the debate goes on

Tuesday, October 12, 2010

While the popularity of sports continues to increase, more and more stories on the sports page have little to do with accomplishment on the field and more to do with the money. Salary caps, union contracts, potential strikes and stadium lease arrangements can override who does what on the playing field. The fan’s interest in their favorite team or player often gets lost when there is more discussion about salary contracts and arbitration instead of yards per carry, RBIs and rebounds.

This change in focus is also readily apparent in the ongoing debates about health care reform. As it turns out, the new health care law has little to do with health care and lots to do with money. No matter where medical care is delivered, it is a unique relationship that occurs one on one between an individual patient and their care provider. Whether it is a therapist at a nursing home, a home health nurse on a visit or a doctor in the office, each touch is health care. The debate that rages between politicians is about figuring out how to pay for medical care and allow people access but it ignores the quality of care, instead focusing on quantity.

Society has a responsibility to provide access to health care to all its members. It begins with preventive health measures, continues though disease treatment and ends with quality end of life care. But as society has responsibility, so too does the individual. Yet there is little penalty for those who abuse their bodies. In fact, there is a perverse incentive for physicians and other health care providers to care for those who don’t care for themselves. Accident victims who drink and drive, who don’t wear seat belts or helmets cost more to care of than those who abstain from risky behavior. Aside from the dollars spent on the individual patient, infrastructure needs to be built to provide that care. Whether it is government who pays or insurance companies who pay or individuals who pay, the money comes from the same pot. Society takes money from one area of need and spends it on another. Money spent on trauma centers is money not spent on cancer treatment programs and it may be the same money that isn’t spent on education.

Ideally, the debate in Washington should begin with a new goal. How can we make those who live in this country healthier, live longer and have better life quality? How do we promise to care for everybody when there aren’t enough physicians being produced? How do we ask health professionals who pay hundreds of thousands of dollars in university education tuition to work for minimal wages? How do we say yes to some care and no to others?

This nation has forgotten that the United States remains a leader in health care innovation and patients come from around the world to seek the expertise that is present on these shores. When these people talk about health care, they don’t talk about HMOs, PPOs or HSAas, they talk about the care that is provided and the opportunity to heal.

Perhaps it might be best to return to a simpler time when the sports pages talked about sports and the health care debates talked about how best to care for a patient. Sometimes money just gets in the way.

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