And Carburetor Tweaking
What we call a “health care system” in America is by my standard a strange and almost incomprehensibly corrupt and twisted thing. The continued existence of such a cruel and dysfunctional system requires that a great deal of mind-fogging fairy dust be continually thrown in our faces by the health care industry and the politicians they own. At all costs, they must inoculate us against the possibility that a spontaneous outbreak of common sense might infect the populace. Rest assured that the strategists for the drug and insurance companies understand what they are up against.
They understand that to keep in place a fundamentally irrational system, they have to maintain an eternal vigilance to prevent dangerous principles like logic, reason and fairness from entering into the healthcare equation. The ‘industry’ must make for-profit medicine seem normal, acceptable, and our only reasonable option. They must also make the kinds of publicly funded healthcare systems operated by most every other nation on the planet seem weird, subversive and dangerous.
Much of the vacuous banter about “healthcare reform” that appears in the press and in speeches by our politicians seems designed to be both boring and to make healthcare issues appear very complex. Health insurance, in concept, is really not a devastatingly difficult thing to understand.
Here’s how it works: The insured pool their resources so that when any of them get sick the pool pays for their care. The pool must also pay the system’s administrative costs. This is the comprehensive list of essential elements.
It only seems so simple because it is.
Most of the complications involved in “reforming” our present system can be traced back to its fundamental design defect. We place a huge burden on our health care system by demanding that “profit” be extracted from its operation. It is this design characteristic that twists, perverts and distorts the very notion of health care in America.
It seems obvious that the first goal of a “health care provider” should be to give the best possible care to those that are “provided” for. Just as obviously, we can see that in our for-profit health care system, delivery of actual care is a side effect.
Is there really any question that a “healthcare” system that allows insurance companies to deny coverage to people on the grounds that they may actually need medical care is one that has been hideously deformed, diverted and subverted? It might be more accurately described as a “profit delivery” system.
But to the dismay of those that are committed to spreading fairy dust, every healthcare system creates a product that can be examined. According to the World Health Organization, our nation ranks 37th in the world in quality of care, placing just below Costa Rica and Dominica. Our system now leaves about 50 million people without access to even basic medical care.
But we are number one, and by a large margin, in cost of medical services, executive compensation, and percentage of healthcare dollars spent on administrative overhead. Without a generous quantity of fairy dust, a phony debate in the corporate media, the complicity of a bought-off Congress, and a new President whose words support reform but whose timid, incremental approach will likely only diminish the possibility of systemic change, the inexcusably lame performance of our health care system would be recognized for what it is: intolerable.
Imagine your car came in 37th in the race, after you dropped more money than anyone thought possible on the most expensive model that was available. If you really wanted to win, wouldn’t it be best to pay attention to the fact that all 36 of the much faster cars that beat you in the race use an engine design that is completely different from yours? What if you discovered that the other cars, in addition to being faster, used only about half the fuel your car burned?
Would you then go home and tinker with your carburetor in the hopes that a little tweaking would somehow overcome the poor performance that results from the basic design of your machine? Or would you consider it obvious that your only chance to compete successfully would be to replace your obsolete and incredibly expensive racecar with one that has been designed to deliver a higher level of performance?
When it comes to healthcare, President Obama seems to support the carburetor-tweaking approach. According to an article by Bill Moyers, Obama was asked at a town hall meeting a couple of weeks ago about the possibility of switching to a single-payer national health care system. He said that single-payer might “make sense” but only if we were “starting from scratch” to build a new health care system. Obama says our current for-profit healthcare system is “too large a percentage of our economy” to consider changing.
To the fifty million Americans without any health insurance at all, and to the millions more that are struggling under the crushing financial burden of our current system, I am sure it appears that health care is too large a percentage of our economy to consider not changing. It is only so very large because it has gorged itself on our misery until it has become insupportable.
If you discovered that leeches were attached to your flesh, would you decline to remove them on the grounds that they had already consumed such a large a percentage of your blood that it would not be wise to disturb them now?
Granted, if I were designing a brand new health care system “from the ground up,” I would not create one in which the primary mandate was to establish and maintain a parasitic executive class whose main function was to generously award itself the largest share possible from funds that would otherwise be available to care for sick people.
But regardless of whether we are in the process of creating, operating, maintaining, or “reforming” our health care system, what does not make sense is to retain the one design element that contains within it a terminal conflict of interest that no tinkering can ever resolve. A for-profit system assumes that we can somehow make people rich as a result of caring for the sick, but what we really do is make people sick by caring for the rich.
One thing is clear: despite spending tens of millions of dollars worth of their ill-gotten profits to buy off our politicians and deform public opinion on the issues, Americans are not buying the traditional array of industry excuses any more. Even absent any substantial support for the idea in Washington or in the corporate mass media, about two- thirds of our citizens want to switch to a single-payer system now.
What is there really to argue or debate? Healthcare industry executives, some of the best paid people on the planet, seem less than eager to appear before the public in front of a banner that reads, “We’re number thirty seven — and that’s good enough!” So they and their politicians and media outlets spread fairy dust.
Virtually all of the current “reform” plans being tossed about by our politicians, including the much-touted “public option,” leave in place a network of for-profit private insurance companies to administer the system.
This arrangement fails completely to address our systemic defect. For-profit healthcare is the problem. It cannot possibly be the solution.
This is why I will not be joining with the liberal groups that are frantically calling for us to support “Obama’s public option” against the forces of darkness. I don’t believe that this is where the battle should be fought. In my cosmology, it seems clear that the forces of darkness have already wormed their way into Obama’s plans and processes, rendering any and all detailed discussion of them a waste of time.
Democrats control the White House and both branches of Congress, and could count on the overwhelming support of a large majority of citizens on the single-payer issue. Yet they refuse to even put real reform “on the table.” Instead, they choose to put all of their effort into a battle over incredibly complex sets of half-measures that are designed to placate the insurance and drug industries by leaving them in firm control of our system. Even then, they seem to be preparing us for the idea that they may somehow actually lose this little skirmish to the big bad evil Republican obstructionists.
This approach is absurd and should be considered unacceptable. It will leave us with no option other than to continue tiptoeing around the elephant that has taken up permanent residence in our living room.
The solution to our perpetual health care dilemma is actually far simpler than all of that. What we need and should demand is fundamental systemic reform. In this situation, the only reform worthy of its name will be of the kind that unequivocally removes the profit motive from our health care system, and covers everyone under a federally administered single-payer plan.