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A tremendous amount of political positioning, propaganda, and debate went into crafting — or pretending to craft rather — a major reform of the health care system.  It had nothing to do with the system itself, mind you, but rather who was entitled to receive and who was required to pay.  All the same players were given the exact same roles as in any other day: HMOs buy and sell medical care like a commodity at a poker table where the house always wins.  And we’re the chips.

For many, many years, an opposing set of legislators pushed — or seemed to push at least — for real reform of the causes of health care disparity rather than band-aid over disparity, recognizing it as a symptom of an unfair, broken, or even corrupt system.  If it isn’t obvious, I speak of tort reform, the implications of which go beyond the insane cost of malpractice insurance that a doctor must cover just to survive.  Beyond the money, the system hurts people directly, and not just the uninsured.  Hold that thought.

The issues with health care are in one way similar to what happened in the sub-prime mortgage market.  No, I do not mean that a mortgage or health insurance policy is a means to afford what you want now and pay over time, though that is true for the most part.  My comparison is that blame for crisis can be easily attributed to everyone involved when it fails to work.  And I would challenge anyone to explain to me how either the bank bailouts or “Obamacare” has addressed the systemic issues at all.

So let’s play the blame game and in particular look at why our medicine men are being driven out of necessity to charge astronomically (regardless of who pays in the end) and becoming more and more ineffectual at their very practice. 

Medical providers inflate bills because they know they will get paid more often than the insurance companies can weasel out of it; Lawyers and judges cost doctors and their institutions so much money that a human procedure can be up to ten times more expensive than an IDENTICAL veterinary one.  My wife, a vet nurse, can verify something such as a hip replacement is the same, line by line, from anesthesia to x-rays, scalpels to stitches, right down to the hardware itself.

Even the prescriptions for those drugs used by both humans and animals are often differentiable by the writing on the bottle label only, but with feather-to-lead difference in price tags.  But this isn’t just about cost.  It’s that institutions pressure doctors to use (and bill for) diagnostic tools simply to expedite a return on the investment.  It’s that if even the most remote possibility of a diagnosis is missed, the legal department will have to don their suits.  But the worst case scenario is an incorrect diagnosis.

For the doctor at least.  When a doctor cannot afford to be wrong, they cannot take the chance when they can be right.  Let me explain.

A dear friend recently went to their physician, and after a battery of tests could not find the problem.  The persisting pain apparently didn’t get the memo there was apparently nothing wrong.  At the prompting of friends — and a hushed hint from a nurse — they went to the emergency room, were given more tests that eliminated more possible causes, and were sent home.  Again. 

There was a time where a doctor could smell your breath and tell if you had renal failure.  Some of them still can, but aren’t allowed to use that knowledge because it’s not a measurable test, and if the measurable test doesn’t prove him unequivocally right, he cannot act on his experience or knowledge.  No one will let him — not the hospital administrator, not the HMO, not his wife who wonders if they might lose their rigorously-earned lifestyle overnight from the slip of a knife.

For every person who died from a surgical mistake, misdiagnosis, or miscalculation of medication (such as my Mother and a high school class mate of mine within a year of each other), how many go untreated due to LACK of diagnosis? 

Biology is a science; Medicine is an ART.  It’s not even a skill like carpentry where you can measure and angle everything in front of you to an expectable result.  It’s about the odds — what works more often than placebo, since the very notion something will work on every patient is a fairy tale.  Some people will die.  MORE will die if you defy that law of nature with endless, costly tests that only confirm what you already know is or is not the problem.

Charging a box of tissues every time a patient sneezes is monetarily fraudulent.  Using expensive, one-use, all-inclusive surgical packs for any and all operations where most components are discarded without ever being used?  Monetarily inefficient, and a waste of resources and landfill space.  Not being able to make judgment calls when needed because the consequences are too great?  That’s a moral crime against everyone.My father always says, “He who hesitates is lost.”  And thanks to the system, out doctors are lost.  At life-and-death junctures, how many lawyers and policies can they feel breathing down their neck?

Physicians have been made to be the bad guys because they make the mistakes.  I say the ability to make mistakes and making the best calls they can make anyway makes them heroes.  Accountability needs to be a two-way street.  Just as some people should have known better than to buy a house they couldn’t make payments on, patients should be willing to accept that complications can and do sometimes occur and it is their responsibility to accept the outcome, all other things being equal.

When medical fallibility is no longer a litigatable crime, the whole health care system will have the chance to become healthy again — and more affordable for everyone.