The Politics of Healthcare Delivery

A comparison of the US and Canadian healthcare systems shows about equal costs and patient satisfaction when comparing insured americans with all Canadians. While one hears anecdotes about the long wait lists for certain procedures, the evidence suggests that this is not an actual issue affiecting morbidity and mortality. In addition, many of the expensive procedures that require long waits are procedures that would be largely unnecessary if the average citizen took better care of themselves. For example, how much heart surgery would be necessary if people ate right and exercised regularly? I have always been somewhat on the fence about socialized medicine. Here is the classic libertarian rebuttal. Nevertheless, the fact remains that 40,000,000 Americans are still uninsured. And when you factor the responses of the uninsured into the comparison, the US fares poorly. So when some pundit says that the American healthcare system is superior at timely delivery of services, this latter group must be left conveniently out of the equation. And then this latter group still utilizes emergency services footed by the taxpayers, services far more expensive than offering insurance to all these folks in the first place.

Some economists have thus argued that in highly technical matters like health care the free market fails as one group, the doctors, have far more knowledge than the patients. In Canada the government professionals are also experts in the field and thus, the argument goes, fairer rates are set. I had never really looked at it that way. Basically, the government, as a true representative of the people, negotiates on the behalf of their clients. Perhaps the American distrust of socialism is not only rooted in irrational residual mccarthyism. But also because our government has not been trustworthy to so many for so long. That is not the experience of Canadians who, with good reason, have largely trusted their politicians to be honest and work in their best interests. I think that's what's the founders actually meant by "we the people". So, if the rest of the developed world delivers healthcare in a fashion completely different than us, is it possible we are wrong or, dare I say it, that our government is not a truly representative one? Maybe if American politics was not so debased by corporate dollars, the politicians would actually suport a true citizen's agenda. It might be Libertarian or socialist or green, but we know for sure it would not be either republican or democrat.

Many in the field of acupuncture are basically apolitical, having more of a self-described spiritual orientation and a general disdain for worldly battles. Ironically they find themselves not in the midst of some blossoming new age, but rather in a profession engaged in a fierce battle for legitimacy and a piece of the American pie. Thus the rank and file are torn between open minded liberals and free trading republicans. Openminded liberals are often willing to consider alternatives to the norm. But typically with a hefty price tag in the form of excessive regulation. Republicans in the heartland are generally suspicious of the new and possibly satanic pagan arts, yet they are strong proponents of minimal licensing and obstacles to trade. With huge loan debts and the possibility of large incomes, many of those who begin Acupuncture school as starving liberals are fiscal conservatives after a few years in practice. This leads more and more in the field to support Republican fiscal policies purely for the issue of low taxes and unregulated herb markets. Yet the healthcare crisis is left unaddressed and many of those who entered the field of Acupuncture to make things better end up being part of a broken system no closer to being fixed. Clearly a partly regulated system does not work. We either need to try a true market approach or become completely socialized. Compromise and tinkering makes no one happy and clealry just results in endless spirals in costs. Its time to set aside cold war rhetoric and construct a true solution to these seemingly intractable problems.