August 26, 2008
There is a malevolent undertone that runs beneath the healthcare debate in America. The wickedness is found in the confusion and uncertainty that seems to be generated by the participants. It mirrors the confusion and uncertainty which is inherent in sickness and disease, the precise anxiety that healthcare should be neutralizing. To try to understand what is happening (and what has been happening during the transition to mass healthcare world wide) one needs to step back and consider the fundamentals of human behavior, and why that behavior has kept this country from making that transition efficiently and effectively.
The published and accepted fact is that the per capita medical expense in the United States greatly exceeds that of every other country in the world. The 2006 World Health Report showed per capita spending in the US at $5,711 annually. By comparison the next largest country was Germany at $3,204 (44% less), then France at $2,981, Japan at $2,662 and Canada at $2,669. Other emerging industrial nations such as Brazil ($212), South Korea ($705), and Mexico ($372) increase the contrast.
There is no debate that within the US health industry there is a huge transfer of resources taking place. Further, and perhaps more important, there is no understanding by the American people, and our leaders, of what the upper limits of those healthcare costs are. The simple reason is that within the gargantuan and shadowy nature of our healthcare system, nobody knows.
What do we know then? As already stated, we know we spend a lot on healthcare. Despite the arguments, we do not know that our system of healthcare is better than other relatively wealthy, educated nations. There are absolutely no studies that definitively show technological advances available today not being extensively used by other nations sociologically and economically on par with the US.
Nor is there any evidence that attention to healthcare, both treatment and prevention, is any better or worse overall. What we hear is anecdotal information (or disinformation) which is used to support a point of view. Given the enormous size of the healthcare systems in any country, making use of any one person’s experience is meaningless. We need to throw away the magnifying glass and just stare at the beast with eyes open.
So what is it about the American healthcare system that is “broken” as all players in the political debate have advocated. I suggest that ‘broken” is a convenient term for politicians to use because it infers that it was somehow unbroken at some point in the past (and they can be the one to put the egg back together again, provide they’re elected).
So what is it about the American healthcare system that is “broken” as all players in the political debate have advocated. I suggest that ‘broken” is a convenient term for politicians to use because it infers that it was somehow unbroken at some point in the past (and they can be the one to put the egg back together again, provide they’re elected).
Our healthcare system is not broken, nor has it fundamentally changed since the advent of modern medicine at the beginning of the 19th century. The better term to use is “old” or perhaps “outdated”. It is outdated because the unique American brand of independence, entrepreneurial spirit, and individual rights has clashed with the realities and dynamics of population growth and lightening fast communication.
Not only did we need the system to gear up for the huge increase in patients, but the knowledge and understanding of medical treatment and its technological advances began to find its way to every segment of society setting new levels of expectations. As a result, the volume of business in the health field started a precipitous rise, and like all supply/demand equations, the costs began going up. What throws the demand side of the equation out of whack is that money to support it has been seemingly unlimited, but that leads to the question of why we so willingly and intentionally begin to pay for healthcare at any cost?
Countries that began regulated single payer or other similar systems effectively removed from the equation the one hallowed and revered behavior buried deep in our American capitalistic marrow, namely: profit. To most conservative thinkers, to question the concept of ‘profit’ is the equivalent of irreverent graffiti spray painted on the Statue of Liberty… you just don’t go there. Yet if we honestly step back and observe the Beast, the clear and obvious problem is that there is simply too much money in the system to be gained by too few.
Countries that began regulated single payer or other similar systems effectively removed from the equation the one hallowed and revered behavior buried deep in our American capitalistic marrow, namely: profit. To most conservative thinkers, to question the concept of ‘profit’ is the equivalent of irreverent graffiti spray painted on the Statue of Liberty… you just don’t go there. Yet if we honestly step back and observe the Beast, the clear and obvious problem is that there is simply too much money in the system to be gained by too few.
Whenever there is that kind of uncheck transfer of wealth there are those who will view, not the opportunity to advance social gains, but to maximize their return on investment. For most businesses this is a fine process and more often than not the most efficient. But in most cases the supply/demand model will show a drop in demand as price goes up. That’s not the case with healthcare since the demand continues to be supported by both public (taxes) and (hard earned) private funds, and with huge amounts of debt, both the public and private.
Who benefits from the profit? Almost everybody on the deliver side of the service; medical corporations, pharmaceutical corporations, medical retail businesses, doctors and other medical professionals, medical advertisers, lawyers, medical supply and equipment companies, and the insurance companies are the ones that seem to stand up and salute first.
The number of individuals is so large and so influential that the process of bringing real change to the system can seem almost as romantic as the change itself. Our politicians love to bash the corporations because it’s so easy to identify themselves as individuals (like you and me) trying to take the bull by the horns (good for votes). They only end up like flies in the field, annoying to the bull but nonetheless irrelevant.
What kind of leader out there is going to take on the doctors and the lawyers? Nothing will happen without them in the formula. Who’s going to present the plan that cuts the profits of medical professionals or restricts the awards for tort lawyers? Who’s going to advocate taking the unlimited profit out of the System? I hear neither from McCain or Obama, quite the opposite. Neither of their proposals address the unchecked profits realized within the system; they only attempt to change the pattern to the flow of money so that fewer people (at least temporarily) will not fall through the cracks. It will, however, ultimately fail under its own unchecked weight.
McCain mind’s is as old as the aged system he refers to as ‘broken’. My hope is that once Obama is in office and the need for re-election is a minimum of 4 years away that a true change to an efficient universal healthcare system in the US may begin. He has suggested he represents a new leadership which is not shackled by special interests. We’ll see. Until then (if ever) we’ll just have to watch the transfer of wealth continue until the inevitable stress on the American public, that sees its assets evaporate, its future mortgaged, and no end in sight, finally fractures under the pressure.
McCain mind’s is as old as the aged system he refers to as ‘broken’. My hope is that once Obama is in office and the need for re-election is a minimum of 4 years away that a true change to an efficient universal healthcare system in the US may begin. He has suggested he represents a new leadership which is not shackled by special interests. We’ll see. Until then (if ever) we’ll just have to watch the transfer of wealth continue until the inevitable stress on the American public, that sees its assets evaporate, its future mortgaged, and no end in sight, finally fractures under the pressure.
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