Saturday, March 03, 2007

Does Walter Reed lead to socialized health care?

OOh boy, the world of the news is going nuts. No matter how unrealistic the various labels are in the opening stages of war. IF it's like this now then imagine how it is going to be next year. The Secretary of the Army "resigned" following the relief of the Commanding General of Walter Reed. Some don't think it's enough and are calling for the Army's Surgeon General to go as well.

Folks I am going to completely tick some of you off with this post. So in advance, I think it is for your own good. You, I, and the rest of the McUSA have got to stop thinking with our emotions and look at the reality of things. Take Walter Reed for example. Unless I missed a story, the issue was in living quarters not in actual medical treatment. The other issue was bureaucracy. I served in the Marines and lived in some pretty humble barracks. I also lived in some awesome structures. The reality is that all units in the service have a budget and priorities. IN the case of Walter Reed, I would assume the priority is in premier health care. I could be way off, but I bet there is more to this story.

So the question has to be: Who is Responsible and who should be held Accountable?

I personally have no problem with the idea that the Secretary of the Army is ultimately responsible for everything that got done or failed to get done IRT the US Army as a whole. But this is a general responsibility. Should he have been held personally accountable for WR? How you answer this question can say things about your thought process.

If you think that his "resignation" was warranted I have to wonder how much you are looking at the day to day realities of that level of responsibility. Obviously he cannot supervise every minute detail of every unit in the US Army. If he did, why would we need Generals, Captains, Sergeants, or Corporals? And in my mind, there is the crux. While he should accept responsibility for the problem and for getting to a solution, I feel that holding him personally accountable was wrong.

It's wrong because at WR there are literally hundreds of leaders supervising even more followers as the minutia of daily operations goes on. It's wrong because you cannot reasonably expect that he would be aware of the problem at WR anymore than he'd be aware of a shortage of toilet paper at Fort Bliss. Frankly, there are subordinate leaders who's mission it is to see the problems coming and head them off at the pass.

I have no problem reliving the Commanding General. HE is the one who is responsible for the day-to-day operations of all aspects of Walter Reed. Which means we can reasonably expect that he should have been aware of the problem. It means we can reasonably expect that he should have had the issue already on his agenda and prioritized properly. Had he said, "Yes, the conditions are tough. But I have XX number of dollars to either rehab the BEQ or purchase a new doohickey for the burn ward. I can save lives in the burn ward." Folks would have nodded wisely and life would have gone on. He also, for all we know, apprised his higher headquarters of the BEQ issues and was told to make do. Most Officers who take thier oaths seriously don't whine about difficulties that blow up on them.

Finally, let this be a lesson to the National Health Care folks. Socialized medicine isn't working well in the UK, Cuba, or Canada. And any government agency (even the .mil) adds layers of red tape to an already bloated system. If we go with a full blast .gov operated health system, you may be the next patient living in WR like conditions.

In fact the best working example of socialized medicine is the US Military Health Care system. Let's see, free or low cost to the patient. Worldwide care available. First rate trauma care. Standardized procedures. Standardized record keeping. Overall, in spite of inevitable bumps in the road, it works very well. Why? Simple proportioning and basic common sense is the thing to look at here.

I believe it (the success) is in the resource to patient base ratio. I don't have boring facts or stats to back it up. I have 42 years of using the system. The first 18 as a dependant, then 22 years of active duty, and the rest as a retiree. Look at the number of hospitals, clinics, unit aid stations, doctors, nurses, corpsmen/medics and money spent. Compare that to the number of folks in the patient base. I bet it is higher than most civil institutions.

Now, if we socialize health care then we increase the patient base by how many fold? But we won't increase the resources to match it I bet. Another thing to consider when figuring out why military medicine works is that the focus of effort is on the active duty population. The active duty folks tend to be physically superior to the civilian norms. Ergo, less likely to need the medical services. The dependents and retirees are treated on a space available basis and are partially covered by the VA and insurance respectively. Yet if you ask most dependants, they would prefer to be treated in civil facilities.

I think that health care insurance should be available to all. So, after means testing, if you need insurance the .gov can provide bare bones coverage for a very small fee. I don't advocate failing to treat anyone who needs it. But, the bill must be paid and I am not sure that the taxpayer is the right one to be paying it.

The NYT Story that got me to thinking about all of this.

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