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Insomnia Ramblings About Healthcare

I am currently on a steroid taper for my chronic migraine since it seems to have taken a turn for the worse over the last month. It seems, though, that I react to different steroids rather differently. Prednisone predictably makes me anxious, hungry and insomniac. I've been on Decadron this time (and my last steroid course) and find that I'm not as hungry, and the sleep and anxiety issues are intermittent. I slept a lot yesterday, probably recovering from Friday's migraine and trip to the ER. But, tonight, I can't seem to relax enough to sleep.

Other non-related thoughts. Our exchange student who is coming in a month or so needs to update her immunizations and we are told that she should try to do this before coming to the US because it is cheaper to do at home. Students are almost always coming from a country with some kind of government-supervised health care.

That got me to thinking about health care in general. Why don't we treat health care in this country as a public good that everyone should have? This wouldn't have made a lot of sense in 1900 when medicine couldn't offer much but some rudimentary surgeries. But, in 2019, appropriate health screenings and treatment save lives every day. And, putting off health screenings and treatment because of the short-term cost just drives up the long-term cost of care.

As an example, mammograms are recommended every one to two years for women age 45-55, depending on the guideline that you read. A woman who doesn't have the ability to pay in the short term for a mammogram for several years may end up getting her breast cancer missed. If this happens, she could end up being diagnosed at a stage 2 or 3, requiring surgery, chemo, and radiation, and still have a significant risk of mortality. Had she gotten her mammograms, there's a good chance that the tumor could have been caught at a stage 1 or low stage 2 with treatment only requiring surgery and radiation with perhaps adjunctive chemotherapy. Her care costs along with stress and missed time from work would have been much lower in the second scenario.

Health care is a public good. It is good for me that my neighbors all have access to immunizations so that, if my immune system gets compromised, they are less likely to carry infectious diseases. The interstate highway system is also a public good. We don't complain too much about maintaining our roads and bridges, but the idea that the government should step in to health care, which benefits all of us is anathema.

One issue is that we think that we can't afford for everyone to get high-quality health care. That's not true. Right now, there are so many layers of bureaucracy and repetition of care that streamlining alone will save tons of money. The fact is that we have people doing work that doesn't need to be done. A more efficient system, whether single payer or multiple, could do the same work for a lot less money. And it should. Because when the workers in an economy are healthy, the economy has a better chance to be healthy.

Well, this turned into a post on health care. I don't know if the right answer is a single-payer or competitive insurance market, but what we've got isn't working right now. When churches are taking up donations to pay up people's medical debt so that the folks aren't going into bankruptcy because they got sick, you know there's something wrong with the system.

This election, listen to what the candidates are saying about health care. And think about health care as a public good, not just something that you can have if you have enough money. We need to think of our TVs as things that are luxuries, not medical insurance.



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