One more on health care
I have a new health care problem. My toe-nail is about to fall off. I must have kicked something a while back, half of my nail turned black but nothing else happened. As I was breaking in my new ski-boots my nail/toe got a really bad infection. By the time I got to my family doctor, after three days of treating it with first anti-bacterial then with prescription antibiotic cream, it was on the mend. She sent me to a Chiropodist. I made the appointment, got it in a day. Here comes the kicker: according to OHIP (the Ontario Health Insurance Plan) just like an abscessed tooth, an infected toe is not a health problem, they will not cover it. It will cost me $55 for a visit. I decided to go because I will go to the tropics in a week and wanted to know what to do if the problem comes back. I came away as a happy customer. I got quick, competent, courteous service, they paid attention to my questions and gave me satisfactory answers; fixed my toe by cutting away the lose parts of the nail and gave me a prescription for a cream in case I need it. I have doubts that I would have gotten the same service had this been covered by OHIP. I asked why it is not, I was told that they are fighting for it. I wish they weren’t. I liked my dealing with them the way it was. I like to deal with dentists. No, I am not a masochist, what I like is the fact that it is a clear business transaction. They have too much regulation (billing codes = price control) but they have no waiting lists and if they screw up, they can be held responsible. For whatever is not covered, I have a chance to get good service. The comment to my last health care post has a very dark tone. I perfectly understand and sympathize with the sentiment, but I think on the one hand that it is not that sinister and on the other that there is a ray of hope. It seems that the services covered may actually shrink. Optometrists were cut off just a few years ago. When my wife had her thyroid operation, she was kicked out of the hospital at 5 PM sharp when the nurses’ shift ended. She still wasn’t able to walk. It used to be a 3-4 days hospital stay to recover from such operation, but at some point it was decided that from that point on it will be a day-surgery. In retrospect, that may have been lucky. No exposure to C. difficile or bacterial meningitis and no matter how lousy a care-giver I may be, she recovered. Maybe all this is not such a bad thing. I don’t want to give anybody ideas, but there are many possible ways for the system to maintain the pretense of universal care while constantly cutting back on the services while also raising the costs. We have a special extra health care tax for the past few years. Once a special tax is in place, changing the rate is no big deal. Analyzing the evolution of government services would be another matter, but these are all predictable consequences. This is what happens with ANY government provided service. EVENTUALLY it may become unsustainable, but as Adam Smith said: “There is a lot of ruin in a nation” and we do not know how it will all go down. I wouldn't expect it to be as sinister as the description in the comment, but just as depressing. We will have to learn how to offer bribes, we’ll have to focus on our relationships making sure that we know someone who knows someone and that we have something to offer to that person in return for their favours. We have to learn how to operate on the black market. Let me say this again:
If you are not paying for it, you are the product.
If you pay for it, you are an asset. If you do not, you are a liability. This is what we ran away from. Being powerless subjects of the system where the people exercising the power are also powerless subjects of the system in other ways. The only way out is the power of the market. The power of money. The power that you can hold in your hand and take it anywhere you wish to give it to only those who treat you right. The question in the end is how can we change it, but I have an even better one: do we really want to?? How many people you know who can see the problems? How many do you know who understands what the problem is – as opposed to those who want to hand over even more power to the government to solve it, to pour even more money into the black hole that the system today is? How many people are aware of your personal experiences? What is your ratio between good and bad experiences? To how many people did you send my health care related posts? Is there anything you disagree with? Here is a quick list of them: Dealing with the free – Missing the freedom Two tier medicine yet again The harm government services cause The triage of money – the cost of free Health care confusion As P.J. O’Rourke said: “If you think health care is expensive now, wait until you see what it costs when it is free.” But that is the point, isn’t it? The state is doing everything in its power to hide the costs. We are at a point today when we have to ask: can we afford free?