What You Don’t Know About U.S. Health Care

“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.

 

Three Goblins In The Health Care Closet

3 Goblins Facing Health Care

D. S. Mitchell

On The Front Line

Writing for www.CalamityPolitics.com allows me a grass root platform to discuss health care, and every other area of our political spectrum, for that matter. It does not give me the right to say anything I want about the issues. With that said, I have ground level experience in health care. Because of that experience and exposure to trench warfare in hospital health care I have strong opinions. Client care and results need to be discussed and evaluated for effectiveness. I have a passionate interest in health care, and in this area, I believe my street level experience gives me the right to discuss the issues. Bringing common sense thinking to health care should always be welcomed. I am an RN, and have worked for 38 years in hospitals in Oregon, Washington, California and Nevada.

The Sickest

My two primary areas of specialty are Crisis Psychiatry and Cardiac Intensive Care. Whether the issues are mental, behavioral, or cardiac emergency, many of the issues facing the caregiver, and the client are the same. Despite the obvious differences in the front line needs of the clients, both of these populations are often the sickest in the hospital. One thing I know, is that the health of the American citizen should not be decided by a politician in Washington, D.C. Sadly, that’s where this battle always shows its ugly underbelly.

Goblin 1: Big Pharma

Suitcases Of Medications

For the first twenty-five years of my career, when I admitted a patient that came to the unit with a suitcase of medications, I believed it was because they were incredibly ill. Like physicians I had been trained to believe in  pharmaceuticals.  As an old nurse, my thinking transformed into, the patient is sick because they are taking so many prescribed medications. I can hear the protests from the audience now. Don’t believe me, just read the labels. These are chemicals and they are toxic and poisonous.

Side Effects

Truthfully, every pill has the potential to cause side effects, some known and some unknown.   When a person complains to his doctor that he is uncomfortable due to the side effects of the medication he is taking, his doctor writes him another prescription to help deal with the side effects.  The patient has pain so his doctor writes him a prescription for an analgesic. When he complains of constipation, he is given a prescription.  You can see where this is headed, right?

Advertising Medications

In America, television is the best friend of the pharmaceutical industry.  Constant television marketing convinces viewers that there is a pill that will fix anything and everything. Unfortunately, many Americans now believe that there is a pill that will make everything in their life better.  Health care policy makers need to take this issue very seriously. I realize drug manufacturers want to make a profit, but I also believe constant repetition creates a need that previously did not exist.

Goblin 2: Poor Life Style Choices

It is important to recognize that there are both Non-Modifiable issues and Modifiable issues.

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

Modifiable:  changeable circumstances, such as life style choices that people can change.  Most particularly, cigarette smoking, poor diet, inactivity, alcohol abuse or overuse, and chronic stress. Most people understand the link between lifestyle choices and chronic illness are undeniable. Understanding that continuation of unhealthy behaviors leads to chronic disease more often than not. People need to make good choices.

Painful Truths

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 and cardiovascular disease. Lifestyle diseases kill more people than communicable diseases. The top five killers in America are:

1.) Diabetes
2.) Cardiovascular disease (High Blood Pressure, Heart Attack, High Cholesterol)
3.) Stroke
4.) Chronic Obstructive Pulmonary Disease (COPD)
5.) and some forms of cancer.

The Numbers Are Eye Opening

More than 70% of deaths in the United States are attributable to one of the above listed diseases.  Even more alarming is that 75% of the U.S. Health Care dollar is spent on the 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. “I’m going to die from something,” is the most common response people make when confronted with their poor life style behaviors.  There seems to be no regard for the overall effects of that attitude on self, family, community or country.

Stop Smoking

Smoking is the leading preventable cause of chronic illness and death in the U.S. and is responsible for 1 in 5 deaths.  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.  Emphysema and COPD are caused by smoking.  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. So, America become your own best physician:

1.) Stop smoking
2.) Eat a plant-based diet
3.) Exercise at least 7 hours per week
4.) Reduce stress
5.) Practice good dental health
6.) Have fun

Goblin 3: The really big lie. A free market solution

Whistle-blower

Former CIGNA Senior VP turned whistle-blower, Wendall Potter called it “general gullibility and blind adherence to ideology.”  The American public has been bamboozled ” by the self-serving propaganda from health care insurance companies and pharmaceutical companies and every other part of the medical industrial complex,” he told Congress in 2011.

Around The World

Government leaders in other developed countries decided long ago, the following: 1.) health care is a right AND as such, is different than the typical free market arenas.  2.) Goblin Three: The really big lie is that health care can be viewed through a free market lens. In 2011, Jason Adkins commented in a Catholic Spirit piece, “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. and often leaving rural hospitals subject to failure.  As as with hospitals, “health care services don’t really compete with one another as equal goods.” My doctor’s care is different from the care provided by my neighbor’s physician.  My medications are different from my neighbors.  Response to care is different for me than for him.  These variables show that no case is the same.  Thus, no “equal goods,” can apply.

Profits Vs Health

Mark Sokr 2/17/2011 said, “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, and to expect better health care results would be unrealistic. 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.

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 goal of this country.  We can cut the cost of health care by billions of dollars.
2.) Give up the idea that a pill will fix everything  and as part of that our doctor’s need to direct their patients to a healthy lifestyle and stop handing out a pill for every complaint.
3.) Personal responsibility and self advocacy must become the center of each individual’s health care and their greatest well-being.
4.) Accept the proven fact that “free market” systems are inappropriate for health care and continuously fail.
5.) A single payer system delivers the best and least expensive care.

“Yes, President Trump, “health care is complicated.”

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