talkpolitics | The Politics of Neuromania: Is that Real Reform or Is that Sears Reform?‏‏

sophia-sadek.livejournal.com posting in

There are two distinct schools of thought on health care reform. One of them advocates genuine changes is the way that health care is delivered and the other does not. The second school is not dissatisfied with the quality of health care. It considers health care to be as good as it is going to get. The second school only concerns itself with how health care is distributed. It is divided into camps which disagree over public vs. private distribution of services. Those who advocate genuine reform in the quality of health care have to contend not only with the poor quality of health care but with the fact that people fight over who is supposed to pay for the delivery of such poor services. This fight over distribution of shoddy services distracts people from the more fundamental issue at hand.

The issue of shoddy services is not limited by ability to pay. People of all walks of life are victims of shoddy health care practices. Many of them have no clue that the quality of care that they receive could be far better than it is. People with more money are actually more likely to be taken in by charlatan medical practice. They are more willing to pay out of pocket for questionable treatments and for treatments that actually degrade the quality of their lives. Poor people will not subject themselves willingly to such treatments. The poor live life closer to the bone. They are not buffered from reality by the comforts of luxury. Only the advocates of shoddy health care for all will do anything to bring poor quality services to those who are not willing or able to pay.

How can we address this problem? One of the first steps we can take is to recognize that health care is a service industry. Health care practitioners are service providers. Thinking of them as scientists does them no favors. Science is involved in one degree or another for all services, but the services themselves are not strictly scientific. The highest quality deliverers of health services are people with more of a human touch than a scientific one. Practitioners who regard themselves as scientists tend to see their patients as experimental objects, and they treat them as such. That is not health care.

Ancient health care has been sneered at because it included an element of magic. There is an extant Platonic dialog that provides insight into the role that magic played in ancient health care. You could look at it as a form of placebo effect. We still have magic in health care, but we call it different things. Bedside manner falls into the category of magic. A physician with a cold manner will not be received well by any patient, except those who prefer such "professionalism." The current medical training system is more conducive to cold practitioners than warm ones. It is a microcosm of rat race competition in which the most rat-like earn the highest rewards.

The political system actually encourages charlatan practice by enforcing standards of shoddy practice. Experiments in humanistic health care delivery have been shut down by the denial of public funds on the grounds that they did not conform to the "scientific" standards of charlatan practice. Once we recognize this problem we can work effectively to promote public funding for humanistic research efforts.

Which school of reform do you find yourself in? Are you satisfied with shoddy medical practice?

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