Z-Pac, this is the seminal issue of our generation: how do we as a society manage the health of our citizens? Is it personal responsibility and free markets? Is it collective government support? The answer is yes.

Apparently, the Miss USA pageant is still a thing. So to generate a newsworthy clip, the winner generated outrage and accolades by giving a direct answer to what is usually a “I just wanna use unicorn tears and rainbow extract to save the world!”-type answer. So we use it as a jumping off point to discuss this crucial issue. Bottom line: none of it matters if we don’t build a better, collaborative, more efficient care delivery model…Health 3.0.

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Join the conversation in the comments on the original Facebook Live video.

  • Jennifer

    This is still being framed wrong. Healthcare vs. insurance. Until people are being turned away from EDs, Everyone in the US can get HEALTHCARE. Not everyone in the US can get (afford to get, desire to get, whatever the case is) INSURANCE. I think decreasing the profit margins is the best way to go. Everyone immediately thinks “doctors” when I say that amongst “lay” people, but as we all know, it isn’t doctors making all of the money in healthcare anymore by a long shot – unless you are a plastic surgeon or dermatologist or in something more “elective”. It is the crazy high drug company charges and CEO salaries, etc. I get it, researching drugs costs money. I get it, every person wants to have some extra money at the end of the month and not just get by. But some of these things are over the top and, in my mind, immoral. And I hold an extremely conservative financial view of the world. Trying to fix it by putting government in charge of healthcare – are you kidding me?! No bueno! See the post by the practitioner who works in Indian Health Services. Government run anything is a fiasco. Put some smart people in the field in charge and lets give their ideas a go.

    • Oldretirednurse

      Those of us who were in health care for 30-40 years knew government run anything doesn’t work. No one is denied healthcare as you so aptly noted. Obamacare was passed with
      no input from doctors and nurses. It was written and defended by a guy who said the American people are too stupid to understand it. The stated problem was no insurance for pre-existing conditions. So we were saddled with this monstrosity instead of funding an insurance pool for pre-existing conditions. People would be best served by allowing competition across state lines and a variety of insurance choices.

      • Epador

        Your solutions are reminiscent of the benefits touted for low tar cigarettes. “Insurance” – that is third party payors thrust between the consumer and the provider are the root of the problem.

    • Epador

      The exorbitant costs are mainly driven by there being a third party payor between the patient and the provider of services or substances.

  • Melinda

    Not everyone can get healthcare, that’s a republican talking point and lie. Yes everyone can be seen in the ER, but they don’t do chemo there or monitor blood pressures or diabetes like a primary care physician does. And Medicare, government run healthcare program, has worked pretty well since it started. If you don’t believe that ask your grandparents how they would feel if you took it from them. It is actually very efficiently run, unlike the insurance-as-middleman system. Medicare for all, single payer, is the only appropriate way to provide healthcare to everyone, which is clearly a right.

    • Jennifer

      And I still say everyone can get all sorts of care in this country. I had pts all of the time who were poor, illegal, old, etc who had all of the care offered to them that they could need. Was it handy or posh? No, but posh takes paying for – that is just the way the Whole World works! Even in England, with the NHS, pts pay for the nicer, more convenient services. We all would like something for nothing – although it isnt free; just check out my taxes! But stuff costs money… That’s life.

      • Epador

        Unlike ZDogg, I’ve worked FQHC (heavily subsidized health care programs designed to be test runs for nationalized health care), private solo practice in specially and subspecialy venues, military medicine, VA medicine and more. I have seen and worked in city charity hospitals, back when they still existed. Jennifer has a good grasp. I’m not smoking HC 3.0. It’s just another form of self-serving mind-altering weed that leads you to lose self awareness and ability to judge your level of intoxication before you really get stoned by continual daily consumption.

  • dianesef

    Who used to OWN this pageant? Ugh…. It’s a RIGHT. I used to work for Medicaid and I saw the ugly side of America’s working poor that no one wants to talk about. WORKING poor – who could NEVER afford care if it was’t provided.

  • dianesef

    Rand Paul is from one of the most UNHEALTHY states in the nation with the MOST citizens on Medicaid.

  • J McClure Salmon

    Holy crap guys, best discussion EVER. What societal issue did you not at least peripherally touch on, if only to at least demonstrate how to have an F-N conversation?!? You guys make a fabulous team. I just hope it’s not lost in the din of the political insanity. Rational discussion is an undervalued commodity; real solutions don’t win elections.

  • Former Christian

    Return to a non- profit healthcare industry… pharmaceuticals included.

  • Barb Morton

    problem is the poor person with no education and no job isn’t going tot he primary care doc for their health care needs the ED which is free to them is used as the PCP. If you are poor the idea is you get everything free. If you are rich you get all the breaks. The burden falls on the people in the middle, the working class. The working class is shrinking. It is not a sustainable system. Everyone must contribute equally. for taxes healthcare etc.. If you are working class and get debilitating ill too soon in life you lose everything to get care. But if you don’t work and live off the system everything is handed to you. Not ok. I am in healthcare. There is a lot of waste, there is a lot of care given when it is futile because the loved one will sue if you say no more and pull the plug. As a society we have no issue paying a ridiculous amount for entertainment but don’t feel we should have to pay for our meds or healthcare. We have our priorities screwed up. Back to basics. Doctors make good money, that is what most people think anyway. If you divide the money physicians make by the hours they work the on call time the off hours visits to the hospital etc… they really don’t make that much. PLus they can lose their livelihood if they do something wrong even if it is because they have been up for 36hrs and are exhausted. I am not a doctor. As a nurse/ APRN my debt from school is large compared to my salary and I get taxed to death. I am single and can not afford to live large. I work for the government too. My health care is not given to me, I have to pay part of my premium each month, I have prescription co pays and office copays. Why should others that are not helping themselves be entitled? Even if on a scale based on income is better than free. If no income then community service for the service, something.

  • Mati

    I ran into this bit of data preparing for a talk yesterday: Tranexamic acid, used to control bleeding, costs 4.38 to 4.89 USD for a course of treatment in the developing world. In the United States a course of treatment costs 100 to 200 USD. THAT’s a HUGE problem and not one that doctors can control. As a physician practicing in a rural community, I can tell you that I am hosed when it comes to outcomes. I don’t think I am a horrible person, but I can talk until I am BLUE in the face and some of my patients will *never* get it. I would *love* it if I could personally deduct on the charity care that I provide in my office. I am also worn out: when patients that are uninsured or underinsured hit our office, it is a rare time when I receive gratitude. Instead, it’s gimme, gimme, gimme. I am supposed to buy their drugs, buy their DME’s……this list goes on and on.