Restoring Family Health Care

Haiku of the Day:
tracing the starlight
interference undulates
affecting image

The primary responsibility for maintaining health is the individual; to the extent there is a strong secondary responsibility, it must be to the family, not an employer or state. Yes, the state has a role in being the provider of last resort, inasmuch as we wish to be a humane civilization, but those with family should be turning to each other first. Yes, employers have a vested interest in making sure the business has employees who are healthy and not overwhelmed with the health concerns of their immediate family, but that interest is fiduciary in nature, not personal. The providers market to us directly, yet we have placed multiple intercessors between the persons affected by the medical treatment, individually or vicariously, and those who are providing the service, making each person a database entry in a workflow that is streamlined for economic efficiency, not human efficacy. The logical step, for most of us anyway, is to get the intermediaries out - decline insurance, save diligently, and turn to your family, not a business, if the situation merits.

A tougher issue may be hospice and the process of dying. Most medical expenses occur in the last 30 days of life; if those 30 days are spent at home, health care costs per person would drop like a stone. Returning to the practice of living with our elder relatives, or at least in close proximity, where family life can address aging without paying a stranger to do those basic things that become more difficult as the body stops cooperating. Incentives should be made to the families of those who eschew assisted living and long-term care facilities to find one's rest at home, either from the companies and governments who save in expenses, the communities (religious and secular) who benefit from the interpersonal networks being maintained, or both.

There are a host of other social fixes for this problem from which to choose. The important thing is for us to choose, not allow the status quo to drag us deeper and deeper into financial ruin while depersonalizing the life cycle. Making licensing of patents mandatory and using some of that revenue to accelerate the process of bringing new treatments to bear would help. So would forming community creches, enabling single women and their children to have the benefits they may not otherwise be able to access, giving both generations better access to the information and skills that improve and maintain health. Effective triage at emergency rooms, redirecting the urgent care needs to the correct, less expensive, less profitable eponymous facilities, could shave a few percentage points (each point being over $10B/year) off our collective expense. All these point in a single direction: reducing the scale and increasing the scope of health care to provide a holistic, permanent solution rather than patching an increasingly decrepit problem.