Friday, August 15, 2014

Fantastic Voyage not covered by HMO.

I was thinking about the rising costs of medical care and the largely urine-sample-poor job of bringing down costs that insurance companies and---God help us---the government has done.

One problem is that medical advances are always expensive, and while we want everyone to have access to everything, no power on earth can afford to give everybody access to everything. Ultrasounds are still costlier than most of us would want to pay for out of pocket; CT scans even more so. There's an economy of scale and a cheapening effect over time on new technologies, but they can only go so far. It's going to be a long while before the local CVS has a tube where you can pop in and have yourself scanned for free while waiting for your bottle of oxycodone.

Another great example comes from the 1966 science fiction classic Fantastic Voyage, wherein a team of scientists is shrunk down in a submarine and injected into a VIP to break up a blood clot in his brain.

How much do you think it will cost to send a molecule-size Raquel Welch into your bloodstream? The HMO ain't gonna touch it. How would you like to be one of the people on the Independent Payment Advisory Board death panel who has to turn down access to the "shrinkerizer treatment" because no way can we pay for everyone to get this thing?

In the case of the movie, the guy they have to save has technical knowledge that's key to the shrinking process and so is the focal point of the Cold War battle over shrinkerizing. Not ones to shrink from danger, our teeny weeny scientists risk their lives to save his. This inspired me to come up with...

The Fantastic Voyage Scale of Importance

Under the assumption that if you're going to have five human beings with advanced degrees injected into you (at taxpayer expense) you have to be very, very, very, very important, we can extrapolate that the kind of care you're going to get is directly related to your personal importance. Here's the scale; where do you fall?

Title: Top Dog
Importance: Your life may win the Cold War for the forces of freedom.
IPAB says: Will shrink down Raquel Welch and inject her into your bloodstream.

Title: Second Banana
Importance: President of the U.S. or wealthy founder and head of a company that gives a lot of dough to the president.
IPAB says: Will shrink down some people and inject them into your bloodstream, but no one good-looking.

Title: BFD
Importance: Beloved celebrity; speaker of the house; Veep.
IPAB says: Robot version---the Raquoomba---shrunk down and sent in; at least we can say we tried.

Title: Well-known for Being Well-known
Importance: Celebrity on an old TV show; sales quota achiever; governor with good poll ratings; mayor of a big city with a strong political machine.
IPAB says: Balloon angioplasty or something. Tell the doctor not to go nuts. Show poster of young Raquel Welch in office.

Title: Local Hero
Importance: Local mayor; business leader; cute little kid; veteran (honorable discharge).
IPAB says: Nothing outside of the PDR please; we're not made of money here. Poster of Donald Pleasence.

Title: Schmoe Six-pack
Importance: Someone's dad, maybe.
IPAB says: Inject something. Whatever's lying around the doctor's office. The PA can handle it. Tell 'em Raquel says hi.

Title: Who?
Importance: Family pet; homeless bum; writer.
IPAB says: Don't waste a needle.

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