“I think the health care market is functioning perfectly.  The problem is that the market is producing profits, not health.”  Unknown

Understanding U.S. Health Care                         

By D. S. Mitchell

Around The World

Things you don’t know about U.S. health care starts with understanding how other world governments look at health care. Government leaders in other developed countries have defined two basic tenets: 1.) health care is a right AND as such, is different than typical free market arenas.  2.) when the ‘invisible hand’ of Adam Smith’s free market philosophy controls a nation’s health care system the result is higher costs and sicker citizens.

In 2011, Jason Adkins commented in a Catholic Spirit article, “slavish adherence to ideology in politics can and does inflict harm to the very people public officials claim to serve.”

Failure Of Competition

One basic element rarely discussed is failure of competition.  The hospital industry is highly concentrated in areas with higher populations while under serving the rural populations of the U.S.; often leaving rural hospitals subject to failure.  As with hospitals, “health care services don’t really compete with one another as equal goods,” The Health Care Congressional Committee (2011).

Each Individual

My doctor’s care is different from the care provided by my neighbor’s physician.  The neighbor’s medications are different from mine.  My response to care is different from my cousin.  These variables make sure that no case can ever be the same.  Thus, in health care; there is no such thing as “equal goods”.

Don’t Expect Better Results

An unknown source made this insightful comment, “I think the health care market is functioning perfectly.  The problem is that the market is producing profits, NOT health.”  Hmmm.  Patients most likely would call this failure.  However, for all facets of the health care industry, profits are spectacularly high, so it can be claimed that the market is a success and doing what it is intended to do, make money. To expect better health care results would be unrealistic in this environment.

An Obvious Dilemma

A very obvious dilemma exposes itself.  Two separate and divergent end desires.  The free market wants profit.  The citizenry wants good, inexpensive health care.   The ideology of profit and successful health care delivery do not coincide.  Since the primary goal of the free market is profit, “Any diversion from this goal is inefficient and against the interests of the holders of capital,” Mark Sokr concluded in congressional testimony in 2011.

Selling Health, One Tablet At A Time

It is not just hospitals. The advertising gurus have taken Big Pharma to the masses. Through near constant media indoctrination the public has been brain washed into believing that there is a prescription (solution) for everything. Isn’t modern medicine wonderful? Unfortunately, the picture is false. Yes, modern medicine is great, and we can do truly amazing things. Unimagined a century ago. But the goals of Big Pharma are not the same as the consumer. Big Pharma wants to sell you a product, over and over, day after day, year after year. You want to heal. So you can stop taking medication. Those goals are not compatible.

Defining Factors

Non-Modifiable:  unchangeable circumstances, such as age, gender, race, genetics.

Modifiable:  changeable circumstances, such as life style choices. Things that can change.  Most particularly, cigarette smoking, poor diet, inactivity, alcohol abuse (or overuse), and chronic stress.  The link between lifestyle choices and chronic illness are undeniable.   Knowing that unhealthy behaviors leads to chronic disease, does not lead people to making better choices, but that needs to change.

You, Your Family, Your Community

“I’m going to die from something,” is the most common response people make when confronted with their poor life style behaviors.  That response is an easy, quick go to, not a thought out desired destination. That “I’m going to die from something” answer gives no regard to the overall effects of that attitude on yourself,  your family, your community or your country.

Predictors

Predictors of chronic illness: smoking, processed foods, fast foods, starchy carbs, bread & pasta, sugar drinks, excess alcohol, overeating, excessive salt use, sugar, high fat diets, and lack of exercise.  These behaviors will lead to obesity.  Obesity increases risks, particularly of diabetes, cardiovascular disease and certain forms of cancer. We, as thinking creatures, are capable of health promoting decisions.

Smoking Dangers

Smoking is the leading preventable cause of chronic illness and death in the U.S.  One in five deaths is directly related to smoking.  Statistics show that 10 times as many Americans have died prematurely from cigarette smoking than have died in all American wars.  Smoking hardens arteries and causes the heart to work harder and causes emphysema and COPD.  Smoking causes 80% of all COPD deaths and 90% of lung cancer deaths.  Additionally, smoking is a major cause of throat, bladder cancer, voice box, liver, pancreas, stomach, kidney and colorectal cancers.

5 Lifestyle Killers

Lifestyle diseases kill more people than communicable diseases.

The top five killers are:
1.) Diabetes
2.) Cardiovascular disease (High Blood Pressure, Heart Attack, High Cholesterol)
3.) Stroke
4.) Chronic Obstructive Pulmonary Disease (COPD)
5.) and certain forms of cancer.

More than 70% of deaths in the United States are attributable to one of the 5 listed lifestyle diseases.  Even more alarming is that 75% of the U.S. Health Care dollar is spent on those same listed diseases.  Furthermore, the numbers do not reflect the personal and economic burden of chronic illness, lost work days, low productivity, disability, and poor quality of life.

Become Your Own Best Physician:

1.) Stop smoking 2.) Lose weight  3.) Switch to a plant-based diet 4.) Exercise at least 7 hours per week 5.) Reduce stress
6.) Practice good dental health 7.) Have fun, enjoy life

Conclusion

To slay the goblins in our health care closet it seems to me that we need to drop the ideology and look at the facts.

1.) Prevention must become the primary health care goal of this country.  Prevention is within our reach. Confronting life style disease can  cut the cost of health care by billions of dollars. 2.) Give up the idea that a pill will fix everything.  It is just well done marketing. This includes re-educating our Big Pharma brain-washed doctors.  Doctor’s need to direct their patients to a healthy lifestyle and stop handing out a pill for every complaint. Tough love, as the behavior mod guys say. 3.) Personal responsibility and self advocacy must become the center of each individual’s health care and ultimate well-being. I know we are all innately lazy and we all love our bad habits, but those bad habits are contributing to significantly shorter life spans and skyrocketing health care costs. 4.) Accept the proven fact that “free market” systems are by their very nature, inappropriate for health care and continuously fail both in delivery and results. 5.) A single payer system delivers the best and least expensive care.  As a massive consumer ‘the single payer system’ buying power can force down prices across the spectrum of health care.

About The Author

I am a retired RN. I worked nearly 40 years in hospitals in Oregon, Washington, California and Nevada as a travel nurse. Although I am retired, I am still passionate about health care. I am an advocate for universal health care. I never want to know of another patient denied health care services, because they lack insurance, or have poor coverage.  Because of my street level experience, I have strong opinions on the state of health care in America and how we can make it better. At the core of that vision is a society that encourages good health through good behaviors and a happier life style.