Many people who advocate for an improved and expanded Medicare for all for life health system in the US tend to vilify the for-profit, private insurance industry and big Pharma but ignore the atrocities committed by almost every other segment of the system. If we are to fix what ails the US health care system, we will have to get a whole lot more honest about all of the factions that lift profit-making above all else when engaging in the delivery of health care services.
And no matter what Congress does or does not do with the Affordable Care Act/Obamacare, until those of us being most grossly effected by our dysfunctional, profit-first health care system get honest about all the players and their roles in that dysfunction, we will continue to tinker around the edges and watch the numbers of health care dead and broke climb ever higher.
We do not have a coherent health care delivery system in the US. We have taken great pains to protect the interests of the few at the direct expense of the many. More than in any other segment of economic, political or social activity in our society, we have weaponized greed within our health care system. From the usual suspects in the private health insurance and pharmaceutical industries to the hospital corporations, medical equipment manufacturers, medical billing companies, health benefit administrators, private physician groups, medical collection agencies, free-standing clinics, nursing homes, home care agencies and services, malpractice and medical liability insurance companies, and beyond, greed and profits injure and kill Americans.
Patients are essential to the profit-making—you cannot make that money without patients to treat and dose—but patients also have almost no protections and no say in the design of this system that injures and kills without any accountability or shame whatsoever. Sure, as I point out often, the direct correlation between lack of access to appropriate care and poor health outcomes is certainly a function of access to public or private health coverage and the approval or denials of needed care. So it’s easy to target the insurance companies as villains. And those companies have earned their status by denying care and collecting premiums. Big Pharma rakes in the cash through all the channels we all have known about and by taking advantage of every chance to boost profits, avoidable accountability and protect patents. But these two target groups aren’t by any means the only groups responsible for weaponized greed in the US health care system.
Ask any family member or friend of a patient injured by medical error or outright medical fraud just how quickly the white-coat ranks close around those who cause the injuries. My husband was once the victim of a botched open-heart surgery (and, thank God, lived to tell about it), and even the surgeon who discovered and repaired the error quickly made it clear after he performed the second surgery that he would not and could not testify against those who made the mistake that resulted in the need for a second open heart procedure to fix the first. His ability to continue making money within a system that protects itself would have been diminished if his fellow surgeons saw him as a risk in terms of telling the truth about medical errors. I am grateful he had enough courage to at least fix the problem since the original group of doctors were all too willing to allow my then 46-year-old husband to go home and die never knowing that his first surgery had been botched. The patient safety community knows so well that safety is not the priority in the US health system. Profits rule.
The US health care system fails to hold itself accountable for harming patients, ruining lives and defrauding government programs because to do so would hamper the ability to make money. Because health care is an industry in which human life literally is held in the balance, protecting and promoting profit-making above all else is an economic weapon that kills. It is true that having an improved and expanded Medicare for all for life system would not remove all of the problems associated with this weaponized greed, but it would certainly begin to cut into the some of the ways in which health care system greed is most commonly valued above human health. The ability to access care at the most appropriate times and settings would be of great value. Patients would have much more freedom to choose their providers and make calmer decisions about where and how to get care.
In the coming weeks, I want to explore more of the reasons I believe that an improved and expanded Medicare for all for life system would help achieve a safer and wiser health system beyond just the health care finance issues. Because if we do not stop using our health system as a weapon for profits rather than a system designed for the common good and public health, more Americans will suffer and die at the hands of those who call themselves healers than currently are killed by other, more traditional weapons. We need a health care system that uses money to fund healing instead of a system that uses money to make more money with little regard for those who need care. We’ve got it backasswards.