The World of Chaos: Organized Medicine + Politics = Health Care Reform

Authors

We used to say the two biggest lies are “The check is in the mail” and “It won’t hurt a bit.” Now, there is a third biggest lie, which is, “We have the best health care system in the world,” as Bill Clinton and George Bush uttered repeatedly during their respective terms. On the other hand, all of the standard measures of health care quality points to ours as being “the best substandard price-gouging health care system in the world”. One such measure is a comparison of cost and longevity. For example, Americans live an average of 77 years at a cost of $4,800 per person per year, while Spain, Canada and Japan respectively have life span-to-cost ratios of 79 years at $1,100, 81.5 years at $2,100, and 81 years at $2,000.

Another measure is the infant death rate per one thousand live births and the U.S. has a rate comparable to third world countries at 6.9 compared to 5.3 in Denmark, 4.6 in France, 3.4 in Sweden and 3.2 in Japan. Additionally, the World Health Organization ranks the United States as 37th in the world, which puts us just behind Costa Rica.

Therefore, we can see that the people of other countries get better outcomes for much less cost, suggesting that we Americans are paying more for inferior quality products and services. Although President Obama and other politicians acknowledge that health care is too expensive, they seem to be downplaying the fact that organized medicine has been giving the public a royal hosing for decades.

Some of the problems with U.S. health care delivery as many other experts have also pointed out are as follows:

  1. Hospitals, nursing homes and clinics are unsafe with medical and nursing negligence being the fifth largest cause of death in the United States.
  2. Lack of access with 76 million uninsured (adding illegal aliens) and 106 million underinsured;
  3. Out of control cost with health care being 16% of gross domestic product (GDP) at $1 trillion which is a 250% increase over the last 25 years;
  4. Price gouging, with hospitals and doctors charging uninsured patients 1000% more than they accept from third party payers;
  5. HMO premium price gouging with high deductibles charging 300% more for individuals who purchase directly rather than through a group;
  6. Health care corporations are guilty of bilking billions of dollars from tax payers with fraudulent billing practices;
  7. Doctors perform unnecessary surgery with bogus diagnoses;
  8. H.M.O. members have to call for approval before going to emergency rooms with call centers outsourced to non-professional personnel in India and other countries;
  9. Administrative cost of DRG’s and CPT codes is $375 billion per year – 25% of total health care expenditures;
  10. Pharmaceutical companies obtain FDA approval for toxic drugs by paying large research grants to medical research facilities to achieve favorable results;
  11. Pharmaceutical companies pay bribes to physicians to prescribe their over-priced toxic drugs with tens of thousands falling prey to side effects.

This short list of scams and rackets is really the largest, most harmful and costly criminal conspiracy in history. The perpetrators include HMO’s, pharmaceutical companies, hospital and physician groups and politicians. Additionally, with the political corruption achieved through expensive lobbying to defeat all attempts to impose regulatory standards, we can see why we pay such exorbitant prices for such shabby health care.

To explain further, medical care has always been a business whereby the seller decides what the consumer will purchase and how much. Couple that control with fear of death, and the buyer will pay any price for care on any terms. Moreover, the people of our generation and the previous one grew up trusting our doctors and listening for the most part, to what they recommended. Then medicine evolved moving from cottage industry to commercial empires.

However, to our disadvantage, we still had this mindset of “doctor knows best”  for decades while the entire paradigm of ethics changed to acceptance of greedy commercialism with corporate executives capturing financial control of health care operations and finding ways to deny coverage for expensive services and equipment rentals with the pre-approval requirement fraud. Once a well-meaning physician prescribes a treatment, a non-professional decides whether it is medically necessary.  Physicians, who became financially dependent upon their corporate “bosses”, would have to capitulate. Then Congress stepped in and gave legislative immunity to HMO’s from lawsuits for wrongful death and damages caused by withholding approval for life-sustaining treatment, thus leaving the doctors and hospitals holding the proverbial bag with malpractice lawsuits. The whole scenario was like putting a hungry shark in a pond to take care of the fish. The shark, knowing that if he swallows everyone in one gulp he won’t last long, says to each of his group members, “There is something wrong with the way your tail is functioning so I’m going to have to bite part of it off for your own good,” and the tasty fish replies, “You’re the doctor.”

In conclusion, there have been some suggested health care reform models coming from various think tanks such as “public good”, which is government provided or contracted care, versus the “public utility model”, being privately owned health care with quality standards and pricing controlled by a government agency like public utilities. Although we get a lot of pundits and politicians arguing the pros and cons for both but we are lacking a viable solution.

On the other hand, to come up with a workable infrastructure, we first need to abandon those policies that have ended in disaster, such as using financial incentives to control physician behavior, defining health care as providing diagnostics, drugs and surgery and autocratic corporate control of treatment plans. Furthermore, we have to stop believing in this myth called “freedom of choice” as if there was any free choice in health care to begin with. This term has become a way to placate us into accepting a crappy plan charging us more for less by saying, “We have preserved your freedom to choose.” So what if I don’t like the pond that I’m swimming in? I can look for another one with a different shark.

On the other hand, there is another fiddle that came from Washington, D.C. called “health care reform”. We now have a new president and his political hacks in Congress who say they have revolutionized the health care industry by making it cheaper, better, more accessible and safer. The problem is that this administration and its pork barrel Congress has no clue as to what preventable errors cause the killing of 200,000 people annually in hospitals across the country, and even if they wanted to stop the carnage they wouldn’t be able to figure out how.

As we listen to the political rhetoric about the current state of health care and how to improve it, we get a sense that health care is not so bad and we can make it better. On the contrary, when we go to a hospital as a patient or to visit and we see that people have to wait thirty minutes for a bed pan to avoid soiling themselves, we wake up to a different reality in the world of chaos. Therefore, as we examine the new health care reform schemes, we can quickly ascertain that our elected officials are planning to put more fish in the ponds and tell the sharks to take smaller bites.

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