Our health system’s
Run amok;
Folks just out,
To make a buck.

America’s hallowed “market democracy” has favored us with a cornucopia of shimmering goods and services. At least, if you can afford them. Unfortunately, that system doesn’t work so well for health.

Here both the “market” and the “democracy” have sputtered. The “market” has succumbed to a massive complexity that makes customers throw up their hands in despair when comparing products. Even employers with their greater resources feel trapped by the surplus of detail, the deficit of competition, and the skyrocketing cost.

In such trying times, when economic power gets too great, true democracies are expected to step in to look after their struggling citizens. In all other advanced nations this has happened. Not here. In the U.S. all that economic power has perniciously purchased the political power. As a result, “democracy” is now in corporate hands and our new health reform law looks first to the health of insurers and drug companies, and only secondarily to the health of citizens.

This outcome speaks on the one hand to the avarice of both insurers and medical providers, and on the other hand to the gullibility of voters. The millions of dollars spent on political and lobbying campaigns, though bearing little resemblance to real-life concerns, generally win the day.

Consequently, the economical and practical health systems that operate in most other countries barely exist in ours, with the notable exception of Medicare. In those other lands universal citizen participation in some sort of Medicare/Social Security-type arrangement often bypasses private health insurers altogether, or else those insurers operate under tight federal control. Even doctors are often salaried, thus reducing their temptation to order excessive MRIs, biopsies, CAT scans and C-sections, which here commonly add to a physician’s or a hospital’s bottom line.

Inasmuch as our system is so heavily based on money, it’s no shock that the poor bear the greatest burden of this mercenary scheme. This sad truth only emerges when sainted dentists combine to hold a free clinic, or veterans are offered a day of free care, or a neighborhood health center opens in a low-income community.

Then the floodgates open. Where do all those sick people come from? It turns out that the public assistance programs we read about are very complicated. It’s easy to miss a date, or answer a question wrong, or not understand, or be unable to get to the office or afford the medicine, or not find a doctor who accepts Medicaid patients.

Ideally, human health is too important to allow such gamesmanship. If we were starting from scratch, our founding principle would be universal membership, just like Medicare and Social Security. We would hire contractors to actually run the system and contract pharmaceutical companies to make the drugs. Everyone would be on salary, just as in education.

But we’re not starting from scratch. We’re stuck with a seriously broken arrangement that puts profit above care. Even the new reforms will leave millions uncovered because of cost or technicalities. Unfortunately, the victims of such harshness seem somehow irrelevant in our political system. Maybe some of those insensitive lawmakers should be irrelevant too.

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William A. Collins

OtherWords columnist William A. Collins is a former state representative and a former mayor of Norwalk, Connecticut. www.otherwords.org

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