Yesterday was my annual physical, so I got to experience a little bit of the American health care system. Since I don’t have any maladies, I only experience the system on these annual trips to get inspected. As is always the case, when you are familiar with something, its quirks seem normal. When you are unfamiliar with something, those quirks and contradictions jump out to you. My trip to the doctor is like visiting a strange place for the first time. All the weirdness stands out to me.
The first bit of oddness is the check-in. Last year they started this new process where you answer a survey when you arrive for the appointment. They ask questions about your personal habits that are none of their business. One question was whether you own firearms and why. There’s no reason for the doctor to know this or ask it, but that question was on the survey again this year. A new question was to list the states I had visited in the last year. It is not hard to see where this is going.
Another new item this year is a kiosk where you check-in for the appointment. One of the things they do is take your picture. My dentist started this last year. There’s no reason for them to take a picture of you, at least not one to do with health. Most likely, the pics are being sold to the tech giants. The mass surveillance system being built out by companies like Google and Facebook will use facial recognition to track us as we go about our business, so they want a database of faces.
In this regard, the health care system is a glimpse into the future our rulers have planned for us. To the people in the health care system, I am just a talking meat stick, one of many, they have to supervise. The relationship between the patient and the system is impersonal and transactional. Health care is a process. The patients enter the system, pass through the system and come out the other end repaired, broken in some new way or dead. No one really cares, just as long as the process continues.
Of course, the American health care system is really just a massive series of toll booths and processing centers. All along the way, patients are turned upside down and given a good shake to get money from their insurer. If you have a malady, you get diverted into a new series of toll booths and processing centers, so the people manning those operations can dip into the insurance pool you represent. The business of treating sick people is a good business for a lot of people.
A good example of how this works is I had patella tendinitis a few years back. I was pretty sure that was the issue, but I asked the doctor about it. He sent me to a quack called a physical therapist. My insurance covered five visits, so he said I needed five visits, then I would be sent for an MRI. To get the MRI, I would need an X-ray. The doctor, of course, needed to see me in-between stops. The point of the process was to squeeze out every dime from my insurance plan.
If the goal were to treat my injury, they would have sent me for the MRI right away, as that would tell them the best course of action. They would see that it was tendinitis and that rest and a brace were the right course. That would not line the pockets of the quack, the X-ray company or the doctor, so that’s not what happens. This is one reason American health care is absurdly expensive. We have great health care, but you have to pass through a lot of toll booths to get it.
Another new thing this year was a giant flat screen in the waiting area running ads for various drugs and treatments. It used to be that the sci-fi movies about the dystopian future would show a world bombarded by ads everywhere you went. That’s where we are headed now. I suspect that the next time I see the doctor, he will have patches on his smock like race car drivers. He will great me with, “this physical has been brought to you by the makers of” some drug being pushed on patients.
The funny thing about the problems of the American health care system is that this is the one area where libertarians could apply their arguments. They don’t, of course, as that would take time away from selling weed and porn to grade school kids, but there is a libertarian case to be made about health care. In fact, we have a libertarian health care system operating in the United States. It is world class and provides amazing results for the patients. It is called veterinary medicine.
In America, our pets get better health care than most humans on earth. The cost, compared to any system in the West, is trivial. The service is phenomenal, as there are lots of suppliers competing for customers. In my area, I have one doctor and five veterinary clinics. I don’t need permission to make an appointment and I am not required to pay a monthly fee for services I’ll never use. It is a great example of how to operate a market-based health care system that no one ever mentions.
Whenever I mention this, the immediate push-back is that you can choose to put down your animal, but you cannot put down your granny. That is nonsense, as we end care all the time for terminal people. In Europe, they are euthanizing people now, sometimes against their will, just to cut costs. All the current system does is disguise these tough choices by shifting them onto the system. For most of human history people accepted that death was the inevitable end of life. We can accept is again.
The good news is the ravages of time have not made me obsolete, so the system recommended I remain operational for another orbit around the sun. Even though I had no issues to report, I was still relieved to learn I was not on that list. Like most men, I don’t like interfacing with the health care system, so good health means less interaction with the system. Of course, it will not be long before my social credit score flags me for refurbishment or perhaps recycling, but for now I get to live another day.
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