Reflections on Health Care

Some things I think about health care in America:

Our system of employer-based medical insurance makes no sense. It’s an accident of history that should be scraped. It places American businesses at a competitive disadvantage. Moreover, it impedes mobility, puts a drag on the labor market and simply makes no logical sense.

Treating health care as a partisan issue makes no sense either. Disease and death don’t respect party affiliations, ideology, race or wealth. Neither should our health care system.

It’s not a matter of entitlement. No one is owed anything. Rather, it’s a matter of what’s right and just. We’re a rich country. America’s brand of capitalism and democracy has allowed many of us to accumulate vast personal wealth. But it’s a system that is poor at ensuring a fair and just allocation of the fruits the system produces. It’s not that we don’t have the money. We spend more on weapons than the next seven countries combined. It’s an issue of priorities. We can afford to ensure no citizen is denied access to treatment and care because of the inequities built into our economic system.

No child, grandparent or other person should die, languish untreated or be compelled to go bankrupt because they weren’t fortunate enough to be born to the right parents, be free of the inherited diseases or conditions that plague some, be well connected, or have the abilities or desire to land a lucrative position. It’s not right that something as basic and precious as health care is rationed on the basis of parentage, personal income or wealth.

Americans are their own worst enemy when it comes to our health. We haven’t adjusted our diets to our sedentary lifestyles. Our habits, propelled by individualistic and materialistic cultural values, are notoriously harmful, yielding high incidences of obesity, high blood pressure, diabetes, stress-induced chronic conditions, emotional and mental conditions, avoidable cancers and drug addictions. Moreover, our over-reliance on chemicals (we call them medicines) and our fear of death also lead us to spend obscene amounts of money to compensate for self-destructive habits and to extend life, regardless of quality or the impact on the community or family. But it is what it is. The health care system must accommodate these realities.

Insurers and monopolists (pharmaceutical companies) walk away with huge profits at the expense of sick and dying people and the country as a whole. Privileged positions afforded by laws passed by elected officials (from both parties) who do the bidding of their donors/masters (insurers and big pharma) need to be rescinded. Patent laws should be changed, and insurance processing should be moved to the public sector or profits capped. Further consolidation among insurers should be blocked and greater competition encouraged and fostered.

Allow citizens to buy their medicines from Canada and Mexico, countries who are more committed to the provision of affordable heath care for their citizens than we are. End protectionist policies that serve the needs of the rich at the expense of the poor and middle class.

Stop protecting the wealth of doctors by excluding well-qualified immigrant professionals. Health care, like education and other systems, abhors competition. Moats are erected to protect the status quo and wealth of its incumbents. Get rid of those moats. Use government regulation to ensure quality and safety, not to protect the incomes of the rich.

Incentives matter. If the system allows for — indeed, encourages — excessive profit-taking, over use, inefficiency and waste, that’s what we’ll get. Indeed, that’s what we get. Design the system to encourage and reward affordable, quality health care for everyone.

Require radical transparency, so patients can compare providers and hospitals by cost and outcomes.

Republicans need to get over Obama. Their guy is president now. And they control both houses of Congress. Own it. Take responsibility.

And come on, Mr. Trump, man up! Honor the promise you made to the American people during the campaign. Chose honor and virtue. Show America what true leaders look like. You have the power to make things better. Stop all the whining and excuse making. Lives and personal well-being of our citizens are at stake. Think about someone other than yourself. Do something that is good for America and Americans.

American can afford affordable, quality health care for all.

The only question is, do we want it?

 

It’s Hard To Stop Laughing On Days Like This

There will be bad days. But this is one of the good ones.

When President Obama was in office, the Congressional Republicans voted to repeal the Affordable Care Act (ACA) so may times I lost track. Of course, it was all for show. They knew the president would never sign their act into law. It was a political gimmick. That’s all.

And then came along the big wind bag. He promised a simple, affordable replacement to the ACA. I knew it was a lot of hot air. I also believed he really didn’t care about the ACA or any replacement for the act. In fact, the evidence is pretty compelling that the only thing he cares about is himself. And perhaps his family.

In any case, all that hot air ran smack into arctic air today. The blowhard failed. Miserably. As did the Republican majority in the House of Representatives. They were unable to agree on a replacement to the ACA. They were unable to pass any bill. And they most certainly failed to fulfill their campaign promise — to repeal the ACA.

That could change in time of course. But for now, we (well, some of us) get to laugh at the circus, headed by the chief clown himself.

So, Vera, here is the larger point: it’s much easier to criticize than it is to actually accomplish anything.

In fact, it’s really easy to snipe. And poke holes. And ridicule. And demonize. And take hollow actions that entail no actual consequences. Or risks. And to huff and puff. And to make empty promises. But to actually do something productive, that’s a much harder lift.

What we’ve witnessed isn’t restricted to the world of politics. You’ll encounter it in the nonpolitical world too. People with loud voices but no skin in the game. And no ability to solve problems and make the world — or their company, other organization, or town — a better place.

Republicans are the teachers today. But it could just as easily have been Democrats. Or anyone else for that matter. No matter who the teacher, there is a lesson to be learned in all of this.

Try to be someone who gets things done and contributes, not merely someone who spouts off. If you do, you may not be able to get elected to the presidency or Congress, but I think you’ll be happier with yourself.