The Problem with Health Care Is ‘The System’

Nightmare stories abound about the U.S. health care system.

The British people have been widely admired for their steady demeanor in times of adversity — stiff upper lip and all that. Until Donald Trump, that is.

In June, our presidential popinjay descended on London with a bombastic proposition that caused the upper lips of the entire British population to quiver at once. There as a guest, and treated to the full pomp of a state visit, The Donald blurted out what he hailed as a “phenomenal” gift in the form of a new U.S.-U.K. trade deal: He offered to bring in America’s health care system profiteers to start privatizing Britain’s National Health Service.

It’s possible Trump was simply ignorant, unaware that Brits love their NHS because its socialized plan provides quality care to all without families fearing they’ll be bankrupted or priced out of treatment by private insurance giants, hospital chains or Big Pharma. Or maybe he was hornswoggled by the right-wing pontificators of Fox News (Trump’s most trusted policy advisors) and their steady stream of lies about anything with the word “social” in it.

Last year, after seeing a Fox News segment (what else?) reporting that thousands of Brits were marching in protest of their health system, Trump smugly trumpeted that they were fed up with care-for-all socialism. But — oops — the uproar was actually in support of the NHS, demanding that the miserly Tory government strengthen it with “more staff, more beds, more funds.”

Trump aside, no country that’s even quasi-advanced is going to throw its people into a health care future modeled on the USA’s care-denying medical industry. Our for-profit system amounts to plutocrat care, providing concierge attention and top-notch treatment to moneyed elites (such as the Trump clan) who therefore perceive it as a marvel of free-market efficiency. They never witness the harsh realities that most U.S. working stiffs, middle-class families, students, the poor and others routinely experience from the most expensive, worst performing health scheme in the developed world.

Karla Diederich, an intensive care nurse in California, bluntly calls the U.S. industry “barbaric.” She told The New York Times about her friend Nelly Yap, also a nurse, who had cancer and was scheduled for chemotherapy — until her hospital changed owners. She lost her job, her insurance and her cancer treatment. “Nelly spent most of her life taking care of other people,” Diederich says, “and when she needed that care herself, it was not there.”

Another nurse, Melissa Johnson-Camacho, recalls: “I had just finished explaining (to a cancer patient) how important it was to take this medication faithfully. ‘Every day you skip it is a day that the cancer has to potentially spread,'” she told him. “And then we had to send him home without it” because the insurer wouldn’t cover the cost.

Similar nightmare stories abound, and most Americans dread they may be next. A nation that only 40 years ago boasted a world-class system of care has been sickened by a corporatized network that treats patients as bookkeeping entries and reduces doctors and nurses to functionaries on the medical assembly line. The hard numbers paint an embarrassing picture:

  • The U.S. ranks 34th worst among developed nations for the percentage of people without coverage (44 million Americans, including 4 million children) — lower than Chile, Greece, Kuwait, Slovenia and Turkey.
  • As many millions of “insured” Americans learn the hard way, high deductibles and copays can make treatments unaffordable, i.e., unusable.
  • Price gouging by drugmakers puts essential medicines out of reach; surprise bills from hospitals and clinics drown families in medical debt; and — most commonly — insurance bureaucracies assiduously work their fine print to deny payment for your condition, injury, medicine, surgery or rehab.
  • Our country spends the most (more than $10,000 per year per person) on a system that often delivers the least. (U.S. life expectancy has fallen to the bottom among wealthy nations.)
  • Most shamefully, roughly a third of the $3.5 trillion we pay into the U.S. system each year is sucked up by corporate paper shuffling, advertising, executive pay and perks, expensive headquarters and other non-care charges. Canada runs its full-coverage programs with less than half (12%) those administrative expenses.

The problem with the system is — hello — the system! While our doctors and other providers have top-level skills and knowledge, they operate within a fundamentally flawed corporate structure that measures success not in care delivered to the many but in profits extracted for the few: the investor elites.

Jim Hightower
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