Yesterday, the Supreme Court issued its much anticipated ruling on the Affordable Care Act. It allowed the “mandate” to stand and the law, for the most part, will remain in effect, and will, in some fashion, move forward. I wish I could say that I feel like celebrating, but I don’t. This is not the first time and it won’t be the last time that I have been out of sync with the liberal weltanschauung.
So how do I feel do I feel about the U.S. health care system after the decision yesterday? Just like I did before the decision: disgusted, ashamed, discouraged, and angry are good words. Why am I not jumping aboard the celebratory band wagon? Let me count the reasons. All of the many reasons could be subsumed under the overriding characteristics of the U.S. medical system, or, more aptly, the “medical-industrial complex.” The characteristics that best describe that system are: immoral, bio-ethically depraved, corrupt, inefficient, and ineffective. The ACA won’t, unfortunately, fix this state of affairs. Thanks to all of the corrupt practices put in place by congress and the medical-industrial complex, the U.S. health care system will collapse of its own weight – it is inevitable.
I will explain exactly what I mean by these characterizations but first let me make it clear that I respect President Obama and laud him for taking a run at the problem. He did the best he could under the circumstances. He was faced with a juggernaut of wealthy industrialists and their high priced lobbyists, “blue dog Democrats” (along with a panoply of spineless Democrats), an army of misguided fools, funded by billionaires, known as the Tea Party, and an ill-informed media with barrels of ink and gobs of face time.
It should be noted that the Netherlands and Switzerland have implemented similar “managed competition” models with a mandate for purchase of insurance from an exchange. It is working rather well in those two countries – especially in the Netherlands. But no one in the press, congress, or anywhere else has bothered to mention that. It probably won’t be working here anytime soon because the medical-industrial complex dominates congress.
Let’s compare U.S. costs – our country with 100 million or nearly one-third of our citizens un or under insured – with the Netherlands and Switzerland, both of which have approximately 1.5% of their populations uncovered by insurance. In 2010 the U.S. spent $8,233 per capita on medical care. The Swiss spent $5,270 per capita and the Dutch spent $5,056 per capita. It must, however, be noted that countries such as Japan, Italy, and Germany, with single payer systems and all citizens covered spend less per capita than the Swiss and Dutch: approximately $3,035, $2,964, and $4,338 respectively. Need we say more? Isn’t it clear that something is very, very wrong in the U.S. that will not be fixed by President Obama’s laudable efforts?
Where does the difference between $4000 per capita and $8000 per capita in health care expenditure go? Ah, that is the question. The answer is simply this: into the coffers of the insurance industry, medical device manufacturers, the hospital industry, pharmaceutical companies, and, let’s not forget, that portion of the medical profession which places greed over the Hippocratic oath (not all physicians are greedy or bio-ethically challenged but some are and they are certainly represented by a bio-ethically depraved organization known as the AMA).
In the days ahead, this blog will discuss corruption in the medical system and how corrupt congressional-industrial collusion has caused the U.S. health care system to be a disgraceful mess. I believe that the big problem is, as explained by Nobel Laureate economist Joseph Stieglitz, an anti-competitive practice known as “rent seeking.” Through lobbying and campaign contributions, various industries and companies are able to keep prices for medical goods and services artificially high. This has resulted in a massive transfer of wealth from the middle class to the very wealthy segment of the population.
Furthermore, funds are drained off of the U.S. health care system through un-regulated industry practices. Let me give you but one costly example. The U.S. is the only advanced industrialized country with no registry or database containing each and every implanted medical device such as a hip, pacemaker, stent, and so forth. We have no way of knowing defective from well-working devices. It is only after a long run of tragedies and inordinate costs that we are able to recognize a product that is defective. Five hundred thousand metal hips were implanted before it became clear that we had tragically implanted a defective device.
When a defibrillator goes bad, it is a very big, costly, and tragic deal – make no mistake about it. Not only do we not have a database with these products so that we can spot trouble right away, the FDA doesn’t even require clinical trials before they are approved. And a majority of the Supreme Court has held that medical device manufacturers cannot be sued for product liability if the FDA approved their device.
Look for more on how the U.S. health care system runs in the days ahead – including lies about and scapegoating of the elderly.