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    Sunday, January 20, 2008

    O Muse 2

    Oh Muse, the best laid plans of Men are folly!
    When I wrote my post, O Muse ..., I originally had it many pages long, but after reflection, truncated it. I feel the thoughts were best elucidated separately, although they do connect. As I pondered the (de-)evolution of blogging, I realized that I had seen this phenomenon before.

    Blogging has changed like medicine. Once it too was a brotherhood. Physicians went through years of schooling to understand the mysteries of the body; heal people. The community respected them. If a physician got sick, he needn't worry about paying, for other physicians would treat him pro bono.

    Then something happened. Physicians in California sold their souls to Kaiser Permanente, and their fellows in Dallas, TX sold theirs to Blue Cross/Blue Shield. In the name of the patient, these physicians sold their autonomy to HMOs. They thought,

    "I can help my patient if I worry about the billing and not him/her."

    The HMOs said,

    "We will entice patients into preventative care if they know they have already paid for it monthly, instead of paying up front."

    Oh Muse, the best laid plans of Men are folly! Gone went the direct payment to physicians, and the hidden became the cost of medical care. Instead of preventative medicine, patients demanded the "million dollar workup" for every disease, because, hey, they had paid for it. Physicians spent less and less time with patients, because they needed to see more and more to cover the overhead of their billing requirements.

    And in the community's eyes, the physician became a well-read technician. Sure, more respected than a plumber, but in stature much like a nurse or a physician's assistant -- someone who looks at a patient, checks a set of boxes, and sends them to a machine (xray, MRI, blood test) that diagnoses the sickness. A glorified car mechanic.

    Except that true medicine is so much more than that. Hence the crisis in Health Care today -- it is an identity crisis. Many talk today about the need to “fix” Health Care. Most propose some combination of patches that extend coverage, and change billing structure. However, the true solution will only come when physicians wake up from their self-imposed slumber, and throw off the dichotomy that afflicts them.

    Health Care must be put back in the hands of the physicians. Patients must be in control of their own health. Blogging has followed much the same path, and similarly, bloggers must never relinquish their camaraderie. It is these bonds of friendship and acquaintance, although spawned first over the virtual web of cyberspace, that keeps the reader questioning reality. It keeps him aware of his surroundings; looking through others' eyes at things which may have been mundane before.

    Only through our ever present desires to push how people view the world, to share insights into life, and to refute complacency, can blogging truly be constructive. It is for that end we must continually strive.

    1 comment:

    Sara said...

    I have an HMO insurance, and love it! Why?? Because it doesn't cost me anything to visit my doctors for annual check-ups (well, besides the premiums I pay every month).

    I see your point--to get back to the basics of caring for people's health and not so much Health Care. But, how do you propose the logistics of such an overhaul occur? Perhaps what really needs to be fixed is society and its view regarding physicians? That would be the most getting back to basics.

    And, your argument goes for many other professions. Look at elementary and secondary teaching--some say that teachers have sacrificed their profession's integrity for the almighty "No Child Left Behind."

    Sadly, I think the problem is more general...I think it's just the way societies are headed. People can get so much more done individually, and that separatist mentality spills over into many facets of life.