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Jackpine Radical

(45,274 posts)
Tue Aug 20, 2013, 10:23 AM Aug 2013

Where's the Outrage over Our Failed Health Care System?

It really needs no comment from me…

WHERE´S THE OUTRAGE OVER OUR FAILED HEALTH CARE SYSTEM ?

By Philip Caper, M.D.


For the next few months we’ll be bombarded by messages from the Obama administration urging people, especially young, healthy people, to sign up for insurance provided under the Affordable Care Act. Without them, premiums for that insurance will soon climb to unaffordable levels.

We’ll also hear plenty of noise from the ACA’s opponents. It will be hard to get any other health policy messages across during the upcoming PR blitz.

But there are some other important and noteworthy things going on in the policy world. Perhaps the most important is the growing interest in the origins of the high costs of medical care in the U.S., now about double that of other wealthy countries.

That interest has been fueled by the ACA. By requiring many Americans to buy private health insurance, the federal government is now obliged to see to it that insurance remains affordable. Whether they are actually able to do so remains to be seen.

Because of that, both government and the lay media have now joined academicians in paying a lot more attention to the costs of medical care in the U.S. and how they compare to those in other countries. That attention was jump-started last March by a Time Magazine article titled “Bitter Pill” by journalist Stephen Brill, who looked at hospital charges and their causes. He concluded that while many of those paying the bills suffered badly from the high costs, those selling health care products and services were prospering, helping to create an island of affluence for themselves and a sea of poverty for everybody else.
That was followed by Medicare’s public release of the prices it was being charged in various regions throughout the country, revealing huge variations without any persuasive explanation as to why these variations should exist.

More recently, the New York Times has published an ongoing series by Elizabeth Rosenthal examining the costs of medical care for various procedures throughout the U.S., and comparing them with those in other countries. So far she has examined three common types of care: colonoscopy, pregnancy and hip replacement. In each case, she found prices in the U.S. were both variable and extremely high by international standards, some up to 10 times the prices for comparable care in other countries. When asked why, one expert commented, “They’re charging these prices because they can.”

In other words, as economist George Akerlof predicted in his Nobel Prize-winning paper “Selling Lemons,” in a market where the sellers have a great deal of information (and therefore power) and the buyers have little or none, the buyers (most of us) are being ripped off big time.

In most countries that have enacted programs of universal health care, two things have taken place. First, health care prices were restrained so as to keep their national programs affordable. Profiteering from illness is not allowed.

Second, the importance of medical care in maintaining a healthy population was put in perspective. Medical care can be very effective in fixing what’s already broken, but not very effective in preventing the breakage in the first place.

What are now called the “social determinants of health” turn out to be much more important than medical care in maintaining a population’s health. They include lifestyle factors such as a healthy diet; exercise; restraint in the use of substances such as alcohol, tobacco and other drugs; and the presence of robust social policies that help minimize excessive disparities of wealth and income within the national population.

Although the ACA does move the ball toward the goal of universal health care, we are still a long way from scoring. It attempts to curb some of the worst abuses of the health insurance industry, but it doesn’t eliminate the incentives to try them anyway. It will leave many people out, and although it makes some efforts to control overall costs and promote healthy living, many experts believe those efforts are inadequate.

As Akerlof predicted, the medical-industrial complex is becoming increasingly corrupt. It is now one of our largest and most profitable industries. Much (but not all) of what it is doing is legal, but it has lost its moorings and is forgetting about its health care mission in the pursuit of profits and growth.
The MBAs have taken over. We are all paying the price.

I don’t blame only the corporate health care providers, pharmaceutical and device manufacturers and insurance industry. After all, they are just doing what they are supposed to do for their “stakeholders” — profit and grow.

I also blame all the rest of us for letting it happen. What we are witnessing is a massive failure of public policy that is not permitted in any other wealthy country. It is being enabled by the timidity of experts in academia and the media, who are paid to be truth-tellers but who until very recently ignored the elephant in the room — rampant corporatism that is subverting the interests of most of the American public and the mission of our health care system. I blame the passivity of a public that consistently permits our politicians to fail to do their jobs to protect our interests.

Where’s the outrage?

Physician Philip Caper of Brooklin is a founding board member of Maine AllCare, a nonpartisan, nonprofit group committed to making health care in Maine universal, accessible and affordable for all. He can be reached at pcpcaper21@gmail.com.
30 replies = new reply since forum marked as read
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Where's the Outrage over Our Failed Health Care System? (Original Post) Jackpine Radical Aug 2013 OP
If you're in it for the money, I don't want you in it. Loudly Aug 2013 #1
The vast majority of physicians are "in it for the money". kestrel91316 Aug 2013 #4
Yes, they are. JoeyT Aug 2013 #6
My husband came from a middle class home Mojorabbit Aug 2013 #9
The profiteering bastard! Nuclear Unicorn Aug 2013 #16
A concept that seemingly is now beyond the American mindset to grasp. The enforced ignorance Egalitarian Thug Aug 2013 #19
I am taking a wait and see approach Harmony Blue Aug 2013 #2
You can't read that and not be pissed off tularetom Aug 2013 #3
"In most countries ... profiteering from illness is not allowed." Scuba Aug 2013 #5
As Akerlof predicted, the medical-industrial complex is becoming increasingly corrupt KoKo Aug 2013 #7
Our Institutions 90-percent Aug 2013 #10
people are too busy being enraged that a Brazilian's spouse was detained for 9 hrs by the British scheming daemons Aug 2013 #8
Worry not. We can multi-task. Le Taz Hot Aug 2013 #12
I am every bit as angry over health care as I am over the NSA survellance. I am upset about many liberal_at_heart Aug 2013 #14
Does this indicate that the detention was ok by you? DisgustipatedinCA Aug 2013 #18
Nah, we need 132;4on123u9h more post on what COULD be happening at the NSA vs some constructive uponit7771 Aug 2013 #11
I'm outraged. hunter Aug 2013 #13
Here's the biggest plus of the ACA. roamer65 Aug 2013 #15
That won't be enough to get insurance companies out. Now that they were able to help write the law liberal_at_heart Aug 2013 #20
like other Trojan policies (NDAA, Gigagate), the ACA will be dolled up until '14 MisterP Aug 2013 #17
With the astronomical costs of healthcare felix_numinous Aug 2013 #21
there is no outrage hfojvt Aug 2013 #22
got a link? Skittles Aug 2013 #23
link: johnnyreb Aug 2013 #28
still not seeing how ACA is a move toward single payer, unless it's because it will be failure. KG Aug 2013 #24
It's not. It's a move away from that. nt Demo_Chris Aug 2013 #26
Believe me, I'm outraged. Jasana Aug 2013 #25
If there is one single thing that would help, it is MindPilot Aug 2013 #27
No kidding: gopiscrap Aug 2013 #29
How does outrage help corporations? senseandsensibility Aug 2013 #30
 

Loudly

(2,436 posts)
1. If you're in it for the money, I don't want you in it.
Tue Aug 20, 2013, 10:32 AM
Aug 2013

If you have an aptitude for the life sciences and a calling to heal, then you're who I want in it.

 

kestrel91316

(51,666 posts)
4. The vast majority of physicians are "in it for the money".
Tue Aug 20, 2013, 10:51 AM
Aug 2013

It's how they support themselves. It's called EMPLOYMENT.

I don't want somebody who feels they have a calling but isn't competent - I want somebody who loves the work AND has some self respect and a desire to avoid homelessness.

If we had single payer, however, the government would lay the law down on those who charge far more than their colleagues.

JoeyT

(6,785 posts)
6. Yes, they are.
Tue Aug 20, 2013, 11:15 AM
Aug 2013

It's probably one of the reasons we rank #37 in health care outcomes.

Under our current system, it doesn't really matter how competent a potential doctor is. What matters is their ability to afford to become one. Competence doesn't really factor into the equation. There are thousands of potential great doctors that are plumbers, or janitors, or ditch diggers because they couldn't afford $30-$50k a year to become one.

Mojorabbit

(16,020 posts)
9. My husband came from a middle class home
Tue Aug 20, 2013, 11:58 AM
Aug 2013

When he graduated he had huge debt. It took almost 15 years to pay it off.

Nuclear Unicorn

(19,497 posts)
16. The profiteering bastard!
Tue Aug 20, 2013, 02:23 PM
Aug 2013

He should kiss the ground of the nation that allows him to subordinate his knowledge and experience to insurance actuaries and system-exploiters! That he should want to see any profit for his family, I think, says just about all we need to know about him!

 

Egalitarian Thug

(12,448 posts)
19. A concept that seemingly is now beyond the American mindset to grasp. The enforced ignorance
Tue Aug 20, 2013, 03:31 PM
Aug 2013

of a binary world. "If doctors can't be rich, nobody would do it" was, not too long ago, the province of the RW wackos. Now it is apparently "common knowledge".

tularetom

(23,664 posts)
3. You can't read that and not be pissed off
Tue Aug 20, 2013, 10:38 AM
Aug 2013

I can remember the first time I heard that "health care accounts for 16% of the GDP in America", and asking myself why that could be, and more importantly, why those who were reporting it were not outraged that such a thing would be true.

That's been 20 years ago, and while the situation has only gotten worse, the liberal media has still failed to tell us that it just isn't right, or even tell us why.

Everybody needs to read this.

 

Scuba

(53,475 posts)
5. "In most countries ... profiteering from illness is not allowed."
Tue Aug 20, 2013, 11:12 AM
Aug 2013
In most countries that have enacted programs of universal health care, two things have taken place. First, health care prices were restrained so as to keep their national programs affordable. Profiteering from illness is not allowed.



Sending our precious healthcare dollars to fatten the wallets of corporate investors on Wall Street and in London, Tokyo and Hong Kong isn't just bad fiscal policy, it's immoral.

KoKo

(84,711 posts)
7. As Akerlof predicted, the medical-industrial complex is becoming increasingly corrupt
Tue Aug 20, 2013, 11:41 AM
Aug 2013

As Akerlof predicted, the medical-industrial complex is becoming increasingly corrupt. It is now one of our largest and most profitable industries. Much (but not all) of what it is doing is legal, but it has lost its moorings and is forgetting about its health care mission in the pursuit of profits and growth.
The MBAs have taken over. We are all paying the price.


90-percent

(6,828 posts)
10. Our Institutions
Tue Aug 20, 2013, 01:14 PM
Aug 2013

The entirety of the Institutions we depend on for a fair and just society have been totally corrupted.

Our entire societies life essence is being extracted by the I got mine by screwing you crowd.

-90% Jimmy

liberal_at_heart

(12,081 posts)
14. I am every bit as angry over health care as I am over the NSA survellance. I am upset about many
Tue Aug 20, 2013, 02:16 PM
Aug 2013

things, education being the most important to me. The defunding of our educational system was the last straw for me, so yes we can be upset about the NSA scandal and still pay attention to all the other outrages as well.

uponit7771

(90,304 posts)
11. Nah, we need 132;4on123u9h more post on what COULD be happening at the NSA vs some constructive
Tue Aug 20, 2013, 01:15 PM
Aug 2013

...action on protecting peoples right to live and to vote

hunter

(38,304 posts)
13. I'm outraged.
Tue Aug 20, 2013, 02:11 PM
Aug 2013

Absolutely, "the medical-industrial complex" is corrupt.

The core of the rot is the health insurance industry. The greater the flow of money they control, the more they can siphon off. Skyrocketing hospital CEO pay? They don't care, pass it on to the customer. Skyrocketing pharmaceutical costs? They don't care, pass it on to the customer. Specialists raising rates? They don't care, pass it on to the customer.

And insurance companies are very good at shedding patients with chronic illnesses who are no longer profitable to them. Can't pay the premium 'cause you are too sick to work? Get lost in the paperwork because your lifesaving medications makes your head fuzzy and your family life has been disrupted? Well ain't that too bad... join the ranks of the uninsured.

The core medical providers -- nurses, physicians assistants, primary care physicians, the people who clean up shit and vomit and blood -- their incomes are not increasing, their standard of living is not improving. It's the fat cats sitting in offices, the money manipulators who are sucking up the money.

roamer65

(36,744 posts)
15. Here's the biggest plus of the ACA.
Tue Aug 20, 2013, 02:22 PM
Aug 2013

It is a very sizable beginning toward breaking the link between health insurance and employment. Especially in states that adopt the Medicaid expansion. Health insurance availability should not be dictated by your employment status. In October 2014, I will look at what is available on the exchange and if I can get one with better coverage then I will ditch my employer's coverage.

liberal_at_heart

(12,081 posts)
20. That won't be enough to get insurance companies out. Now that they were able to help write the law
Tue Aug 20, 2013, 03:38 PM
Aug 2013

it will be harder than ever to get them out of health care.

MisterP

(23,730 posts)
17. like other Trojan policies (NDAA, Gigagate), the ACA will be dolled up until '14
Tue Aug 20, 2013, 02:54 PM
Aug 2013

and then suddenly it will no longer mean "everyone has health care" or "no ACA, no democracy" (as we saw in the LA Times)
but it'll be a fait accompli

felix_numinous

(5,198 posts)
21. With the astronomical costs of healthcare
Tue Aug 20, 2013, 04:21 PM
Aug 2013

no one should be surprised people seek alternatives, which include safe and unsafe treatments. It's their own fucking fault.

My most recent bill for a meet and greet and a CT and lab work? $11,000.

Jasana

(490 posts)
25. Believe me, I'm outraged.
Tue Aug 20, 2013, 05:42 PM
Aug 2013

I'm also disabled and during my last 24 hour hospitalization, I was left in my own urine for 2 hours, 2 medication errors happened and in the end, I was charged for medication I didn't take and also charged hundreds of dollars for occupational therapy I never received. I tried fighting it but Medicare paid most of the bill even though I alerted the fraud department. Your tax dollars at work for the Hospital Industrial Complex. As if the MIC wasn't bad enough.

 

MindPilot

(12,693 posts)
27. If there is one single thing that would help, it is
Tue Aug 20, 2013, 06:11 PM
Aug 2013

Allow Kaiser to operate nation-wide.

My contribution is a whopping $55 per month. Co-pay is $25. No Co-pay for any well-care (flu shots, BP checks, routine physical) I can have a procedure done near my house and get the stitches out (no co-pay for that either) at a facility near my work. Most everything happens in one building. the best part is you know exactly what it is going to cost: $25. None of this crap of getting bills from a dozen different places for weeks after your "visit".

I know some have had bad experiences with them--nobody's perfect--but from what I've seen, the Kaiser model is a very cost effective way to deliver a lot of care to a lot of people. And doing it about as hassle-free as one can expect from a medical provider.

senseandsensibility

(16,933 posts)
30. How does outrage help corporations?
Tue Aug 20, 2013, 08:55 PM
Aug 2013

And if it doesn't help them, why would the corporate media cover it? Simple, really.

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