Healthcare, Obama and My Volvo Wagon
A couple
of years ago, round about infamous tax time, I noted that my trusty Volvo
240 (affectionately called Wilhelmina, “Willy” for short)
was getting far better healthcare than its owner, and a lot cheaper too.
Now, as you will guess from the model number, Willy is not a new, flashy,
multi thousand $$ plastic model. She is over 18 years old (over 70 in
human years, as Dave says), a nice, solid Swedish
box. It doesn’t matter whereabouts in the US we are, when it’s
time, she
always comes back to Dave at Independent
Volvo for her checkups and work. She smiles as she
drives, and rightly so: she has great healthcare, thanks to “Dr. Dave” at
Independent Volvo in Albuquerque.
Willy has been serviced and looked after by Dave for over 12 years and it’s got to the stage that we both trust him thoroughly. Dave is always on the ball for preventative care, and when he says you need to do something, fix this, take better care of that, you’d better do it, even when it means digging deep in the pockets. On the infrequent occasions when I have foolishly resisted, Dave has this iron cold stare that he turns on me to let me know I’m considering doing something that is just not in Willy’s best interests and I’d better reconsider. Well, what can I say? “Dr Dave” cares, and we have a trusting relationship that works.
Now Willy’s owners are not as lucky as she is. We (my wife
and moi) are in our sixties — no spring chickens. We’re
not
health-nuts but we like to be active,
walk and swim, and generally take pretty good care of ourselves. Knock
on wood, we've never had any major illnesses. Living in Santa Fe as we
do, we have used “alternative
medicine” with
great success. Now for the zinger: we are both self employed and to put
it frankly our health insurance is crap. We pay $400 a month for catastrophic
coverage which gives us one cursory check up, no preventive care and, to
add insult to injury, our deductible is around 2,500 bucks. In the last
10 years we have probably seen more different doctors between us for
primary care than we can remember. The good ones, the ones we liked, eventually
became so disgusted with the
system they just retired. Three of our good friends are in the health
care business and two have flat out refused to deal with any federal,
state or private insurance companies, so if you want their care, which
is damn good, it’s cash on the barrel only. Sadly, both will be retiring
in the next few years.
Which brings me to my thesis: the big problem with health care as an entitlement,
with easy insurance should we get it, is it’s absolutely worthless
without the great medical equivalent of thousands of Daves at Independent
Volvo — and where are they going to get and train these people? I
can tell you, they sure do not exist today. I have lived on several continents
where public healthcare is the norm, and I will simply say that you get
what you pay for, period. Cheap = cheap, and the consequences of doing
things on the cheap become expensive real quick. If you like the Canadian,
British and French systems where it’s standard to wait forever for
simple visits to see overworked healthcare people, more power to you. My
view is, it’s nuts, and besides that, it doesn’t work. And
I can tell you, no way is Willy ever going near any federal program for
her care!
The biggest problem with any huge federal program is that they never work
like they are meant to, because the basic prerequisites (like training
and supplying good doctors and nurses) get lost in the rhetoric, and someone
always gets hurt in the political brouhaha. To promote healthcare as
a free entitlement, where the patient has no responsibility, is a
zero sum game that leads to 10 percent of the patients eating up 60 percent
of the care dollars to deal with problems that often could have been avoided
with lifestyle changes. Just like Dave makes
me a part of the program and responsible for Willy’s health, I should
be expected to be actively involved in my own health maintenance and lifestyle
choices. It sure would be nice, but I've yet to find a conventional healthcare
practice or a doctor who felt this way and wanted to work with us. No piece
of paper drawn up and voted on by anyone will change that until the real problem
is addressed: we need good, available doctors who can make a decent living
by working in tandem with patients to help them take responsibility
for their own better health.