Thursday, November 15, 2018

Assessing the Reality of American Medicine



During the recent political campaign, the Democrats concentrated on the alleged problems of American medicine.  Despite the embarrassing failures associated with ObamaCare, they proposed a federal takeover of the entire medical system.
Was this because our medical care is in dire trouble?  Are we dying like flies because it is ill managed or bankrupted thanks to its unrestricted costs?  Why did so many voters say that their number one political concern was health care?  Was there a valid reason for their apprehensions?
In recent months, I have had intimate interactions with a number of medical facilities.  This has enabled me to assess their quality first hand.  Despite of all the negativity in the press, I am pleased to report that accounts of their medical malfunctions have been greatly exaggerated.
First of all, the equipment available in our hospitals and clinics is outstanding.  It is cutting edge and constantly being upgraded as innovations are introduced.  Up and down the line, for almost every ailment, this makes improved treatments accessible to most patients.
Next, our medical personnel are top-notch.  They are well trained and for the most part dedicated to doing their best.  The nurses could scarcely be more congenial, the technicians more assiduous, and the physicians more steadfast in their efforts.  
These are good, intelligent, and committed human beings.  They know that what they are doing concerns life and death and therefore they seldom slack off because the work is hard or the results can be disappointing.  There may be exceptions, but few of these professionals and semi-professionals are slap-dash in their exertions.
Nor are patients treated disparagingly because of their status.  I witnessed consistently respectful conduct notwithstanding social class differences.  The poor were not written off because they are poor.  They were not shunted off into back rooms where they were allowed to wallow in misery.
Of course, mistakes are made.  My wife studies medial error so I have heard untold stories of tragedy. Nonetheless, I have also talked to doctors and nurses who told me they have nightmares about giving the wrong medication.  These are responsible people who endeavor not to do harm.
Then there is the issue of cost.  In my case, insurance handled most of the expenses.  In the case of my wife’s parents, Medicare has done likewise. No doubt there are exceptions. Top quality care is expensive and therefore some people must fall through the cracks.
But is there widespread suffering because people are being bled dry and/or denied the appropriate attention?  If so, I didn’t see it.  This, to be sure, is Atlanta.  Somewhere there must be backwaters where high quality interventions have not penetrated. Yet does this mean they never will?
Which brings us back to our political concerns about medicine.  The irony is that Democrats are exploiting these. Given the recent boondoggles surrounding ObamaCare, this should have been impossible.  Soaring costs, lost doctors, and broken promises ought to have made this issue toxic for them.
Nonetheless, liberals, who were answerable for the dramatic increases in insurance rates, still promised reduced outlays.  They were even able to make a total federal takeover of the medical system sound attractive, although a smaller takeover turned into a fiasco.
Democratic candidates also claimed that Republicans wanted to eliminate protections for those with pre-existing conditions.  This charge was blatantly dishonest, but it resonated.  What persuaded so many voters to take obvious canards seriously?  Weren’t they listening?
The culprit, in my opinion, is elevated expectations.  Modern medicine has done so well that we expect it to cure all of our ills.  When we get sick, we anticipate getting better almost immediately.  We also require this to be cheap.  How could it be otherwise in the richest nation in the world?
And so we accept promises of panaceas.  Told about the wonderful free care available overseas, we demand the same. It doesn’t matter that the quality of foreign interventions does not match ours.  It is irrelevant that in places like Russia life expectancy decreased, whereas ours increased.
Wanting more and better is part of the human condition.  Even so, making major changes without investigating whether these will be genuine improvements is seldom wise.  If we exchange something that is very good for something that merely sounds good, it is our health that will suffer.
Melvyn L. Fein, Ph.D.
Professor Emeritus
Kennesaw State University  

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