Wednesday, September 17, 2008

National Health Care ---- Fuhgettaboutit!

Up until a just last week, the big buzz amongst us doctors was the impact of a McCain or Obama victory on National Health Care. We doctors have understood for quite some time that millions of Americans do not have access to basic health care. Thus, when they do get sick, it's usually more catastrophic -- and hence, costly -- than if a modicum of prevention had been available.

These folks may often tie up our ER's and other Urgent Care facilities for mundane fever and flu affairs. This off-kilter practice not only burdens the health care system, but proves costly for municipalities, tax payers, and even the poor patients themselves who have to miss ordinary day work or child care time in their quest for basic service.

McCain, in predictable Republican fashion, seemed to advocate the present employer-based insurance model, with government and other charitable entities picking up the fringes. Obama appeared on the verge of a nationalized system, herding every citizen into some type of program as would cover basic health care costs -- essentially Medicare for everyone!

This week's $80 billion governmental purchase of the AIG insurance company; and last week's $100 billion purchase of Freddie Mac and Fannie Mae; as well as our $90 billion annual expenditure in Iraq seems to guarantee no money left for any new health care initiatives, except for possibly offering free Band-Aides at your local city hall.

Is this anyone's particular fault? Well, this corresponding neurologist -- who certainly possesses no qualifications when it comes to economics -- does not think so -- despite McCain's demands for a Congressional "inquiry". You see, our society made a collective decision over the past decade or so, that a big house, flat screen TV, fancy car, or Disney vacation had to be had today without real ability to pay or significant down payment.

In Grandpa's day, we had something called "lay-away". Indeed, my grandfather Harold Buckman's clothing store in South Baltimore had a signficant lay away program. To the significant chagrin of my grandmother, Selma, he offered customers -- interest free, of course -- the ability to choose their clothes at the start of the fall season when selections were best , and lay them away in time for Christmas (Back then, we weren't terribly political correct, so it was your job to know someone's religion and wish them a "Merry Christmas" or "Happy Hanukkah" accordingly; Kwanza did not exist).

I have fond youthful memories of lots of folks coming in on payday and plunking down $20 toward their "lay-away" purchase.

There were no fancy derivatives, "interest free payments until June of 2015", outsourcing, call centers, rebates, etc. However..."Pop Pop" got his money and the customer got their clothes. Now, the investment banks have lost their money, and the U.S. taxpayer is nakedly exposed.

I am not typically nostalgic and certainly don't wish to go back in time -- although it would be swell to once again visit my Mama and Pop Pop! However, the current economic turmoil will certainly put a comprehensive national health care plan on the back burner for the foreseeable future as the government -- with diminishing credit reserves -- will surely have to put any new initiatives on long-term "lay away".

posted by Neuroblog at 5:52 PM


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