Healthcare – A Root Cause Analysis

 

Ten years ago, I knew a woman who died of breast cancer, simply because she couldn’t get health insurance in time to save her life.

I know people who in the past could not get permanent employment simply because of a pre-existing condition (that had already been treated and they were again healthy) could have placed too high a burden on their prospective employers healthcare insurance plan.

Along came a government plan that tried to stop these situations from happening. Millions of people could get healthcare, and the government system was called the Affordable Care Act (ACA) and was quickly given the derogatory (or respectful) name of Obamacare.

Obamacare was an attempt to bridge the gap between the needs of healthcare product providers and the simple need of the USA population of not dying from stuff that the rest of the western world were protected from. It was a flawed first pass at the issue, but rather than fixing it, the opposition used it as a way of trying to destroy the first black president. Calls for making Obama a one-time president as the primary objective of the opposition became a rally cry, and hundreds of attempts were made to repeal the ACA. No attempt was made to improve it, and so the USA population limped along with a flawed, but slightly improved but very expensive healthcare system. Millions more people would receive healthcare, but the costs were crazy, and were underwritten by tax increases (which no one really likes).

Through all of this, the simple fact that the cost of healthcare in the USA is dramatically more expensive than any other western country was not addressed.

The laws in the USA favor health insurance companies and drug and device manufactures. Unlike any other contract entered, healthcare contracts in the US are legal when signed under stress or duress. It’s common for patients entering a hospital to have to sign blanket contracts that demand they will pay all charges that the healthcare provider decides to point their way, and if the insurance companies decide not to pay any part of it, the patient is directly responsible for it. Even the smallest medical procedure can lead to many thousands of dollars in unexpected charges, that the patient has to negotiate on a one to one basis with the legal behemoths employed by the healthcare industry.

The ACA did not do anything to change the closed-market, uncompetitive nature of healthcare.

It is illegal for a USA resident to purchase drugs from overseas. Even though these drugs may well be the same at the ones available in the USA, even in the same packaging from the same vendors, but just available at a significantly lower price.

It is against the law for the US government to negotiate lower prices on drugs or medical devices, by buying in volume.

Doctors in the USA must pay for very expensive indemnification insurance, because there is no control on what types of law suits anyone can file for medical malpractice, even though it is widely recognized that medicine is generally high risk. Costs which must be passed on to the consumer.

Medical professionals in the USA must spend hundreds of thousands of dollars to become registered professionals, and with a for-profit education system and for-profit student loans, they must spend decades paying it back. Costs which must be passed on to the consumer.

Healthcare in the USA is not just big business; it is the biggest of businesses. Generating billions of profits from trillions of revenues every year.

The “pay for influence” USA political system allows, and encourages the whole healthcare industry to spend a very small fraction of their revenue to buy influence at every level, ensuring that the preferential legal framework they have currently, continues.

The fix to the USA healthcare system is quite simple to see, but incredibly difficult to achieve. The costs must be taken out of the healthcare system. Government subsidies in the forms of tax breaks, and payments to consumers and healthcare companies must be reduced and so must the actual charged costs of healthcare. This means healthcare businesses will need to make a lot less money. This means changes to many parts of the law to cap costs, reduce the legal exposure for doctors and hospitals, change the education system, reduce the cost of drug and device development, and place strict cost goals on all purchased products that ensure that pricing is globally competitive. These things will take money out of the pockets of businesses that have been used to getting it, and will not happen without a fight. But while politicians can be effectively paid to take a position, it is virtually impossible.

Healthcare must be a human right. When you are sick you are not able to negotiate. It must be the most basic right of a civilized society. Healthcare must be part of a civilized society, it is social, and the word socialism has been usurped to mean evil and anti-American. Obviously social is not anti-American, unless you believe that the military is anti-American, along with fire departments, the police, power and water services are anti-American (and some people do believe this of course).

This is not a partisan issue; every party currently agrees. Unfortunately, they agree that it’s great that healthcare companies pay politicians huge amounts of money to stand with them and maintain the current model.

Who knows, maybe having a crazed orange thin-skinned self-centered egotist is exactly what is needed to destroy this status quo. Clearly having a Kenyan Muslim didn’t do it…… (you have to love (and laugh at) the propaganda of politics sometimes.

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