Healthcare Reform Rhetorical Analysis: The Debate Term Paper

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Healthcare Reform

Rhetorical analysis: The debate over healthcare

According to Thomas Goetz, the executive editor at Wired Magazine, the current national debate over healthcare reform is missing a critical point that is driving up costs: technology. In his 2010 Health Blog article "The paradox of technology in healthcare," Goetz compares technological advancement in healthcare and other industries and finds a critical paradox: "In nearly every sector of the economy, technology drives costs down -- just as your digital camera gets cheaper and better every year, so technology drives down the cost of manufacturing, the cost of retailing, the cost of research. But for some reason, in healthcare, technology has the opposite effect; it doesn't cut costs, it raises them. In fact, medical technologies -- from CT scans to stents to biologics -- are a significant factor in the 10% annual growth rate of healthcare spending, a rate that's nearly triple the pace of inflation" (Goetz 2010). As technology improves, so will healthcare costs, states Goetz, unless something is done to prevent this fact.Download full Download Microsoft Word File
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TOPIC: Term Paper on Healthcare Reform Rhetorical Analysis: The Debate Over Assignment

Goetz attempts to apply logos, or rational facts and figures, to the often-emotional topic of care, including the issue of breast cancer screening. For example, digital technology is more effective for early cancer screening, but also more costly. Goetz points out that healthcare costs rose 20% from 2006 to 2008 in Massachusetts, largely because of the use of new and more costly imaging technologies. Although he does not state so explicitly, given the pathos or emotional resistance to rationing mammography, he believes that technology must be deployed more judiciously, to keep costs from spiraling out of control. Yet even a "government-appointed task force on screening mammography was explicitly forbidden to consider the costs of offering mammograms to women for whom the benefit is very small" (Kolata 2010). Goetz wishes to emphasize the use of low-cost personally empowering health prevention technology, versus high-cost technologies such as digital screening. But to approach this potentially unpopular stance, and to convince the reader, he uses facts and figures to reduce the natural resistance to setting limits on, or redefining what types of technology are used.

The high cost and dubious benefits of mammography for many is an important point because Massachusetts is one of the few states to have implemented a program of universal healthcare coverage. Costs have risen exponentially in Massachusetts because of ineffective incentivizing of cost control in the healthcare industry. Goetz does not state he is favor of specific political party's healthcare package (this could also increase partisan resistance to his argument). Instead, he attempts to persuade the reader to look at the debate, not in an ideological fashion, but in terms of the peculiar economics of healthcare.

Goetz makes an analogy between healthcare technology and technology in other industries. For example, Moore's law in economics supports the idea that because of economies of scale, as technology becomes more ubiquitous and mass-produced, it can be offered at cheaper and cheaper prices. Technology gets better, and the means of producing it gets better, and the results are "Cheaper and faster chips, sensors and storage [which means] that digital technology is constantly scaling up and out, touching the lives of more people. These improvements in cost and power are the democratizing force that has propelled GPS from a military technology to a cellphone feature, and they're what helps Apple convince us to buy a new iPod every 18 months. Scalability is the secret sauce of the digital revolution" (Goetz 2010). But healthcare is not 'scalable,' and it does not get cheaper as it gets better: in fact, quite the opposite.

Goetz's cool style is exemplified by his discussing iPods and breast cancer screening in the same rhetorical breath: he examines technology as a commodity, and deliberately does not place a human face upon it. However, behind his dispassionate approach, he clearly has an agenda: to show why, the current healthcares system does NOT work to contain costs. His first point: a lack of full, fair and free market competition. "There's far too little price transparency in the medical technology market. Without an open marketplace of prices and services, it's difficult for hospitals and clinics to know whether there's a better deal elsewhere, and manufacturers can keep costs high" (Goetz 2010). Of course, a lack of transparency, in the refusal to improve both banking and healthcare, seems to suggest that Goetz is on the side of those attempting to change the system in Congress. But Goetz merely uses transparency as a buzzword, to attempt to persuade more liberal readers to listen to his argument.

Goetz quickly states that there is another, more important reason for the high price of technology in healthcare: the human cost necessary to use it effectively and safely. "Medical technologies still tend to rely on an expert class to actually deploy the technology. GPS may have turned us all into amateur navigators, but CT scans haven't turned us into hobbyist radiologists. Those highly trained and expensive experts are still needed to actually put the technology to work, making it impossible to entirely automate a process. The result is that technology stays expensive to use, and costs keep going up" (Goetz 2010). Healthcare, as a specialized field, requires highly-trained and highly-paid individuals to provide its services, thus there is a limit to how low the price threshold can go.

In contrast to his dim view of high-cost technology such as digital imaging, Goetz speaks of a new type of health technology very favorably, one that can supposedly empower healthcare consumers to keep track of their own health: personal monitoring tools for blood sugar and pedometers. Falling in line with his earlier call for transparency and free market competition, Goetz ultimately believes that 'personal responsibility' is the solution for spiraling healthcare costs. The primary ethical value, or ethos, behind his essay is that of using technology to make medicine a 'DYI' effort. Facilitating personal choice rather than improving the provision of care is touted as the most moral and effective goal of reform efforts (Janhaur 2010). Goetz likes self-monitoring technologies because "they put the tools directly in our hands, and get us engaged in our health before we need the expertise of specialists" (Goetz 2010).

The real reason Goetz calls for greater transparency and small-scale personal monitoring technology is because he wants a healthcare marketplace where the individual can see him or herself in complete control: along the lines of the Republicans who emphasize the ability to be able to buy healthcare plans (often inferior ones) across state lines as a kind of personal, free market 'choice' in a supposedly competitive market results in lower costs. But "from a consumer protection point-of-view, the result of allowing sales across state lines would be that the state with the least restrictive regulatory scheme would have an advantage and could undercut all the others, and you would have a race to the bottom" (Herszhenhorn 2010).

The re-deployment of technology, in Goetz' piece is all about personal empowerment, and despite his statement that healthcare is a specialized field, his approach would put non-specialists -- namely you and me -- in control of our own health. "It's time to reassess how we deploy technology in healthcare, and put the digital revolution to work not just for our entertainment, but for our health, too" he says (Goetz 201). However, if knowledge alone were power, food and calorie labeling on supermarket products would have prevented the obesity crisis. And not all healthcare issues can be solved through the individual's will to improve his or her lifestyle. Self-monitoring can improve personal health and reduce the need to use expensive catastrophic services, but does not preclude the need for better care. Furthermore, if individuals live longer, to older and older ages, they may even cost the system more… [END OF PREVIEW] . . . READ MORE

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