Last night listening to Bill Moyers and Wendell Otter discuss the insurance industries' "texts, lies, and video-deceits" over the past 30 years, the one fact that hit me between the eyes is that the amount of the paid-in dollar that goes to actual patient care has decreased from $.95 when Clinton was trying to pass a health care initiative to $.80 today—because of pressure from Wall Street [ironic to hear that phrase in this context too!] in order to increase shareholder profits.
Wait!...Shareholder profits in Health Management Companies? Companies that deliver patient care services also deliver earnings to investors? The physician in me just automatically knows that there is a conflict of interest in this proposition, as surely as the consumer in every patient knows that it is unethical for physicians to have financial ties to pharmaceutical companies. Health care companies should never have any incentive not to deliver the best possible medical care, and they surely should never have any incentive to withhold medical care for the purpose of delivering monies to somebody…anybody else!
This country believes it has the basic premise for the set-up of insurance exactly right. And it is exactly wrong. Not only was third party payer wrong in the first place. The people of the United States sat idly by and allowed Richard Nixon to implement Henry Kaiser’s middle-man HMO/PPO plan in which now an entire extra middle layer of bureaucracy executives reap extraordinary benefits while their underlings (for paupers’ wages) do nothing more than slow down the delivery of appropriate, expedient health care.
What the people of this country need to do is get everything having to do with “for profit” as far away from the delivery of health care ASAP. Then they need to make physicians, hospitals, and hospital staffs accountable via numbers of successful surgeries, infections rates per hospital, per surgery, per physician, etc. available to the public. These kinds of numbers are being collected from hospitals on a voluntary basis today; they could be collected and published for the public by law if enough of the public overcame lobbies like the AMA, AHA, etc.
If we haven’t learned from AIG, Chase, Citibank, Bank of America, Chrysler, General Motors, and the phrase “Wall Street” itself that “for profit” in the twenty-first century means that institutions take care of themselves and to hell with everybody else, that Adam Smith’s theory of the basic good man at the root of conservative economic theory died along with the definition of the word “usury” sometime in the nineteenth century…then we just aren’t facing facts. In which case we deserve whatever the weak hearted Democrats and the theory blinded Republicans in Congress give us for health care legislation.
But if we, the people, are willing to accept the fact that they, the “Stan’s with a Plan” [to make a buck] got it entirely wrong the first go-round, we can re-create a health care plan that makes common sense, makes nobody rich, and gives everybody who needs it just about exactly what they need. It will take a lot of work, but not nearly as much work as commitment, and not nearly as much commitment as belief in ourselves when the “Stan’s” start their “Harry and Louise” tactics to try to make us quit believing in ourselves.
But the “Stan’s” have had their turn; they’ve gotten rich and left us with a rotten system. They can’t make us quit believing in ourselves. Only we can do that. And how can we possibly give up on a revolution when nobody knows that it won’t work?! The worst that can happen is a return to a system that we know for sure doesn’t.
Wait!...Shareholder profits in Health Management Companies? Companies that deliver patient care services also deliver earnings to investors? The physician in me just automatically knows that there is a conflict of interest in this proposition, as surely as the consumer in every patient knows that it is unethical for physicians to have financial ties to pharmaceutical companies. Health care companies should never have any incentive not to deliver the best possible medical care, and they surely should never have any incentive to withhold medical care for the purpose of delivering monies to somebody…anybody else!
This country believes it has the basic premise for the set-up of insurance exactly right. And it is exactly wrong. Not only was third party payer wrong in the first place. The people of the United States sat idly by and allowed Richard Nixon to implement Henry Kaiser’s middle-man HMO/PPO plan in which now an entire extra middle layer of bureaucracy executives reap extraordinary benefits while their underlings (for paupers’ wages) do nothing more than slow down the delivery of appropriate, expedient health care.
What the people of this country need to do is get everything having to do with “for profit” as far away from the delivery of health care ASAP. Then they need to make physicians, hospitals, and hospital staffs accountable via numbers of successful surgeries, infections rates per hospital, per surgery, per physician, etc. available to the public. These kinds of numbers are being collected from hospitals on a voluntary basis today; they could be collected and published for the public by law if enough of the public overcame lobbies like the AMA, AHA, etc.
If we haven’t learned from AIG, Chase, Citibank, Bank of America, Chrysler, General Motors, and the phrase “Wall Street” itself that “for profit” in the twenty-first century means that institutions take care of themselves and to hell with everybody else, that Adam Smith’s theory of the basic good man at the root of conservative economic theory died along with the definition of the word “usury” sometime in the nineteenth century…then we just aren’t facing facts. In which case we deserve whatever the weak hearted Democrats and the theory blinded Republicans in Congress give us for health care legislation.
But if we, the people, are willing to accept the fact that they, the “Stan’s with a Plan” [to make a buck] got it entirely wrong the first go-round, we can re-create a health care plan that makes common sense, makes nobody rich, and gives everybody who needs it just about exactly what they need. It will take a lot of work, but not nearly as much work as commitment, and not nearly as much commitment as belief in ourselves when the “Stan’s” start their “Harry and Louise” tactics to try to make us quit believing in ourselves.
But the “Stan’s” have had their turn; they’ve gotten rich and left us with a rotten system. They can’t make us quit believing in ourselves. Only we can do that. And how can we possibly give up on a revolution when nobody knows that it won’t work?! The worst that can happen is a return to a system that we know for sure doesn’t.
