Friday, August 15, 2008

Health Care is Killing America, Part 1

Let’s forget for the moment that most Americans simply lack restraint when it comes to our self-indulgent lifestyles; we simply won’t stop overworking, sunbathing, eating processed foods, or drinking and smoking in excess. Not only is this bit of reality a given, but so is the knowledge that our way of life creates a laundry list of accompanying health problems. After all, it’s been said that the aging process is only 20% chronological, but 80% environmental…more of a product of what we do to ourselves than who we are. Ask anyone you know with a particular self-destructive vice why, at the risk of inflicting bad health, do they indulge in such irrational behavior and you will more than likely receive the usual cop-out; “Everything causes cancer!” “I just like it,” and the always justifiable, “You gotta die of something, right?”
Even if such BS were rationally sustainable, it still flies in the face of the human proclivity for trying to remedy a problem after the fact. We have a health care system in America that, for the most part, is based on fixing our individual medical boo-boo’s only after we have abused ourselves with fast living, fast foods, fast driving, and “need” for fast fun. And in much the same way that we have rationalized our counter-productive behavior with fatalism, we have done the same with our lack of resolve in having some kind of universal health care insurance covering all of America’s citizens. Given the current precarious position of the average American’s financial stability, as well as America’s vulnerability in a globally integrated economy, we have to conclude that the current health care system is killing America.
So how is the current state of health care endangering America to the point of our potential decline as a nation? First off, too many people are too quick to adopt the patriotic rhetoric about how America “has the best health care system in the world.” This would be true if every American had access to that “best health care.” But as it stands, such defensive ideological-based rhetoric blinds us to the fact that not every American can afford to have “the best.” Consider the following experience, written by a medical professional:

…I find peace of mind in knowing that if someone runs into my car and tears a fender off I can stand the expense. My insurance company will pay the bill. The same thing is true of fire. If my house burns down I am guaranteed the funds with which to rebuild. If I should come to die I should have the satisfaction of knowing that my life insurance policies will at least keep the family from the poorhouse.
‘But if I or any member of my family should have another serious illness I doubt if I could ever be rid of the debts with which my life would be burdened. I cannot understand why society has not devised some method by which I and millions like me may be assured in advance that we can meet the costs of illness. After all, I am more likely to be sick than to suffer by fire or be robbed or lose my life. Why can I not be protected where protection is most likely to be needed?

This is not a recent article written in a left-of-center leaning publication; it is an article published in the October 1930 issue of The Atlantic Monthly entitled “A Cure for Doctors’ Bills.” Even then, some could see the need to affordability in health care. You read right…1930! One has to wonder how and why such ideological rhetoric has blinded us to this crisis for so long.
At the risk of sounding like a 60s radical, the reason why ideology has so successfully repressed any attempt come up with a solution is that political and economic interests have mastered the art wordplay. More to the point, they have such a mastery over the control of any and all language associated with maintaining the current health care funding model, that it could best described as the “’P’ Phenomenon;” mixing Politics and Patriotism to create Propaganda which controls Policy or even Proposals. This is to say that those interests with a stake in the current model have successfully posed that the free-market is the only way to remedy both universal access to health care as well as control the rocketing costs that’s makes health care affordability prohibitive to begin with. Although there is no law that says that America has to adhere to a free-market solution to any policy, interests have managed over the years to successfully ingrain this notion into people’s thinking to such a degree that even proposed solutions by progressive-minded politicians adhere to this ethos. Anything that remotely smacks of government intervention or involvement in health care is maligned as “socialism,” and is avoided as if maintaining a solely free-market were the chief mandate of the Constitution, which it is not. The reality is that we already have vestiges of a socialist-like mechanism already in policy; the government provides health care to our soldiers and veterans, to our federal legislators, on a local level, states do the same with children and the aged. The more we adhere to secondary political ideologies that prevent us from opening our minds to new solutions for open and equal access to health care, the more we destroy—at least in a philosophical sense—the primary ideological foundation for why America exist in the first place…equal opportunity.
Aside philosophically dying, inaccessibility to health care for those who can’t afford comprehensive (or even partial) health insurance is killing American literally. Who can forget the article in May 2nd, 2002 edition of USA Today, which cited the conclusion of a study by the non-profit Institute of Medicine that blamed 18,000 deaths a year on a lack of health insurance? According to the report, 1 in 7 working-age Americans don’t have employer-provided insurance, and don’t qualify for government medical care; this doesn’t include the estimated 10 million children who go uninsured. According to the latest statistics, between 40 and 50 million Americans total lack health insurance of any kind. The bulk of those individuals who die do so needlessly, lacking coverage for life saving health screenings for diseases such as diabetes and cancer…so they simply go without. The report started talk on many a radio station on the subject of universal health care at the time of its publication. No one doubts—especially after the 3,000 deaths that occurred on Sept 11th—that if we had lost 18,000 of our fellow citizens in a single conventional or terrorist attack that we would have declared war and/or reacted almost instantly. One has to question the lack of an equal response to 18,000 deaths annually due to system of our own creation.
But it is in the realm of the economy where America stands to lose its current life. Since records have been kept, the cost of health care has only risen year after year. Currently, a minimum of between 10 and 20 cents of every dollar spent in America is spent on health care. In 2007, that was equivalent to 16% of the nation’s Gross Domestic Product (GDP), or $2.3 trillion; by 2016 it’s expected that health care spending will reach approximately $4.2 trillion or 20 of the GDP, which includes government spending on Medicare and Medicaid. And with an already record-level budget deficit, the nation runs the risk of spending itself into penury. With the more traditionally higher paying jobs moving offshore and supplanted by lower paying service-based jobs, we obviously cannot maintain this level of consumer spending on this single but growing portion of the total economic output of the nation. Many familes already know the potential end result of doing so, as the majority of declared bankruptcies filed in any given year are due to the inability to pay medical bills. Under higher paying jobs, paying for health care was a strain; with the lower-paying positions that have replaced them, the choice simply comes down to—for many—paying for health care or paying a utility bill…in worse cases, it comes down to food or equally-needed prescription drugs. Health care in American has become unaffordable for both businesses and individuals.
The reasons for these soaring costs in health care include the high cost of prescription drugs (a crisis in itself), the high cost of medical technology, and the high administrative cost of the sophisticated multi-payer system that our system is based on. In addition, the high numbers of uninsured contribute to these high costs because chronic or developing conditions, which could be nipped in the bud by way of preventative care, often progress into the more expensive, often more life-threatening condition of whatever their silent or chronic symptoms may indicate. Furthermore, we pay hospitals and doctors in our country more than they’re paid in other countries, particularly medical specialists and specialty institutions, such as the Mayo Clinic and the like. These specialists in turn, tend to rely on the overuse of costly medical technologies and procedures…again in levels that far exceed both their use in other countries and their need in individual cases. And last, but not least, America’s litigious nature—suing for every possible reason as it relates to malpractice claims in particular and health care in general—drives up health care insurance premiums to beyond the reach of many to afford. America’s health care system is questionably the best in the world, but definitely by far and away the most expensive.
And while both the American consumer and employer struggles based in-part on the current health care scheme, our global competitors thrive without such burdens. China, our biggest economic competitor currently has a tiered system that is based on a patient’s location in the country. Under the 2005 implemented New Rural Co-operative Medical Care System, 80% of the country’s rural population is covered state-sponsored insurance, ranging from 60% to 80% coverage of general health claims (under their system, patients requiring specialists have to pay for most of those related services themselves). India, another up and coming economic power in competition with America for a share in the global market, has a system made up of local “government hospitals” which provide treatment as well as selected drug at taxpayer cost. Even though there are shortcomings in their systems, the two most populous nations on the globe—growing economic powers with a combined billion or so potential workers—see the ethical and practical need to cover the cost of health care for its citizens. More to the point, these powers-to-be are challenging America’s economic dominance, and they don’t have businesses in their countries locating abroad in an effort to lower health care-driven labor costs (for a recent in-depth focus on China's rise toward becoming the next preeminent global superpower, see the CBS newsfeed at
These businesses have the advantage of having government subsidized health care for their workers. Their need to fuel their economic growth as it relates to health care, is not stymied by bickering political ideologues, or business interests who seek to maintain the status quo for the sake of inflating their profits. Health care is killing America.

To Be Concluded


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