Friday, March 6, 2009

Getting Sick Over Health Care

Dr. AIG Will See You Now

Remember the old Jack Benny bit? A crook sticks a gun in Benny’s face and says,
“Your money or your life!” Jack mulls. “Well?” the crook prods. “I'm thinking,
I’m thinking,” says Jack.

I watched a bit of Obama’s White House health care confab. It made me sick. The key subject seemed to be how to ensure cooperation between the private and public sectors to, as they say in Washington, contain costs. Yes, as everyone agrees, health care costs are spiraling out of sight. And that will take us broke.
In every other first world country health care is a public service like police or fire. People who get sick go to a doctor or a hospital. Their taxes pay for it. That’s it. Here in America when people get sick they have to check with a financial company that decides whether their treatment will unduly cut into its profits.
In those other countries the purpose of health care is to keep citizens hale and hearty at a reasonable cost to the nation. In the U.S., the health care system is designed to make money for those who invest in it. As the saying goes, those investors are not in business for their health, let alone ours.
The goal all private enterprises share is to grow larger and increase profits. The health industry has been amazingly successful at this. When I was born just before World War II in St. Clare's, a non-profit Catholic hospital in Hell’s Kitchen, health care amounted to a tiny two or three percent of our economy.
Today it’s up to 17 percent and wants to grow even more. It has long since topped manufacturing and is now increasingly a component of FIRE (finance, insurance and real estate), our biggest and least stable economic sector. The exhorbitant premiums we pay to insurers don’t make us any healthier. They go to investments in derivatives and other exotic forms of debt and to pay ridiculous salaries to their execs (you may recall the controversial billion buck compensation package for William McGuire of United Health).
Inviting these companies to a White House conference on expanding health care and limiting its costs is like inviting Jeffrey Dahmer to a cookout.
People who claim belief in capitalist competition are oh so careful to avoid mentioning the fundamental supply and demand equation at the heart of health care. Let’s call it the Jack Benny calculus. For all but Benny, the demand to stay alive and healthy goes without question. Who would not give all to avoid death or debilitation? Thus, by capitalist logic and morality, those able to supply the demand for life and health by way of medical services are entitled to charge all the traffic will bear. And they do.
Society cannot meet such prices. The rest of the first world avoids them by taking health out of the market and making it a public responsibility. Here in America we learn to live with them. Since all but the wealthiest individuals can't afford them, our government and private employers pay the obscene amounts demanded by the financial companies and their confreres in the health business. When their stranglehold become unbearable, we try to reduce it through greater efficiencies such as those being touted by the White House. The prices and profits of the providers remain sacrosanct and untouchable. Indeed, we're now giving them even more billions to cover their bad debts.
The economic crisis has given Obama a magnificent opportunity to rationalize health care by eliminating the discredited financial parasites who feed off it. He has merely to ask Americans if they want the AIGs and United Healths to remain responsible for their life and death? He has merely to ask whether America should consider the time-tested, practical and money-saving example of every other first world country and remove health care from the commercial realm and turn it into a public service like police and fire?
But that remedy was not on the agenda at the White House meeting. Some of its proponents were invited to show Obama’s sense of inclusiveness, but went unheeded to affirm his loyalty to the FIRE flacks with which he has surrounded himself.
As I recounted in an earlier blog (The Heart of the Matter, June 18, 2008), I had a cardiac angiogram in Paris for which I was charged $1,300 by the French state. Had I been a citizen of that nation, I would not have paid a penny. That same procedure in the U.S., which I underwent on a half dozen occasions, was billed between $16,000 and $25,000, depending on whether a stent was inserted.
The difference between the amounts charged by the French and by Americans is the difference between a healthy society and a sick one. So far, Barack Obama, despite his splendid bedside manner, doesn’t seem much interested in narrowing that chasm. Tante pis.

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