Wednesday, August 12, 2009

A Libertarian question--and answer--about bringing health care to millions of uninsured people ... now

The question is, why can private organizers do what the government can't: bring basic health care services to those in need on a shoestring budget like Remote Area Medical?

Here's what the purely private organization does:

The organization was founded in 1985 and years of research and planning yielded a vast, carefully developed network of men and women who have come together to make RAM a highly mobile, remarkably efficient relief force. Volunteers are doctors, nurses, technicians, and veterinarians who go on expeditions at their own expense and treat hundreds of patients a day under some of the worst conditions.

Volunteers have provided general medical, surgical, eye, dental, and veterinary care to tens of thousands of people and animals, with 60% of the expeditions serving rural America. There are plans for expansion of US expeditions, an airborne medical treatment center, a permanent clinic site in Guyana, and a program start-up in Africa.

I never thought Inglewood CA would be considered remote, but maybe urban California is remote in terms of accessible medical care. So here is what RAM is doing, even as I write:

Inglewood, CA (AHN) - Charity clinic Remote Area Medical (RAM) started its eight-day free medical, visual and dental check-up to uninsured and under-insured individuals at the Forum in Inglewood, California on Tuesday.

RAM volunteer doctors will serve 1,200 individuals per day starting at 5:30 a.m. until 6 p.m. As usual, RAM will not require individuals seeking treatment to show proof that they don't have healthcare insurance or have low income.

RAM has set up 45 medical exam rooms, 100 dental stations and 25 eye exam sites at the basketball stadium. Exams include mammography, chest X-ray, PAP smears, blood pressure screening and diabetes test.

Prescription eye glasses will also be fitted and prepared on site.

RAM has some corporate sponsorship and gets donations, but its average yearly budget ranges in the $100-250K range--that's thousands, not millions.

With that, and a willingness to go anywhere, jump through any hoop necessary, and practice in fairgrounds, animal stables, or even on bleachers in the rain, they make a difference and save lives--over 300,000 patients and counting.

RAM founder Stan Brock epitomizes the humanitarian (and libertarian) ideal that it is not acceptable to wait for the State to do it for you.

Which brings me to my major point: the answer.

Why can't the government do this? Suppose Stan Brock had a budget of $1 Billion and worked for the government. Government regulations would not allow him to just lease pieces of ground with no real facilities. Government would require records and authorizations of those who came to be treated. The government would have to have a multi-thousand page manual, a quality control panel, a diversity impact committee, a physician licensing inspection office....

For $1 Billion I will be willing to be you that the government could not treat the 300,000 people that RAM has treated over the past twenty years for less than $5 million.

One of the more ominous pieces of bait and switch in the current debate is when the administration and key congressional leaders stopped referring to what is going on in Washington as health care reform and started calling it health insurance reform.

And rushing us to pass a bill immediately that won't even change anybody's level of insurance or treatment until 2013....

We could make a difference right now, if the State were not so mired in being the State.

Toss some regulations overboard and send the US Public Health Service doctors and nurses out to do RAM-style expeditions at the drop of a hat, with nothing but what they can carry in....

Give poor communities matching grants they can use to invite RAM to come visit them.

Too simple. We need bells, whistles, health advisory panels whose membership is driven by obscure qualifications.

Ah horseshit --waves hand in disgust--you know the answer as well as I do, even if you're not willing to admit it publicly.

So what to do? They need money, and anybody can send it.

I have twenty-one years experience as a medic in the US Army, including specialties in innoculation, physicals, and record-keeping. There is an RAM expedition in Grunday VA on 3-4 October. I'm calling today to volunteer.

If one out of every thousand people jacking their jaws on either side of health care reform would actually get off their ass and do something positive, there would not be a health care crisis of such magnitude in this country.


Waldo said...

It's an interesting meditation, but it seems to beg the question- if private medical bidnesses can do this in one place or another, why can't/won't they do it everywhere? One presumes it's because they make more money NOT doing it.

A very big chunk of the uninsured market is people just like me- single, middle aged, and not making sackful. I have a hard time thinking the last time the status quo did anything for my situation, and everything I hear/watch/read says they've got no interest in it moving forward.

Steve Newton said...

You miss my point: this is not a private business. This is a non-profit entity.

And my question is that if a private non-profit can do this on such a low budget, why can't the government do so with the funds that represent a rounding error in the national budget.