Sphere of Domesticity

It's no secret that the main focus of American politics for the last few years has been foreign policy. But while the issues that concern our interest across the seas are important, equally so are the issues that face us here at home. This week and next, I'll be doing a 10 part feature on what I consider to be the biggest domestic issues facing America that do NOT deal with social policy. In other words, gay marriage, abortion, flag burning, and other such issues will not be included in this discussion. I don't see them being solved in the very near future, and when it really comes down to it, there is no pressing need to solve them. While I personally feel that gay rights are an issue of major importance, and the lack of equality is atrocious and deserves immediate remedy, the lack of such a result isn't going to cause the downfall of the nation at any point in the future. The issues I have in mind are of serious consequence to our country and our future. Many of them are of pressing need, and require attentions. Others are simply solid issues that I think should be addressed. The issues that will be discussed, are as follows:

• Healthcare
• American Personal Finance
• Taxes
• Energy
• Transportation
• Education
• Social Security
• The Military
• The Budget
• Compulsory Service

Every couple days I'll post a new issue until they are all done. Without further pause, I give you the first issue:

Healthcare

America spends more on healthcare than any other nation in the world, and for our money, we don’t have a better system in place than anyone else, in fact, it rates much lower than much of Europe. There needs to be a new focus on prevention, not treatment. Certainly treatment is a big issue, but billions can be saved in dollars, and thousands in lives if we don’t allow problems to crop up to begin with. That means making sure US citizens all have access to an affordable doctor, it means they have to get regular checkups, and it means they need to follow the advice given by those doctors. We can expect to see a major drop in diabetes and heart disease, two things that are the result of obesity, which is more and more becoming a major epidemic in this country. Once everyone is covered, the price will go down for everyone, as we slowly get this country healthy as a whole, we’ll have to spend less overall.

The problem is more deep seated than just a lack of prevention focus. With the way our healthcare system works, healthcare providers are more willing to pay $50,000 to amputate a diabetic’s foot than to pay a cheaper price to simple provide them with the testing supplies and insulin to maintain their disease and keep them healthy. Chronic diseases that shouldn’t be life threatening are costing us big time because, among other problems, healthcare providers are more willing to pay the costs derived from waiting too long rather than the cheaper cost of prevention. Hospitals too are getting in on the game. The hospitals make more money off that $50,000 amputation, but hospitals that attempt to run clinics that check up on and help diabetics’ manage their disease lose money. It makes more sense as a business for them to work this way, but healthcare providers should be trying to make and save the most money for themselves. And above all, no one seems to be concerned with the overall health of the patients themselves, which should be the primary focus of healthcare. We know that prevention centers like a diabetes management team works to reduce complications and help people lead healthier lives. It reduces costs across the whole system, and it should make employers happier by reducing their healthcare costs and keeping their workers healthier and more efficient. But for some reason we buy into this most odd system of taking care of our citizens. It’s time for a change.

We must also make strides to reduce the cost of prescription drugs. Any plan to make us healthier and to reduce the overall cost has to include drastically reduced prices on drugs. Seniors are buying unsafe drugs from Canada illegally in the thousands, and there are no checks and balances to ensure that those drugs aren't created in some basement in Argentina. They are unsafe, and seniors are dying because they can't afford the real stuff, and because they don't understand the risks involved. We must find a compromise that will protect the profits of Big Pharma and at the same time make their products affordable for the masses. Currently it costs billions for a pharmaceutical company to research and bring a new drug to market. If such a product ends up failing, those billions are lost, even worse if the whole line of drugs fails as has happened lately. And yet their parents last for such a relatively short period of time that they must charge outrageous sums of money for them in order to recoup their investment and profit, and still have money to keep other projects moving. While in the end this system may be profitable for the company, there must be a balance found between profits and the consumer.

There must also be reform of the legal process involved in malpractice cases. We cannot drive good doctors out of the industry through outrageous lawsuits. There needs to be a cap on pain and suffering, which I would arbitrarily set, at its highest, at $250,000. People need to realize that surgery is not 100% safe, and there are no guarantees. If we can’t come up with a way to protect against outrageous lawsuits, then soon there might not be any doctors to solve our health problems at all, and then we’ll be in serious trouble.

We also need to work on cutting administrative overhead. Billions of dollars are wasted on administrative costs, the paperwork, which should be used for treatment. We can help to do this by moving to a paperless system. Making all the information electronic, we can cut down on errors, easily and quickly transmit medical history, and reduce waste. In other words, we’ll save money, increase efficiency and save lives.

But there is much more to do than major policy issues. We need to get back to some basics and take a look at hospital safety measures. A high percentage of post operative infections, and of hospital infections in general are caused because patients get sick from other patients, and the main way this is done is from physicians who don’t wash their hands in between patients. If we exact stringent measures on the food industry to make sure that food is cooked to a certain temperature and sauces are heated and cooled in the correct amount of time, certainly we can expect doctors to wash their hands in between patients. We’ve spent a lot of time and money over the past couple decades to make sure there are sanitation stations all over hospitals, in every room even, but still 100,000 people die every year from infections they got in hospitals, and billions of dollars are lost, as hospitals aren’t reimbursed for extended stays and complications. It will save lives, it will reduce costs to hospitals, and it will get patients out of the hospital faster.

Employers need to take part in this as well, and for good reason. Right now employers are footing a decent part of the bill, and this is the reason why so many are cutting benefits to employees. By making their employees healthy, they can reduce their own costs, and they can increase their productivity through less sick days, maybe even awarding more vacation days, increasing the quality of life in this country by destressing the country. But all in all it will make them more competitive in the world market. They should be an equal partner in offering good health plans to employees, and should offer health club memberships and incentives to use them as well. They should also add incentives to employees who get yearly physicals. These efforts might sound altruistic, but really it all has to do with profit and efficiency. Healthy workers are happy workers, and healthy happy workers are productive workers. Productivity equals profit, and when companies are constantly pushing for increased production for lower costs, anything that can boost it at a lower cost is worthwhile.

In the end I think employers will find this model to be extremely business friendly. Already billions of their dollars are going to a health industry that isn't necessarily giving them a good return on their investment. Once the healthcare system is fully overhauled, and the nation is healthier, prices will go down for business as well. Their money will be much better spent on this system.