By James Fieseher, M.D.
New Hampshire Union Leader, April 29, 2021
TO UNDERSTAND the fundamentals of Americaās health care system, imagine you are sinking in quicksand, descending slowly up to your chest with only a few minutes left before you disappear. Already the weight of sand against your chest makes it difficult to breathe. Nearby, a man stands on solid ground, but he asks for money before heāll throw the rope heās holding.
How much would you give to save your life? Would you even have to think about it?
The man with the rope represents our wealthy health insurance companies. The rope is our hospitals, doctors, and medications with their ability to keep us alive. The quicksand is made up of all the infirmities that afflict our health.
We are hostages to our health. Our health not only determines whether we live or die, but the quality of our lives. Private health insurers understand this and leverage their role as medical ābrokersā to hold us hostage to our own mortality.
Making a profit has become the primary goal of our health care system. There are individuals within the system who are truly concerned for your health, of course, but the people pulling the strings: the presidents and CEOs of the pharmaceutical, insurance and for-profit hospital systems know that the bottom line is to make more money.
Missing from the quicksand analogy are the simple things we would do if this were an actual quicksand bog. We would post signs warning of the danger. We would set up guardrails and fences to decrease the chance of someone falling in. Finally, we might post some type of lifeguard to monitor the area and rescue those who fall in despite our efforts.
We could do much more to prevent illness and disease. We would put more emphasis on warning of the dangers of smoking, processed foods, high carbohydrate diets, and work harder to avoid cancerous toxins in our environment.
Instead, common sense is drowned out by health care industries investment in advertising and political lobbying to maintain the lucrative status quo. In our analogy, a portion of the money we spend getting out of the quicksand is spent lobbying against warning signs and fences.
Americans spend little on preventive care. Common diseases such as obesity, diabetes and hypertension can often be avoided by aggressively pursuing healthy lifestyle changes. Many of our cancers, especially those that affect our children, have been strongly linked to pollution.
But our for-profit health care industry knows that there is more money to be made by treating an ongoing health condition than in prevention of disease. The U.S. has many of the finest medical schools and best trained physicians and practitioners on the planet, yet our health care system ranks 46th in the world, behind countries like Barbados and Guadeloupe.
Those who want to keep our health care the way it is insist that creating a āfree marketā of health insurers will lower costs through competitive bidding. In our quicksand analogy, that would be akin to having more guys on stable ground with more ropes. Not only would we still be without adequate preventive care, but for-profit medical insurers have a limit as to how low those bids can go.
Public health measures are not a form of socialism. Health care in the public interest doesnāt change our political or economic policies, it makes our health care system more efficient and cheaper.
Most doctors and medical practitioners, especially those in primary care, find the practice of profiteering from the sick and dying anathema to their Hippocratic Oath. Everyone should be paid fairly for their products and their labor, but not excessively when it comes to our health.
We can all live longer, healthier lives while simultaneously increasing our ādisposable incomeā and still live in a capitalist society simply by reforming our health care system. Removing the profiteering motive from our health care industry will refocus it to the true purpose of health care: preventing sickness and disease and quickly and cheaply caring for the ill.
There is no bottom to the quicksand pit, nor is there a bottom to the greed in the health care industry. If we donāt make changes, the quicksand of medical profiteering will bankrupt our country. A national plan to provide health care to all would free capital to grow a more vibrant economy.
Every comparable industrialized nation has a different, more effective model of health care than the United States and every one of them manages health care as a national policy. We should too.
Currently, there is a wide disparity of health care models in the U.S. that is based upon socioeconomic and regional (remoteness) differences. We need a system that provides the most benefits while still being cost-effective. Forging the right plan will take patience and the need to listen to a lot of voices to maximize the winners and minimize the losers.
Doing nothing is not an option. The physical and economic health of ourselves and our children depend upon it.