Commentary by Randy Carlson: Health care, half a glass

We've all heard about the half glass of water. Show it to a pessimist, it's half-empty. Show it to an optimist, it's half-full. But, show it to an engineer, and he will tell you the glass is too big.

This is how I feel about health care and the debate we are having over Medicare, Medicaid and health insurance. Democrats say too many folks are uninsured, so we should spend more. Republicans say health care costs too much and we should spend less. I'm an engineer, and to me, the problem is, we aren't getting our money's worth.

We spend more than twice as much on health care, per person, as they do in Australia. Or in Denmark, or England, or Finland, or France, or South Korea, or Japan, or Portugal, or Spain, or New Zealand. And the citizens of every one of these countries live longer than we do! Austria, Canada, Luxembourg, Germany and Switzerland spend less than two-thirds what we do, and their citizens outlive us, too. What's wrong with this picture?

Since we spend twice as much as they do in France, shouldn't we live twice as long as Frenchmen? Why not?

If we spend twice as much as countries whose citizens outlive us, doesn't it follow that half our money is wasted? If they get better results for less money, why can't we?

The reason we aren't getting our money's worth is pretty obvious. All of our discussion, all of our debate, all our thinking, is focused on providing, delivering, needing or paying for, health "care." But health "care" isn't what we really want. What we really want is health. And, the less "care," the better.

I have a great doctor. Known him for a quarter century. He's competent, conscientious and provides great health care. Still don't look forward to visiting him. Health care, even very good health care, is inconvenient, unpleasant and expensive. The reason I show up for my appointments, tolerate the ordeal, and pay the cost, is that I want to be healthy. You probably feel the same way.

For us to live healthier, longer lives while spending less for health care, like folks in the rest of the developed world, something has to give. That something is our health care industry on which we spend a couple trillion dollars every year. If we somehow stop spending the half of our health care dollars that are being wasted - about a trillion dollars - a lot of health care workers will be looking for other work.

Our politicians go on arguing who should receive health care and who should pay for it because actually making health care efficient would cost a lot of people their jobs, and establishment politicians don't have the courage to do that. It's easier to just argue the glass is half empty, or half full. What we need are leaders willing to tell us the health care glass is too big.

• Randy Carlson is a Carson City resident.