I anxiously await hearing what solutions Washington comes up with regarding our Health Care nightmare. I realize this is a bit of a different blog, but I did practice Internal Medicine in Santa Monica for 25 years. I also admitted hundreds of patients to the hospital. I have witnessed for many years the extreme waste within the medical system.
Two of my children are in Health Care. One is a third year resident in Anesthesia at UC San Francisco and one is completing her first year of medical school at USC. I was talking with them the other day about their feelings regarding waste in the system. After speaking with them, I decided to bring up a very, very delicate issue. My daughter has become fully aware of this problem in less than one year of her training. I have now seen this for 30 years.
The issue is all about “rationing” care. Rationing simply means giving more care to some and less care to others. Rationing is nothing new to anyone. Nearly everything in our lives is rationed in one way or another. With regard to healthcare, we have elected as a coutry to ration care based upon social and economic status. So, we have over 40 million un-insured and tens of millions more receiving less than standard care.
Medicine needs a bailout just like the rest of the country. It has been overspending resources and very poorly allocating valuable resources. We have to begin to choose as a country how we spread our resources. Medicine is like everything else. So, the question is, are we happy with what we have? If not, we have to begin changing how we spend our assets of money, equipment, personel, hospitals, vaccines, bypass surgery, joint replacements, etc.
When there were inadequate number of kidneys for transplant, committees decided who got the kidneys. The same happened with bone marrow transplants. Now there are inadequate resources available in nearly every area. We must change our rationing position. I believe we need to look at end of life spending on truly hopeless cases. We spend 95% of the Medicare dollars in the last several years of life. Perhaps this should be looked at?
We all realize what I am referring to and it is so painful. On the other hand, do we really want to keep our ICU hospital beds full and neglect basic vaccines and preventive care for young and productive individuals? No other country in the world gives out unlimited care to everyone; we certainly don’t either.
Where should the resources go?