It is pothole season in Michigan, with roads crumbling under the pressure of winter cold. Then again, with the condition of our state’s dismal economy, pothole season is becoming a year-round phenomenon here in the Great Lake State. Michigan’s government can no longer afford to fix roads like it used to, and the same goes for bridges, water mains and other infrastructure. And don’t even get me going on budget cuts to our public education system.
While Michigan’s auto-based economy is the main cause of our fiscal distress, physician that I am, I cannot help but see MRIs lurking at the bottom of the sports-car-sized pot holes that litter the roads on my daily commute. An MRI costs a few thousand dollars a pop, you see, and we doctors order such tests almost unthinkingly. Back bothering you? Shoulder pain lasting more than a week? And that blip on your liver enzymes? We need to make sure nothing terrible is going on. Time for an MRI!
Our willy-nilly use of MRIs occurs in part because we doctors don’t pay for these tests. In fact some of us (but not me!) actually make money by ordering these tests.
The same goes for medical procedures. A primary care physician like me makes a token amount of money during a routine (and frequently time consuming) annual checkup. But if we can bring that same patient back for a skin biopsy, that ten-minute visit smells to me like a college tuition payment!
So we physicians order tests and procedures, and other folks pay — sometimes insurance companies, sometimes patients themselves, and increasingly often, the government through Medicare or Medicaid. Eventually, of course, we all pay for these tests and procedures. Our crazy health care system is basically a huge transfer of income from the general public to people in the health care industry.
States like Michigan are facing enormous budget pressures in the face of the recession. But even before this recession hit, many states were starting to buckle under the strain of Medicaid inflation, leaving huge SUV-sized holes in their annual budgets.
We need healthcare reform because we need to control health care costs, or we will end up with an infrastructure that would embarrass a third world dictator.
And the Democratic party needs to tell us more about how its reform efforts, should they succeed in the face of the Massachusetts senate debacle, will control costs.
And the Republicans need to stop whining about healthcare rationing, if they actually care about the future of this country.
We are facing a serious challenge. If politicians don’t meet this challenge, we will all have lots more to worry about than potholes.
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