of chronic disease is also in there. Countries like England solve problems by the built in delays in their system. By the time the chronically ill and failing in health elderly person gets into the care system, they are close to death and rational countries (who haven't the well developed malpractise system) allow them to die. Many countries do not resuscitate the smallest neonates. Much less carry them for months only to have most be developmentally disabled. It may sound cruel, but this is alot of the cost we talk about. As for bone marrow transplants, those are very, very expensive. You should have a very big savings account and fund raise for those- since many do NOT work. Technically they are experimental. No one wants insurance companies or drug companies to make money. Really? So they should just work for the public good? If you can get my car mechanic, grocery store and gas station to do that, I'd really appreciate it. If you want an MRI, someone HAS to pay for the machine, the person operating the machine, the scheduler who gets you into the books, the insurance coder who files your insurance, the proper person to read your MRI, the person to type up your MRI results, the person who mails your bill, the person who purchases the paper your results are copied on, the person who takes your parking ticket, and the people who buy the supplies for the MRI and brings them up to the MRI lab. Unless you can get your OWN MRI machine, this is the cost of modern innovation. In order to FIX the health care system, you have to first guarantee that profits can be made. Or you will no longer have insurance companies, physicians, professional RNs or drugs in the system. Then it won't be just broken- it will be gone. Good luck figuring out this one.