Monday, November 13, 2006

Sometimes Krazy Glue isn't

'Let me glue that for you...'

My neighbors often chide me for recommending Krazy Glue as a cure-all (untrue). But it is true that Krazy glue fixes lacerations quite well- as long as the wounds are not too contaminated nor under too much tension. I have four boys, so the stuff gets quite a lot of use at my home. 50 cent tubes from the local supermarket work just fine, though you can come to my emergency department and I will use a re-branded version called Dermabond and charge you $150+. The idea of using Krazy Glue to fix some cuts seemed a little 'crazy' when I first learned of it many years ago. But the truth is that it works fine.

Which brings me to the point of this, my first, blog: sometimes 'crazy' approaches are not so crazy after all. Though it may be 'cliche', sometimes looking 'outside the box' is just where we should look when searching for solutions. In particular, our nation faces a health care financial crisis of unparalleled magnitude. Over a series of blog posts, I hope to share some of my observations on some unspoken causes of increasing health care costs. My only credentials in this endeavor are my own two eyes, the fact that my profession puts me at the center of our health care system (I am an emergency physician), the fact that economics is kind of a hobby for me, and the fact that I like to think 'out of the box'. Hopefully you will find some of my 'crazy' observations at least interesting, if not worth exploring further.

Before we go any further, I want you to know that I know you know the population is aging, I know you know drug costs are increasing, and I even know you know Americans are getting fatter by the day. But beyond these significant demographic trends, whose solutions are difficult at best, there are other, unspoken structural issues which go unvoiced simply because they seem too 'out of the box' and have no vocal champion. Solutions to some of these issues, might even represent 'low hanging fruit', that is to say they could be easy, cheap, and achievable. Some are not easy at all.

Certainly addressing some of these unspoken issues would be easier than trying to solve America's aging demographic crisis. But though the ideas I address are real, as I have said, they have no champions-- indeed at first blush they might even seem a little crazy-- for reasons which will become quickly apparent. Like Krazy Glue for wounds, even discussing them might seem a little 'crazy' to some of you-- crazy that is, until you think about them for a little while...

Have you ever considered the simple issue of trust, and how the lack thereof might effect our entire health care system? Have you ever thought about medical certification, why we do it, what it guarantees, what results it guarantees us, and what reasonable alternatives exist to it? Have you weighed the pros and con's of each? If you are interested in escalating health care costs, and have not, perhaps you too have become too befuddled by our system's complexity. Like many of us, you too may have become lost looking at the proverbial health care trees, and forgotten to take notice of the forest they reside in.

I hope my views will be a voice for discussion regarding some of the 'unspoken' causes of escalating health care costs. As you read, you may come to suspect there are many-- though they seem to share a common thread. None are difficult to understand. Whether you are a supporter of 'free market' health care reforms (I sympathize with you) or a supporter of a nationalized health care system (I sympathize with you too), I hope you find this blog helpful.

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