What Ails our Healthcare Industry?

Amid the current national discussion over health care and healthcare reform, Robbinsense will endeavor to unravel some of the actual issues in play.

The two primary issues at stake are 1) the health of our population, and 2) the cost of providing healthcare. The primary obstacle to real “health care” is a system conducted within the realm of “private enterprise”….that is, it’s driven by profit motive. There’s very little profit in health. Profit comes from illness. Hence, to maximize profit the system ultimately must be designed to promote illness. Unfortunately, our political system is perfectly aligned with that objective, as we will see.

Pundits and talking heads on the right tirelessly decry the “socialization of medicine” and use the catch-phrase: “Do you want a government bureaucrat standing between you and your doctor?” to rally their passionate troops. Their unspoken answer is: “No, we want an insurance company bureaucrat to do this instead.” Let's take a look, and you decide which you would prefer:

Our healthcare system is a dance between the healthcare industry and the insurance industry. The HCI, which includes the pharmaceutical industry, is profit driven; it makes money off of illness, not wellness. The insurance industry maximizes profit by excluding ill people from its roles, regardless of whether they have been paying premiums. Only government stands between that industry and this objective. Hence, ultimately, we find the government bureaucrat---plus an attorney---standing between us and our doctor whenever the insurance bureaucrat is also there. If we want to cut bureaucracy, the logical figure to cut is the insurance guy. But try to tell that to a right-winger.

The greatest obstacle to real health care is our political system. Republicans are predictable as mosquitoes in the spring: they back industrial interests. They have masters’ degrees in smoke, lies and distortion, PhD’s in the use of fear and semantics---at convincing the middle class that they have their interests at heart. They use catch-terms (“socialization”---I don’t know why this is bad, but they make it sound bad) and compelling advertising: Harry and Louise.

Democrats, as usual, are confused and disorganized because they know they are “supposed to” represent our interests, but actually they are in the pockets of industry also. The healthcare industry, the insurance industry, the pharmaceutical industry are all enormous contributors to our political system. These three industries want no change because they’re making huge profits. And they don’t care about our health.

Only two countries in the world allow “direct-to-consumer advertising” of pharmaceuticals. The drug companies claim high prices are necessary to fund research; yet, they spend twice as much on disgusting ads that foul our TV screens as they do on research. The “sick” part of it is that doctors are “on the take” in prescribing these drugs, while they know that the placebo effect has the best chance to cure their patient regardless of what they do. So while the drug companies bamboozle us with their ads, we request the advertised drugs, doctors comply with prescriptions, the patient is “cured” by placebo effect, and everybody’s happy. But this leads to skyrocketing healthcare costs, and it results in people taking more and more drugs, which ultimately makes them sicker, not well! This re-stokes the cycle.

So what about solutions? The first real answer is for doctors to stop prescribing pills and start making their customers responsible for their health. A typical, ill American is suffering from a bad life-style---poor diet and lack of exercise. If his doctor prescribes life-style alteration, the patient will go to another doctor. A typical doctor dealing with a middle-aged, over-weight, perhaps pre-diabetic patient with high blood pressure and arteriosclerosis will prescribe a drug regimen that is essentially a pharmaceutical cocktail. This targets the patient’s symptoms, but will not cure him. The drugs lead to lethargy, perhaps depression, muscle depletion, and a host of additional problems.

This, my friends, is where good government steps in. But our system is not only designed to keep us sick, it’s designed to make us sick. A typical middle-class or lower-class family consumes multiple meals per week at fast-food restaurants. Why? Because the kids want this food, and because it may be the only thing the parents can afford. The prices at these eateries are so low that people cannot prepare decent meals for their family at comparable cost. But the low check-out price conceals the actual cost. The food, as Morgan Spurlock showed us in his 2004 movie, Super Size Me, has little or no nutritional value. In fact, it makes people sick. The “social” cost of this diet is ill health. A staggering percentage of our population is overweight and headed toward diabetes, if not already there. The expense of that will continue to spiral upwards.

The low prices of the fast food industry are by government prerogative. Our government subsidizes beef; it subsidizes potatoes, and significantly, it subsidizes corn. Most of what we buy at a fast food restaurant comes from corn, including the beef, soda, even the packaging! Ranchers feed corn to their cattle because it makes the herd sick!! (This is sick!) Cattle are grass-feeders. They can’t digest corn, hence it makes them ill. Their body chemistry changes; they eat more, exercise less (if that’s possible), put on fat, increase weight. The farmer fattens up his herd; making the cow sick makes it worth more at market. He uses antibiotics to contain the illness, introducing these dangerous chemicals to the food-chain. Ultimately we consume the antibiotics by eating the meat, leading to more serious illness from drug-resistant bacteria. A single beef patty at McDonald’s will contain meat from a thousand animals! If any one of those cows has a serious pathogen, guess what! This is all carried out under government aegis. The government is getting paid off through contributions from the ranchers, farmers and fast food industry--- as well as the insurance, healthcare industry and drug manufacturers.

Again, the answer is not “less government”, but good government. First, government should stop subsidizing the cycle that has such profound ill-effects for our health and budget. Next it should reverse the process by taxing these products and subsidizing the foodstuffs that promote health. The cost of delivering quality food to our markets is somewhat fixed, while the cost of manufacturing junk, that’s “fun to eat”, is extremely small. Even with low prices, these manufacturers make huge profits. But these profits are essentially extracted from the public weal in the social cost of poor health. Considering this social cost, responsible government should do whatever it takes to make nutritional food less expensive than junk food, and that includes candy, chips, soda and Twinkies in the supermarket as well as fast food restaurants. That would promote better health and save billions. The drive to accomplish this in the face of huge political forces can only come from us, through pressure on our representatives and/or through direct pressure on market forces.

Today a “healthy”, 60 year-old “independent contractor” pays upward of $1000 per month for health insurance, with $1000 deductible. If he actually gets sick, the insurer will do all it can to deny coverage, frequently leading to the additional expense and stress of legal redress. If the person tries to “shop for coverage”, changing carriers will open the door to intense scrutiny of medical records to uncover “pre-existing conditions” that will further deny coverage. This system is obscene. We need to get the right wing to stand down, and stand up---for us!

The plans now being advanced take a piece-meal approach to solving our problems. The government is advocating a “modified” plan for health insurance, where it will offer insurance to compete with the private system already in place. This would be a system comparable to Medicare, but available to those not covered by that system. Presumably, the government plan will put downward pressure on insurance costs and people will be drawn to it.

As usual, this approach picks away at the symptoms without addressing the real problem. We need a single-payer system like in Britain or Japan, and to focus on the real healthcare problems that we’ve spoken about here. Healthcare should be a public utility instead of “for profit” enterprise. But even aside from the Republicans, enormous political forces are amassed to resist these changes, and at best we will move slowly with a piecemeal compromise. If the government plan is well-received, we may be able to move toward real reform.

Good luck. Try to get involved.