Mike the Mad Biologist

Atrios identifies the problem with the Republican choice-based ‘vision’ of healthcare:

Well, really, the Republican vision, as slobbered over by cenrtist [sic] David Broder.

In this case, he is visualizing a radically different kind of medical marketplace, in which families armed with specific information about the treatment success and prices of hospitals and doctors can shop at will for the best quality and most affordable care.

We pay doctors to make these decisions for us because most of us haven’t been to medical school. I know this point is simple and obvious and everyone makes it, but as I said before our elite discourse is so fucking stupid.

One of the most ridiculous ideas to come down the pike is the notion that most people, who are woefully ignorant of medicine and biology (e.g., the massive misunderstandings a out antibiotics and infectious disease), will actually make intelligent decisions regarding their own healthcare. In fact, I bet most people would do worse than flipping a coin in many situations. That’s before you get to the roughly twenty percent who are functionally illiterate.

This probably sounds elitist. And you’re right, it is elitist. Because, as Atrios notes, medical doctors are part of an elite group of people who have extensive experience and training in medicine, which most people lack. While trying to ‘puzzle out’ your healthcare treatment options isn’t quite as stupid as trying to puzzle out how to build a nuclear reactor, it’s still pretty stupid.

Stupid Republicans.

Note: There are many more reasons why Leavitt’s visions are stupid; I’m picking on this one, but feel free to add more in the comments.

Comments

  1. #1 jeffk
    October 22, 2007

    I never understood the conservative argument on this one. Which do they think I want:

    – get sick, spend hours and hours doing research, trying to figure out which doctor/hospital is best even though I know nothing about medicine, and because it’s a private system they’re all probably lying to me anyways

    – get sick, go to nearest hospital, get treated, go home.

    Hmmmm…. gee, I just can’t decide on that one. It’s one thing when a car salesman lies to you. Imagine now the claims that would be made when they’re all spending half their time fighting for patients.

  2. #2 David B.
    October 22, 2007

    I don’t think the public is ignorant as much as mis- and ill-informed.

    Just this morning Boing Boing is touting a fantastic diet where you eat fruit and vegetables (with lots of dressing) all day while exercising a lot. What a great way to become a diabetic!

    As I write this I’m contemplating writing a blog about vaccination dodgers, their kids, and the disastrous consequences to us all.

    There’s always this small group of doctors that get on board for this stuff.

    http://www.theskinofmyteeth.com

    David B.

  3. #3 PalMD
    October 22, 2007

    Before you call the insurance company for your car, you should be required to determine what is wrong with it and how best to fix it, and then find the best and least expensive person to do it.

    Also, before building a bridge, you should take bids from the cheapest builder, rather than the one who uses actual engineers.

    The analogies can go on and on, but since the founding of villages and guilds, we have had specialization, because we realize that not everyone can do and know everything.

    Seems obvious.

  4. #4 Occam's Trowel
    October 22, 2007

    One of the most ridiculous ideas to come down the pike is the notion that most people will actually make intelligent decisions regarding their own healthcare.

    No, but they will make decisions that are exceedingly profitable for certain others… cha-ching!

  5. #5 Genn
    October 22, 2007

    One of the most ridiculous ideas to come down the pike is the notion that most people should not be making their own decisions.

  6. #6 Brian
    October 22, 2007

    Guys, as a conservative I simply trust people to make decisions not the government. I hear your concerns, but isn’t it hard to live life thinking that the government can take care of you instead of yourself? I am just not wired that way.

    I disagree with the comments regarding knowing medicine. Of course we don’t know medicine, but we can find out quality providers on our own. Do you know everything about plumbing when you hire a plumber? No, you ask your dad or neighbor who they think is a good one. Even then, you may not know anything about plumbing.

    Know matter what, America can’t afford all the “freebie” stuff including healthcare. Afterall, its not really free, its going to cost you a heck of a lot in taxes.

  7. #7 Jonathan Paul
    October 22, 2007

    I feel that some aspects of this whole huge Healthcare System debate are not being properly framed (sorry about this word). Healthcare is expensive, we pay for doctors, nurses, administrative staff, medical equipment and supplies, diagnostic technicians, pharmaceuticals, biomedical research (very, very expensive), etc.

    Plus, we pay for a very complicated bureacracy to negotiate the payments. The current system is an interesting combination of public and private systems that kind of co-exist in slightly different niches (e.g. the very old, and the very poor, versus the lucky and wealthy). These niches need to be expanded in order to ensure that everyone has access to affordable healthcare.

    We will pay either through taxes to the government or “premiums” to private insurance companies.

    The private insurance industry is obviously not good at providing everyone with affordable modern health care. Therefore, the government programs should expand until it is certain that everyone has coverage, and this includes knowing that some people in the middle income range will have a choice between private and public health insurance.

  8. #8 Gabriel
    October 22, 2007

    I love so much the anachronic and wrong idea of the perfect consumer. As perfect consumers, we will aways have all the information available and aways will choose the best possible option for yourself. Beautiful in theory, awful in practice, and eventually can lead to disastrous and imbecile proposals like that one. Like you said, Mike, it can only lead to death and equivocated medical treatment. Very equivocated medical treatment.

  9. #9 Richard Simons
    October 23, 2007

    Brian said ” America can’t afford all the “freebie” stuff including healthcare.”

    A couple of years ago, while looking for data to use in a statistics course, I came across a list of the total cost per person of health care in a range of countries (I no longer have the url but IIRC it was a CIA site). The total cost of health care in the US was close to twice that of any other country and about four times the average. Can America afford not to have a proper health care system?

  10. #10 Coin
    October 23, 2007

    cenrtist [sic] David Broder.

    Atrios has consistently questionable spelling and grammar :(

  11. #11 Graculus
    October 23, 2007

    Guys, as a conservative I simply trust people to make decisions not the government.

    I am so tired of this fucking bullshit.

    In your wonderously free system a bureaucrat whose loyalty to the bottom line of the corp is paramount makes your healthcare decisions for you. This clerk can over-ride a doctor’s recommendations if they feel like it. They choose what doctors you can see and what treatments you can recieve.

    Here in commie-pinko Soviet Canukistan I can see any doctor at all, and recieve whatever treatment the doctor reccomends… without paperwork.

    Which is the “nanny” state of affairs, again?

    You’ve labelled fascism as “freedom”, and proceeded to wallow in it.

  12. #12 Brian
    October 23, 2007

    Well, coin, you could not be more wrong. In your world you see corporations as evil. In mine, I see corporations as providing jobs.

    What you are describing above is only in regards to HMOs. There are many many people in PPOs and other more fee for service type models like the new HSAs. Everyone is not in an HMO. Even in an HMO it is not quite as bad as you have described, not for everyone.

    A previous post is absolutely correct, we have both a mix of private and government healthcare.

  13. #13 Graculus
    October 23, 2007

    see corporations as evil. In mine, I see corporations as providing jobs.

    Apples and oranges, theycan do both at the same time.

    Mind you, being as corporations are completely amoral, they can’t be evil. Or good.

  14. #14 Michael Schmidt
    October 23, 2007

    “Do you know everything about plumbing when you hire a plumber? No, you ask your dad or neighbor who they think is a good one. Even then, you may not know anything about plumbing.”

    My dad doesn’t live in the area. My neighbor rents and the landlord would be hiring the plumber. So am I up a creek? No, we have a thing called licensing…. So even with plumbers we depend upon the government to keep us from getting into deep do-do. We might not get the best plumber, or the best deal, but at least the threat of delicensure will keep our mediocre plumber from being truly criminal in his or her incompetence.

    “I hear your concerns, but isn’t it hard to live life thinking that the government can take care of you instead of yourself? I am just not wired that way.”

    You’re setting up a strawman. I don’t believe the government can take care of me. I just believe that, as a representative of 300 million people, it might be able to negotiate me a better deal. Isn’t it hard to live life thinking that you can really do everything completely on your own? I’m actually wired that way, and it’s a pain in the butt!

  15. #15 Coin
    October 24, 2007

    Well, coin, you could not be more wrong. In your world you see corporations as evil. In mine, I see corporations as providing jobs.

    Why do you hate grammar?

  16. #16 PalMD
    October 24, 2007

    That was a whopper of a straw man! Putting more decision-making onto the consumer via high-deductible health plans is one way to try to fix the health care system. It’s opposite is not “socialism”.
    There are many ways to design a health care system–one way (current U.S.) is not to design it at all. So far, mixed results.
    I think many people commenting forget that the average IQ is 90-100–that’s not where you’d like to be. You can’t expect an “average” person to decide whether coronary bypass or PTCA with a drug-eluding stent would be a better option for them.

    And the other commenter is correct–to equate criticism of our current system with socialized med is bullshit.

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