Otis Webb Brawley, M.D. (the author of How We Do Harm and the chief medical and scientific officer of the American Cancer Society) becomes especially upset when he hears politicians and pundits declare that America has the best health care system in the world. Those who say we have the best health care in the world are either completely ignorant and out of touch with the reality or they are straight up lying out their asses. Just look at the statistics. The U.S. ranks 50th in the world in life expectancy with an average of 78.37 years. Meanwhile Canada is over 81 and the UK is over 80. And Monoco - at 89.7- has an average life expectancy at almost 90 years of age. The U.S. also ranks 44th in infant mortality. Yet we pay more in health care than any other nation on earth. We pay 50 percent more than our closest competitor (which is Switzerland). In fact, American's health care costs account for 17.3 percent of our gross domestic product and we are on course to hit 25% by the year 2025.
In How We Do Harm, Brawley writes: "I have seen enough to conclude that no incident of failure in American medicine should be dismissed as an aberration. Failure is the system."
And he quotes Peter Bach as saying, "America does not have a health-care system. We have a sick-care system." Bach goes on to say that "system" is not even an accurate word to describe what we have in our country, because "system" denotes organization.
Brawley further criticizes the "system" by saying, "Too often, helping the patient isn't the point. Economic incentives can dictate that the patient be ground up as expensively as possible with the goal of maximizing the cut of every practitioner who gets involved."
Question: Who is responsible for American's health-care/sick-care "system" being such a disaster?
1) Health insurance and pharmaceutical companies
2) Medical professionals and health clinics
3) Consumers, i.e. patients
4) The government/large corporations
5) All of the above
It seems like a trick question. I mean, is the patient (whether they be a low-informed consumer or not) to be blamed for taking the advise of experts who recommend procedures and drugs that do more harm than good? Obviously not. But is that same patient to be blamed for a lifetime of smoking, eating poorly, engaging in unhealthy or exceedingly risky behavior and not properly exercising? Yes. They are.
Or who's fault is it that patients do not trust the medical profession, and instead of going to them early enough to be treated in the early stages of a disease (in which they could be fully cured for $30,000) they wait years until they have no choice but to see a medical professional and end up having treatment that costs over $150,000 which will only delay death from that disease for a few months?
Or are the doctors at fault for experimenting with drugs and procedures that have been approved by health care agencies and experts? What if these doctors did not reveal everything they know and everything they do not know about these procedures/drugs to the low-informed consumer/patient.
And what about large corporations that are polluting the environment and pumping toxins into the air, water and earth we live with? Like in 1977 when big chemical corporations decided they could make billions of dollars for years and years if they convinced our corporate-politicans to put fluoride in the water, even after Congress used the National Toxicology Program (NTP) to determine that fluoride caused the bone cancer called osteosarcoma. That was over 20 years ago, but guess what we still have in our water?
Also, who is to fault for there not being enough quality medical professionals available to treat all Americans?
The finger pointing can go round and round and in the end everyone involved is acountable for some of the blame. Brawley writes of middle-aged black women who are so afraid of hospitals and doctors that they go without medical attention, knowing they have breast cancer, for nine years or more until their tumor becomes so big that it actually causes their breast to fall off. He writes of sick Americans who actually can not afford health care or who can not afford to take off work to get treatement when they need it. He writes of patients whose health care companies pay for unesseasry procedures recommended by doctors who are taking advantage of a system that is just out to make money. He writes of patients who are prescribed unproven drugs that lead to worse health problems and then have their insurance companies drop them because they are too much of a risk. So in this vicious cycle, where there is plenty of blame to go around, there is one thing that is for certain: SOMETHING most be done to change the "system".
ObamaCare in a Nutshell
The first step in instituting ObamaCare came in the form of two ("fucking big deal") health care acts passed by Congress in 2010. Assuming that The Supreme Court does not declare these two acts unconstitutional (the Supreme Court has scheduled six hours for oral arguments from March 26 to March 28 of this year and will issue a decision by the end of June) then the next step in ObamaCare is for Congress to pass the public option. The public option, for those of you not up to speed on the debate, would basically be a government-run health insurance agency which would compete with other health insurance companies - it would not be the same as publicly funded health care (like Medicare) because it would be financed entirely by premiums paid by those who buy into it (with no subsidies from the Federal government). President Obama, the Congressional Democrats and others say that the public option would:
~Drive down premiums and provide choice where few options exist.
~Break up monopolies that control state and local markets
~Be a moral advancement (as Paul Krugman wrote in his New York Times column, "The most successful [health insurance] companies are those that do the best job of denying coverage to those who need it most.")
~Force other insurance companies to share information and reduce costs.
~Possibly force several insurance companies out of business.
In a recent address to Congress, President Obama explained why he thinks the public option will cost people less money to buy into than privately owned companies. The public option, according to him, would avoid "some of the overhead that gets eaten up at private companies by profits and excessive administrative costs and executive salaries, it could provide a good deal for consumers, and would also keep pressure on private insurers to keep their policies affordable and treat their customers better." That logic sounds a bit idealistic considering the government's ability to create red tape out of nothinginess, but many Right-wingers who oppose the public option use Obama's reasoning to express concern that the public option is simply a stepping stone toward a single-payer health care system. They say that the public option will eventually run the competition (the other insurance comanies) out of business and that the public option is an attack on the free trade market beause the public option would mean that the federal government would not only be providing a health care option, but it would also be regulating the health care industry--which is sorta like playing football against a team that not only has their own players in the game, but has their own referee and commissioner as well.
Even if all of these things are true and the public option makes toast of the private health care insurance industry, most Americans honestly won't mind. How many Americans do you know that have a huge love affair for big private insurance companies? The real concern with such a public option (that eventually evolves into a single-payer system) is that:
1) the federal government has too often been a breeding ground for fraud, waste and abuse as witnessed in several of its other large government agencies and it would therefore just breed fraud, waste and abuse into a single-payer system.
And 2) that the government will become even more intrusive in our daily lives--making decisions about our very health and depriving each of us from making these decisions for ourselves.
But despite these concerns, the public option (and then eventually a single payer system) still appears to be the only way forward in the repairing of a broken, corrupt and disasterous private health care system that is draining the American people and ruining the American way of life. And the alternative, the Right-wing Republican option, is to DO NOTHING. And that is just not acceptable.
So What Changes Should a Government Run Health Care System Implement?
The Wagemann Health Care Plan could be our most effective way forward. The first part of the Wagemann Plan is something we already see being done: Sin taxes. But the Wagemann Plan calls for this concept to be expanded. Alcohol, cigarettes, foods with transfat, foods with pesticides and preservatives, etc should all be taxed at 100%. Under the Wagemann Plan a bag of potato chips should cost 9 dollars. A single doughnut or a Twinkie should cost 4 dollars. And so on. The idea is that this will encourage folks to consume these things in moderation. By the way, the Wagemann Plan also has something that Right-wingers should like: under the Wagemann plan none of the SIN foods will be able to be purchased with food stamps. If Ghetto Joe wants to buy junk food that is going to risk his health and make him a burden on the health care system, then Joe is going to have to pay for it out of his own pocket--NOT THE TAXPAYERS.
The second part of The Wagemann Plan calls for something similar to a program that our military has in which military members are required to have a physical fitness test once a year. The Wagemann Plan calls for giving all individuals in the health care system a physical fitness tests at least once a year, and then using that fitness score to determine the cost which each individual will pay for their health care. Different factors go into determining the test results, like age and height, etc. And of course the plan calls for exemptions for people with disabilities.
If implemented, The Wagemann Plan would not only be an incentive for people to eat right and exercise--which would dramatically lower the costs of health care in this country--but it would also be the most fair Health Care Plan there ever was and put some factual mustard on statements such as "America has the best health care system in the world".
Is the Current Health Care Bill nothing but yet another Bail-Out for Big Corporations?
If you are a frequent reader of Rockism101 you will know that we do not generally delve into politics. One controversial exception was made when we endorsed Barack Obama on the day he announced his candidacy for President a few years ago. However recently R101 has received numerous requests and questions as to where we stand on the Health Care bill signed into law this past week. There is one glaring aspect of this bill that is particularly irksome. As soon it was known that the bill was going to pass the stocks of all the corporate health insurance and drug companies skyrocketed. This was the first signal that this bill was just more of the same old, same old.
A couple days later, after Obama signed the bill, 13 states immediately filed law suits claiming that mandating Americans to buy into the corporate health care system is unconstitutional. Whether the bill is unconstitutional or not, the idea of forcing an individual to buy into a very corrupt and profit-motivated corporate health care system is wrong. It's also wrong because the responsibility for our current health care crisis is not entirely the fault of the Individual. If you look at nearly any ailment that the typical American is likely to get, it is quite likely a direct result of something that our Corporate Consumer System has caused. Whether the ailment is from the bizarre experimental drugs that the corporations pump onto the market, or by the pollution that their chemical plants pump into the food, water and air, OR from the cancer-causing preservatives and pesticides, etc that they glob our food and drinks with, it is the Corrupt Corporate System that is MAKING AMERICA SICK. Take for example the water in this country. Years ago, big chemical corporations decided they could make billions of dollars for years and years if they convinced our corporate-politicans to put fluoride in the water. But then in 1977, some "whacko" enviromental group convinced Congress to use the National Toxicology Program (NTP) to determine whether fluoride causes cancer. It wasnt until 13 years later that the NTP released data showing that lab rats given fluoridated water had a higher rate of a rare bone cancer called osteosarcoma. According to a memo by the Environmental Protection Agency, the data indicated "that fluoride may be a carcinogen." That was 20 years ago, but guess what we still have in our water? This is just one tiny example. The list goes on and on, so why not make the Corporations take responsibility for the part they have played in the health care crisis in this country? Why are we bailing them out of this crisis--yet again--by making Joe Taxpayer foot the bill??? However, pointing the finger at Corporate America and making them take responsibility is only part of the solution. American Individuals must also be held accountable. That is why Rockism101 is a staunch supporter of the Wagemann National Health Care Plan.
The Wagemann Health Care Plan
The first part of the Wagemann Plan is something we see already being done: Sin taxes. But the Wagemann Plan calls for this concept to be expanded. Alcohol, cigarettes, foods with transfat, foods with pesticides and preservatives, etc should all be taxed out the wa-zoo. Under the Wagemann Plan a bag of potato chips should cost 9 dollars. A single doughnut or a Twinkie should cost 4 dollars. And so on. The idea is that this will encourage folks to consume these things in moderation. The second part of the Plan calls for something similar to a program that our military partakes in, where military members are required to have a physical fitness test once a year. The Wagemann Plan calls for the institution of an agency that is responsible for giving individuals physical fitness tests once a year, and then determine the cost that individuals pay for health care based on the physical fitness test score they get. Different factors go into determining the test results, like age and height, etc. Of course the plan calls for exemptions for people with disabilities. If implemented, the Wageman Plan would not only be an incentive for people to eat right and exercise--which would dramatically lower the costs of health care in this country--but it would also be the most fair Health Care Plan there ever was.