Monday, January 21, 2013

Catastrophic Care by David Goldhill

The insurance model of health care is broken, according to David Goldhill in CATASTROPHIC CARE - How American Health Care Killed My Father, And How We Can Fix It. "There are many perverse incentives," Goldhill says, "that are bankrupting the system." The book arose from an article the author wrote for The Atlantic magazine after his father died of infections acquired in a New York hospital in 2007. Amazingly, Medicare paid the bill in full for his father's treatments of several hundred thousand dollars, after the hospital first failed and then failed again (the patient died.) Goldhill then went on to research the problems within the health care system, asking how it could be that common medical errors coupled with unnecessary (or wrong) tests are considered "normal" by a public which seems to accept the continually rising prices of hospital or doctor visits as "inevitable." We shout when gas prices rise 10%, he says, but say nothing when, say, the simple pulling of a tooth goes up over 100% since one's last visit (as it did for this reviewer.) America spends $2.5 TRILLION per year on health care, more than any other country by any measure (per capita included.) This rise in costs is unsustainable, yet both Republicans and Democrats bat around the same old ideas that are not solutions, but simply more nails in a coffin that will delivered to everyone long before their actual death. Narrated by Dean Sluyter, the book shows why the insanity of making insurance pay for everything, (not just catastrophic care,) needs to be changed before the truly inevitable occurs---which is the collapse of the system. "Insurance for everything medically related has resulted in more procedures, higher costs, lower quality of care, and more paperwork. It's a lose-lose." Ironically, if one compares technology in consumer computers to technology in health care, home computers are cheaper and faster while health care technologies are more expensive and slower. Why? The system (whether Obamacare or the Republican model) is rigged to reward inefficiency. In no other business or enterprise do we pass out bonuses and paychecks based on how much was wasted that week. "We have all bought into this model, and it has to end." Goldhill tells how as well as why, along with nightmare examples of what happens to real people caught in the cogs of a berserk machine fueled by insurance premiums instead of prevention and accounting.  
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Years ago there was a PBS series on the connections between events and discoveries or inventions which seem unrelated. The nature of science is such that progress is not achieved in a straight, progressive timeline. Random events spark ingenuity and insight. A and B sometimes does not lead to C but rather to G or T. Stagnation can last for generations. In an examination of how we are connected to the base materials (chemicals) of which we are made, Neil Shubin presents a series of essays titled THE UNIVERSE WITHIN: Discovering the Common History of Rocks, Planets, and People. Read by Marc Cashman, the book covers the entire history of the universe in an easily understood and personably performed format. From the evolution of the solar system to continental drift…to ice ages and global warming…and to how animals and plants have adapted within complex environmental structures, Shubin provides a broad view of essential science and biology for those who might feel overwhelmed with more technical material. (6 1/2 hours unabridged)

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