
Twelve Steps To An Affordable Health Care System
by Dean J. Earlix

One look at competing health care proposals makes it pretty obvious
no one with both understanding and need of public health care was
ever consulted.  Even an impoverished doctoral student in one of the
allied health fields using just the leftover dregs of his imagination
could do better.  In fact, could anyone be better qualified?
Consider these 12 steps to an affordable health care system:

1.  Put a lid on those pointless medical procedures, but avoid the
    costs of new bureaucracy, by letting an *existing* federal agency
    spot-check surgery and diagnostic tests.  I figure the Internal
    Revenue Service--which is already geared for audits and Internal
    anyway--could handle this.  Who knows, maybe this year the IRS
    can start saving Americans money instead of just grabbing it.

2.  Know from the start if your doctor is any good.  Toss out all
    those old magazines in doctors' waiting rooms and replace them
    with current medical journals and a medical dictionary.  Now when
    you sit down, you can read about your symptoms and quiz the
    physician before a consultation.  This measure could cut down the
    need for expensive multiple opinions, motivate doctors to study
    the current medical literature, and no doubt shorten waiting
    periods.

3.  Improve the accessibility of primary health care.  Move
    specialists out of those expensive, inconvenient medical centers
    and into retail districts and malls where you can also cut costs
    by eliminating offices.  Optometrists are already working out of
    eyeglass stores; why not have child psychologists in toy stores,
    a marriage councilor at the florist, and gynecologists in
    lingerie shops?

4.  Motivate people to undertake preventative health care. Most folks
    vaguely know that preventative health care saves society money,
    but how do we give John and Jane Q. Public their piece?  How
    about this: say epidemiological studies indicate a certain test
    for premenopausal women will save society millions of dollars.
    Use census data to work this out on a per patient basis and send
    out savings for the test in a recognizable form... perhaps as
    discount coupons.  Of course, the expiration date on some of
    these coupons, menopause in this example, could be messy to
    check.

5.  Lower the costs of medical research, which should drop the cost
    of medical treatments, by using white collar criminals in
    research labs.  Criminal labor that is--I won't even ask what you
    were thinking.  Myself, I've been wondering why we should have
    college-educated lawbreakers just stamping out license plates or
    working out with weights when they could be washing lab glassware
    or running analytic equipment.  Far from being worried, the
    medical researchers I've worked for would love having an
    assistant they could threaten to send to prison for sloppy work.
    And do so nightly.

6.  Fight the multibillion dollar costs of addiction by selectively
    decriminalizing addictive substances and dispensing them from
    government clinics that give mandatory therapy.  Conservatives
    worried that decriminalization amounts to social approval, fear
    not: We'll let the anti-abortion industry handle the accompanying
    graphic of what drugs *really* do to the brain.  Yech.  For
    liberals concerned about the victims of decriminalization, those
    poor disenfranchised drug traffickers, we could retrain them for
    urban distribution of prescription drugs.  At today's prices,
    they'd hardly know the difference.

7.  Eliminate the nettlesome conflict of interest between health
    plans and health plan users.  In case we legislate which
    procedures are covered by national insurance, let's consider
    trivia like dollar estimates of physical pain, mental anguish,
    and chance of failure.  No doubt, health plan executives will
    insist on determining these values themselves.  Sounds fair: For
    verisimilitude, offer to drape them in paper gowns, belt them
    onto the examining or operation table, chill the instruments, and
    ask them to suggest dollar values for everything they are about
    to experience.

8.  Widen the health tax base.  As long as we tax people to disease
    themselves with alcohol and tobacco, why not add health tax to
    other unhealthy substances?  We could tax raw fish and rare meat
    at restaurants to cover parasite and food poisoning treatment,
    tax tanning salons and bikinis to pay for skin cancer operations,
    and maybe a workplace stress tax leveled against abusive
    superiors.  Admittedly, if folks start living more healthy lives
    and treating each other with respect, the tax base would all but
    dry up, but I don't suppose there's much danger of that happening
    soon.

9.  Institute no-fault medical malpractice insurance that completely
    covers doctors, generously awards victims of human error, and
    leaves lawyers out in the cold.  Practitioners could lower their
    fees across the board once they stopped paying malpractice
    insurance premiums greater than their patient's annual income.
    If they hold true to form, lawyers' groups with names like "just 
    plain folks against malicious medical malfeasance" will be
    contributing more money to fight the measure than is spent by all   
    presidential and legislative candidates *combined*.  Just a 5%
    tax on these political contributions could probably fund
    reasonable damage awards through the twenty-second century.

10. Substitute unemployed professionals for overpaid medical
    specialists.  For example, hire unemployed Hughes engineers and 
    computer programmers to replace $200,000/year anesthesiologists.
    As an added benefit, the new anesthesiologists could talk to the
    patient about their former work, greatly decreasing the required
    amount of anesthetic.  We could also cut costs by replacing
    physical therapists with drill sergeants recently released due to
    military downsizing.  Can't you just hear it echo down the
    hospital hallway now?  "Streeeeraaatch those tendons you WORM!"
    Last, use the natural inclination of medical malpractice lawyers,
    hopefully unemployed due to no-fault malpractice insurance, as
    blood-letting phlebotomists.

11. Allow elective medical treatments to be paid by elective
    donations. Hospitals and clinics are chronically short of blood 
    because, if cash is paid, they get donations from undesirable
    types like alcoholics, drug abusers, and college students.  If
    payment was non-cash--credit for elective procedures--
    undesirables would not be attracted by the cash.  A couple
    gallons of blood (separate visits, please) and those braces won't
    cost a cent.  Indeed, if doctors had switched earlier to the
    serpent and staff caduceus and dropped the gilded balls of the
    Medici device, the notion of cash for blood donations might never
    have come up: While the Medici name is remembered in the word
    medicine (and Medicare) the family device has remained the symbol
    for their other line of business, pawn shops.

12. Read more humorous material.  Not only is laughter cheap, it
    might just be the best medicine.                            {RAH}
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The author, Dean J. Earlix, has worked in a diagnostic lab and is
currently a doctoral candidate at Auburn University in an allied
health field.  Admittedly, it is the fish health field.  He can be 
reached on the Internet at: DEARLIX@AG.AUBURN.EDU

