Diary

Systems Thinking 2 --- The Health Care Plan Will Fail - Unless Obama Really IS God

We systems types are fond of simple calculations. They keep us from getting so lost in the trees that we forget there was a forest. When we get lost we can end up with those $600 toilet seats or worse. Obama has not done this thinking for his health care plan. Or maybe he would rather not say.

So look at this little table:

Item

 

 
Source

 

 
Number

 

 
Needed Today

 

 
       
US Population

 

 
CIA 2008

 

 

303,000,000

 

 

 
Number Without Insurance/Care

 

 
White House

 

 

46,000,000

 

 

 
Number of Nurses

 

 
Census Bureau 2007

 

 

2,400,000

 

 

365,000

 

 

Number of Doctors

 

 
Census Bureau 2007

 

 

800,000

 

 

122,000

 

 

Number of Hospitals

 

 
Census Bureau 2007

 

 

4245

 

 

644

 

 

Number of Medical Schools

 

 
AAMC

 

 

130

 

 

20

 

 

       
MediExpenses 2008

 

 
White House

 

 
$2.7 T

 

 
$405 B/year

 

 
       
Estimated Delay Without

 

 
  55 Days

 

 
 
       

The last column shows what we must have to pay off on what Obama is promising. I echo three of his stated presumptions. No plan means no care; services will be at least as good as they are now; and we can, must, do it all right now. So Obama and his next crew of czars will need to materialize half a million doctors and nurses, 644 hospitals, and 20 medical schools.

The bottom row is my own contribution. I simply estimated how long it would take for the existing system to take care of 46 million new customers before seeing any repeat customers. That delay gets worse as time goes on. It’s not fancy but it gives you some idea of how long you might have to wait for your first next doctor’s appointment under the new plan.

All of this, which roughly equates to conjuring the greater Albany New York area in the middle of nowhere, makes David Copperfield’s vanishing and reappearing the Statue of Liberty look like a minor parlor trick. Compared to that, making that $250 billion a year in expenses vanish is child’s play.

To do all this Obama must… not might, must… violate the law of the conservation of mass and energy. That’s physics, folks, and it’s a law not a theory. Basically, you cannot create something out of nothing and that is exactly what Obama proposes to do. Any reasonable systems thinker knows that you can’t get from here to there in anything less than the time it takes to create the needed trained people and infrastructure. It takes 10 years to grow a doctor, maybe half that for a nurse. Hospitals take years to design and I don’t want to think about what it takes to put together a medical school. That, as I pointed out my previous post, is why fascists are always asking you to trust them. They don’t know what they’re going to do so they can’t tell you.

All of this holds unless, as some say in faith and others in jesting, Obama really IS God, the anointed one. I don’t think so. If we start down this road as now described to us we are going to have one ungodly mess. And we won’t get the medical care most of us want, many of us need, and American economic competitiveness seems to me to require. Republicans needed detailed, rational, explainable, and fundable alternatives. We need to get out of the trees of politics, interest, and power to take a hard look at the forest. And we must remember that good capitalism is as much about destruction as it is about preservation. It is not about adding on; it is about creating the new.