8/24/2009
Although I’ve witnessed a lot of great debates in my short time on the planet, the current discussion of healthcare going on across the country is probably one of the most compelling. This time, it isn’t some weighty matter like war, elections, and impeachment that has us talking. Instead, it’s a policy issue that just happens to affect us all. Not surprisingly, most Americans are following along and many have opinions to offer. So here’s mine, in a nutshell: if we don’t insist on better healthcare, we’re never going to get it. Conversely, if we say we’re ok with crappy healthcare, then that is what we will get. It’s that simple.
I have a real problem with healthcare in America and have had ever since it became a for-profit system. Starting in the early 1980s, hospitals and healthcare providers began converting to for-profit companies instead of operating as not-for-profits as they had for generations past. This was not surprising since healthcare is highly lucrative. Unfortunately, this folding of healthcare into capitalism turned out to be disastrous for patients, people, and businesses who saw healthcare costs skyrocket in the decades to follow.
In the last couple decades, I have not met a single person who is actually happy with the way healthcare works, and the lower their income, the unhappier they tend to be. Everyone’s got a story — they run the gamut from out and out medical negligence to shabby treatment in hospitals to endless struggles with insurance companies. People have problems with medication, feel they’re prescribed too many or the wrong drugs, and that prescriptions cost a fortune. The litany of complaints covers doctors, hospitals, clinics, pharmaceutical companies, insurance companies, and nursing homes.
That said, there are still people who will tell you that we have the best healthcare system in the world. If that’s the case, then why are so many people unhappy with it? I would argue that if our system was as stellar as some on the right would have us believe, most Americans would be singing its praises. Clearly, that’s not happening. More to the point, most Americans can barely afford to have healthcare at all, regardless of quality. Add to this the 5-plus percent annual premium increases and it’s no wonder so many people are dissatisfied.
No, we really do have a healthcare problem in this country and this is our time to do something about it. But what shall we do? That’s a good question. If it were up to me, I’d just abolish insurance companies and tell the healthcare providers to reorganize as non-profits. Et voila. But fortunately for the rich capitalists, I’m not in charge. And anyway, nothing like that is going to happen.
But before I move on to reality, I do want to point out that once upon a time, as recently as the 1960s, a struggling family of four could still afford healthcare without insurance, as my family did. Growing up, I got all my checkups and shots, penicillin for my ear infections, and regular dental visits. But my father paid for it out of pocket as I believe most people did in those days. Healthcare would set you back but not like it does today.
Thus, I would argue that it was insurance companies and for-profit healthcare that created the problems in healthcare today. To fully appreciate this, you have to remember what’ for-profit’ means — the goal of a for-profit healthcare business is to minimize costs (your care) and maximize profits (your bill). That’s what it means and that’s how healthcare operates today, make no mistake. My father’s nursing home chain is owned by a hedge fund. Enough said.
If all this sounds wrong, and I contend that it is, then we need to do something about it. Here’s where it gets dicey. The folks on the right don’t want the government to operate a public health insurance plan to compete with private insurers. They say this is socialism, which these days is the same as communism, and means the country is doomed. On the left, people say that a publicly-run health plan is the only way to drive the cost of healthcare down.
I’ve been on the fence for a while with this because like my friends on the right, I don’t trust the government either. But when it comes to who I hate more, it’s really the insurance companies that I think need to get pushed back a few yards on this one, and the only way to do that, as far as I can see, is the so-called “public option.”
The goal we’re trying to achieve, and I honestly don’t care how we achieve it, is that people need to be able to get quality healthcare at a price they can afford. The insured need this as much as the uninsured. More than that, we need a healthcare system that cares as much about the well-being of the patient as it does the bottom line. In fact, the notion of profit in healthcare should be discarded altogether as it corrupts medicine from its true mission — the fulfillment of the Hippocratic oath, i.e., caring for patients.
Meanwhile, the debate is still on and there’s time on the clock. How it will be decided depends a lot on what we’re willing to accept or not accept, as the case may be. This ‘we’ I speak of includes everyone, not just partisans on either side. Whether we’re right or left or standing on the line, we all need healthcare and we all have to pay for it. So how shall we proceed? Let’s hope that whatever we decide, it leads to improved healthcare and quality of life for us all, and not a continuation of the sad, tiresome status quo. To allow the current system to stand would be more than a wasted opportunity — it would ensure that the problems of the present will be with us for years to come.
