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Money and Health

by: John Cory, t r u t h o u t | Perspective

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John Cory writes, "Let's face it folks, if health care was manufacturing or Walmart, the jobs and services would already have been outsourced to the cheapest foreign competitor." (Photo: estherase / Flickr)

    The media tells me that health reform is a very complicated issue, that it is hard to understand and even harder to explain to simple-minded and politically unsophisticated people like me. It is about money and costs and free-market and big government socialists versus real America, or something like that.

    So, I ask: How can the majority of other industrialized nations manage to provide affordable health care to their citizens?

    The fabulous media roll their eyes and show me the following Organization for Economic Development (OECD) report:

    Total health care spending per person as of 2007:

    US: $7,290

    UK: $2,992

    Japan: $2,581

    Canada: $3,895

    France: $3,601

    The average OECD expenditure: $2,964

    Now, this health care spending gives the US a sort of neutral bang-for-the-buck result. We do better in some areas and not so good in others.

    O.K., got it.

    Next question: If other countries spend less than half of what the US spends (on average) with good results, where does all our money go?

    This is where my neat-o media suddenly points across the room at the man jumping up and down about wanting his country back or the lady hollering about the Muslim socialist in the White House. Look, look they say, Jerry Springer politics is so entertaining!

    But I still want to know where all that money goes. Don't you?

    We spend twice the money on health care as most other countries and we are supposed to just accept this as the cost of a free market, the price of being American? Let's face it folks, if health care was manufacturing or Walmart, the jobs and services would already have been outsourced to the cheapest foreign competitor.

    I'm not a journalist or a particularly educated guy, but golly, gee whiz Batman, it seems to me that somebody is getting ripped off here - and that somebody is, us.

    Here's more figures I hear tossed around without examination: The administrative costs of Medicare run about 3 percent while the corporate health insurance industry administrative costs hover at 30 percent.

    How can that be? I thought the government was really bad at managing anything while private enterprise is expert at cost containment. But the businessmen require ten times as much overhead costs as big government politicians?

    Whatever happened to the old adage "follow the money?" Who in our media or journalist-pundit class is willing to give up the ratings gold of raucous town hall meetings to investigate where our money is going?

    How much of that $7,290 per person in the US goes to exorbitant CEO salaries? How much goes to lobbyist funding to deregulate the insurance industry? How much is waste and fraud? How much of that money is actual medical treatment?

    This is America, the greatest nation with the best health care in the world. I know, because my TV tells me so. But something is not right here. Something is off.

    America is the home of innovative capitalism. Europe is a bunch of socialistic democratic republics. How can they provide health care at a lower cost? How do they get lower drug prices than we do? Why can't we?

    There are lots of numbers and lots of questions. Lift one rock and you find more and more. Medical bankruptcy comprises 50 percent of all bankruptcies nationally. And 80 percent of medical bankruptcy comes from people who have insurance.

    Our friends and family are one paycheck, one illness from catastrophic ruin. We see it over and over - the community fundraiser for cancer treatment or organ transplant or critical surgery not covered by the current policy. Life-saving treatment is just a wallet's width away. Treatment clinics set up by Remote Area Medical on American soil from California to Kentucky just to provide basic health care to those who cannot afford it. Think of that: A medical organization that specializes in Third World underdeveloped countries has to fill a need in America, the wealthiest country in the world.

    Is this what we've come to? The value of a healthy life is determined by deductibles? Does the value of a life have a monetary cap? Is life itself a pre-existing condition? The corporations that sell insurance think so. They sat before Congress and justified "rescission" as a cost-effective management tool, and no matter the examples of ruined lives shown to them, when asked how many of those executives would put a halt to these practices, not one manicured hand was raised. No need to fear government death panels - they're already here in tailored suits and silk smiles that say, "Show me the money."

    US: $7,290 - the average: $2,964 - results: Quality is fairly equal. How can that be?

    It's always about the money.

  

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John Cory is a Vietnam veteran. He received the Purple Heart and Bronze Star with V device, 1969 - 1970.

Comments

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Follow the money? It seems

Follow the money? It seems that the media is biased, possibly due to advertising dollars provided by big pharma and the insurance industry. Reports that taxpayers are against the health care reforms are followed by pictures of angry 'teabaggers," implying that everyone wants government out of the health care business. In truth, half of the opposition comes from those who FAVOR single payer. We are also bombarded by references to the "controversial" government plan. What's so controversial - we already have Medicare and Medicaid? What should really be considered controversial is the mandate. When in American history has the government put a gun to citizens heads to force them to purchase a product from a for-profit company? Never! This is the most anti free-market plan possible. Where are the capitalists?

"How much goes to lobbyist

"How much goes to lobbyist funding to deregulate the insurance industry? How much is waste and fraud?" And how much goes to drug advertising? That money goes to the TV industry, which is thus encouraged to look aside when awkward questions are raised that might impact its revenue stream.

Thanks for a GREAT article.

Thanks for a GREAT article. I'm posting it as a link on my email signature.

How Come We're so Dumb? We

How Come We're so Dumb? We Americans think our experience as a nation transcends reality. We think rules that apply to the rest of the world don't affect us. "What works for them won't work for us." Even Obama has said the European-style single-payer system won't work here. No explanation given. It explains why we continue to drive gas-guzzlers while the rest of the world gets real about transportation. It's why we dive into foreign wars so quickly never experiencing the bloody reality up close, save for one day back in 2001. We don't see Vietnamese peasants dying of cancer induced by Agent Orange some 40 years ago so it's not real to us. It doesn't exist. We'd rather drive 70 mph (80 mph in parts of Texas) and lose some 30,000 lives than slow down. We have this naive belief that if some go-getter starts and runs a for-profit enterprise, he's more honest and deserving than some bureaucrat on a public salary. We'd rather spend $4 on insurance premiums to save $1 on taxes. This attitude may never change in my lifetime. If you listen to these wackos at the "town hall meetings" and talk radio ditto heads, you see that hubris and ignorance is deeply ingrained in the American character. We're better than "them." Our music and culture is superior, our inventions better, our philanthropists richer and more generous. Hence, the belief that our "free enterprise" system trumps all other ways of life. The die-hard fundamentalists believe we're closer to God and our innovations will save the human race, despite the collateral damage.

It's always about the money

It's always about the money and how money is mixed up with ideas. People I know who are against public option or single-payer are afraid that their whole system of value will become obsolete. What value? They believe that they are hard-working and smart and the money they make allows them to feel good about themselves. Burger flippers get sick and die. Airplane mechanics get sick and then get well and live because they have the money to. That's why they work hard. They sweat, they toil, they make money. They feel good about themselves. But if everybody gets good health care then why are they working so hard? Their feelings of self-worth come into question. If even hamburger flippers get just as good a health care as airplane mechanics, then how are the mechanics going to measure themselves and find themselves worthy? Against this ideology, the Tea Partiers and their ilk echo Reagon who said, "Don't bother me with the facts!" Add in not just that the media will always go for the sensational but also that their advertising revenue stems from bringing the public to the product and you see that it makes money sense for corporate media to take the Chamber of Commerce view. It takes a philosopher to feel and understand the inherent dignity and value of each individual human life, but anyone can use money as the mis-measure of all things.

There are probably thousands

There are probably thousands of individuals out there like me. Seriously disabled, bankrupted from healthcare and too depressed to fight city hall anymore.

BRAVO!

BRAVO!

Excellent rhetorical

Excellent rhetorical question and discussion. it should go to every legislator and leader in the Senate and House, as well as to the President. they claim they are most concerned about the well-being of the citizens and not just in stuffing money into insurance companies pockets. Where is the money going? This is the right question. How long will it take to get an answer? Will we get an answer at all? Let's see who has the nerve or honesty to answer it.

A very good article

A very good article published in the LA Times during the '08 election points out why the insurance mandate is unconstitutional: http://articles.latimes.com/2008/mar/24/opinion/oe-court24

30 per cent overhead by the

30 per cent overhead by the health industry compared to 3 per cent by the government. Simplistically we could assume that the health industry is 27 per cent more incompetent and less efficient than the Government. So why we still want to believe that the Government is the problem and not the solution and that the private run enterprises are better managed that the government’s. There is lot of waste in the private industry which goes unreported. Maybe we watch too much television or we do not know what we are talking about. .

A most excellent article

A most excellent article !!!!!! Ain't it just like our policy makers to bumble through national policy without assessing the foundation. Yep, FOLLOW THE MONEY. Then we should talk. Until then, let us create the system. Remote Area Medical, of outstanding principals and practices, is a needed reaction team..... but let's keep creating our system with or without the money grubbing CEOs.

I think America is afraid.

I think America is afraid. Afraid of: change, a non-white president, taking action... afraid of just about anything that someone tells us we should be afraid of. We don't try to understand things. We cower from them or strike out at them. We dismiss ideas and beliefs that don't immediately conform to what we have been trained to think. If God appeared before us and said, "Global warming exists and is a problem we need to deal with now", we'd wait for a news broadcast ("What you need to know about God and global warming... details at eleven.") or Limbaugh or Obermann to tell us what God 'really' meant. Listening, thinking, questioning, evaluating and deliberating are all abandoned because someone says 'socialism' or 'death panel' or 'increased cost'. We should be saying, "Explain that. And if you can't, be silent." The dialogue / debate has been uncivil and has set a precedent for the unruly discussions that will ensue for all future contentious issues. Shame on us for letting the boogymen make us afraid to work on things together.

Lost in this whole thing:

Lost in this whole thing: health itself. How can we "debate" what reforms are needed when we don't even talk about what it means to be healthy -- and that includes mental health because mental well-being affects one's physical health)? Not only that, but nothing's transparent. Under the current system, what's the incentive for those who have insurance, say, through their employer to ask how much procedures cost? You just assume that, within certain parameters, things will be covered. The costs are utterly opaque. Why shouldn't we shop procedures, even general physicals, just like anything else? And shop the doctors, too? People do do this to some extent, but it's by no means done across the board. All good questions raised in this piece, Mr. Cory. Hope you'll do a follow-up with some answers.

"... if healthcare was

"... if healthcare was manufacturing or Walmart, the jobs and services would already have been outsourced to the cheapest foreign competitor." It's already happening, Americans who cannot afford healthcare or are denied services by their provider are going to India, China et al to receive affordable treatment. I'm sure by next year AETNA will offer this as an option.

I fully agree with the

I fully agree with the author of this article. Either Americans who favor full private insurance for health care don't think, cannot think or are unable to think because of being brain-washed by advertising and delusional thinking about special status of American democracy which transcends reality, or else they are dumber as a total population than anyone wishes to admit. We must not forget the role of the media in all this non-conversation about health care. They do not report on the Truth of what the reality is but on what people say. "Some say this" "Some say that". This is NOT a conversation but false reporting. Listen to Wolf Blizter whose questions are longer than the response he is willing to listen to ! It is so disappointing to see how such a great nation (at least potential great nation) like the USA can let itself be driven by lies, false advertisements and people bent on destroying the govt. because they don't like the man who is at the helm. Listen to those who wish Obama his Waterloo". Do they realize it would also be the country's "Waterloo" Some don't even know what "waterloo" mean. Great country ? So many of our Senators and Representatives are so poor in their knowledge and understanding of history.... and they wish us all to bankrupt ourselves if we are sick. The Greatest country in the world, the most religious country in the world.... Love thy neighbor as yourself, not yoursel more than your neighbor ! Remember, the Good Samaritan not only gave his money to help his neighbor recover, he promised even more money if that was needed. The commercial I hear over and over is "What's in it for ME". That does not sound like the Greatest religious remark that we should hear from the Greatest religious country in the world !

good article examining myths

good article examining myths but the author is stillstuck in other myths...i.e.USA is the richest country in the world...even by conventional measure this is no longer true [as it was in the 1950s] . If you factor in inequality it's even less true,the spread between the rich and poor is a chasm and growing inexorably. Now,if you try to measure quality of life USA is scrapping the bottom of the OECD barrel. Cubans [non-OECD] get better medical care, Europeans and Australians get better public transport. New Zealandhas less red tape. So the myth of a great but expensive health-care system is as false as the myth of US exceptionalism generally.Bring on the end of the Empire if not for yourselves then at leqst for the rest of the planet. P.S. granted,you lead the world by a huge margin in people held in prision per head of population and money spent on war.

In the 2008 elections, the

In the 2008 elections, the health insurance industry alone contributed $40,903,824 to the President and members of Congress for their campaigns. That does not take into account Pharma, Hospitals and HMOs, nor does it account for the money being spent on lobbying Congress each day. Nor does it speak to amount of money this industry spends to spread outright lies and misinformation about health care reform. Source: http://www.opensecrets.org/

What makes you think we have

What makes you think we have even average quality? Most of the statistics, we seem to be in the bottom 1/2 of the OECD countries.

Actually, Anon. @ 17:51,

Actually, Anon. @ 17:51, check out this article in USA Today -- http://www.usatoday.com/news/health/2009-08-22-medical-tourism_N.htm -- and you'll see they've already begun pilot programs. It's no longer patient-elected medical tourism. Sad... very sad. We're now going to outsource our medical care for the middle class. This, in the greatest country in the world?

Is there a reason we should

Is there a reason we should not outsource health care? If most of the first world has equal care for less cost, why don't we outsource using the French, Japanese, Canadian, UK systems as the providers. We can part it out the same way GM outsources the different parts of their cars, or the Pentagon for their expensive military projects.

Anonymous 17:51: If this

Anonymous 17:51: If this bill passes, it is very likely that the guidelines for any "approved" insurance policy will prohibit use of offshore health care services or prescription drug sources. The American people will be forced to "shop at the company store."

Without tossing some things

Without tossing some things out such as extreme profit motives, insurance allowing or disallowing payment at will, legal stops on choices of "non-western" or "alternative" treatments, then moving on from certain forced treatments which are barbarous and destructive and not healing such as chemo and radiation as well as moving on from some of the ridiculous and disproven ideas promoted by big pharma that treating a symptom is treating, let alone curing a disease and which typically results in medicating the medication many times over, I don't think we are making meaningful and intelligent progress. There are a lot of choice issues not involving funding that I think must be addressed if we are to have true "health" care and treatment available. How to fund it when the US is essentially bankrupt is another question. What, print more money?

Please be certain that Obama

Please be certain that Obama wants to help us. However, NOTHING of any good will pass through THIS cesspool of a senate, and Obama is ONLY the president, and a law-abiding one too. No whining please. No misinformed, puking 'liberal' angst please! This only plays into the hands of the well informed right wing money pigs who want to loot and pillage us further. What can we do? Join your party of choice and VOTE in the 2010 PRIMARIES. Eliminate not just the republican criminal incumbents, but the over 60% of the democrat party's 'blue dog' corrupt hogs ESPECIALLY too! All of these corrupt pols want Obama to fail and YOU to die. Beat them in the 2010 PRIMARIES, and you have a chance to put in WORTHY candidates who will form a CONGRESS that will work WITH our president to heal our nations gaping wounds. No whining. LEARN how the American government works and WORK AND VOTE to bring the changes WE ALL WANT. No number of billionaires and 24/7 hate radio jocks can deter the will of the PEOPLE. Become informed and patient. Teach others the truth, and give them time to comprehend. WE CAN DO THIS.

It's pretty simple: the

It's pretty simple: the extra money goes to the health insurance company parasites, and then some goes from them to their investors. It's also simply obvious that government is much more efficient than corporations are, and the myth that the opposite is true is yet another lie spread by the corporatists.

Yes, listen to Obama's

Yes, listen to Obama's 9/9/09 speech: "We will cap your out of pocket" "We will not allow pre existing condition exclusions" Both of those propositions sound great in isolation, right? Where is the word "premium" in there? So they cannot refuse to insure people with a pre-existing condition or who are over 60, BUT the insurance company can set the premium for those people at ten thousand a month, twenty thousand a month? That's tantamount to denying coverage, no?

to "how come we're so dumb"

to "how come we're so dumb" - kudos. although expansive in the argumentation, nonetheless big picture relevant. the article also bit into the crux of the biscuit in respect to the "show must go on" aspect. media plays us with town hall tumults dressed up in "the democratic process". Then, it's presto change-o, subject matter be damned and inherently sensitive issues for the networks that could bite the hand that feeds them are scuttled. maybe that's as close as we can get to democracy - shabby soap operas. but hey, the snow must go on!

I work in Europe but I

I work in Europe but I trained partly in the US in the late 1990s when HMOs were growing. Of course for-profit HMOs were often abusive, but at that time there was briefly a wave of interest on the part of young doctors in becoming primary care physicians (general internists, family practice...) who would have been the new "gatekeepers". Our training took the whole patient into account, and quality was judged by preventive measures taken. We thought twice about ordering redundant tests. A health care system should in fact refocus on primary care and prevention. Reduce financial incentives for specialists (I am one) and increase them for general practicioners who spend time with patients to evaluate them correctly and treat them in a scientifically sound manner. Otherwise, public option or not (I'm all for it), costs will continue out of control. Also, reduce M.D. college debt and malpractice costs.

First: Great

First: Great article. Second: Why isn't where the money goes to after the bankruptcies are completed being debated? Those bankruptcies result in family bank accounts being drained, and family assets sold to pay those bills. The money goes to the corporations and the individuals managing them that already have unreasonable wealth and control over our society. Simultaneously, the bankrupted individuals and families are left in a state of destitution which they are unlikely to climb out of for a generation or more, if ever. Thus, we have the development of a new feudal system, where the upper class demands and receives ever greater proportion of society's wealth, and those not in that upper class (a vast majority of the population) become vassals living on subsistence wages that could disappear in the blink of bad luck. And the rationalization that the corporate class uses to justify their claim on the bankrupt people's assets is contract law: that the bankrupt made a choice to run up those bills in order to retain their health or life. That's a choice?

Mr. Cory, the health care

Mr. Cory, the health care industry has already been outsourced to foreign countries. When was the last time you were in a hospital or nursing home? When my mother was in a nursing home I had to spend a bit of time looking for a nurse who spoke English. I had to make sure they could read English well so they could understand her chart and instructions. The health care industry in the US is being turned over to medical emigrants who will work for the lowest pay and in the worst conditions. Since it would be hard to actually move the hospitals and nursing homes to a third world country, they just bring the third world people here to work in them.

Come on why doesn't anybody

Come on why doesn't anybody say it? Bottom line is the "health" industry is the biggest money making business in the country. We can't get affordable care because instead of turning out compassionate individuals interested in helping their fellow man from our medical schools and training facilities, we are turning out competitive, greedy, wealth and power loving, cold hearted individuals who will let you die on the sidewalk if you can't pay them. Think about it-if you had the ability to save someone would you really let them die right before your eyes because they did not have a buck to give you? This issue is about compassion and why we have a system of "helping" professionals who have none. The people who do are already out there trying to make a difference. Stop making the medical profession about money and power and make it about a calling, as it should be. In time, health reform will make it unprofitable for business tycoons to dress up as doctors and that will be good.

Making Money: The Only Goal

Making Money: The Only Goal of Insurance How is any corporate CEO going to accomplish the goal? Lose people who become sick or have pre-conditions; Increase the premiums and raise the deductibles; delay payments; Refuse payments; Restrict care through pre-authorizations; Squeeze medical care Providers on what they charge; Permit use of only low-cost drugs; Sign up the largest employers and negotiate hard with smaller employers; Form processing service companies and skim. Follow the money in this system, and it is amazing how little of it has to do with getting actual healthcare from a provider.

I think the issue is a joke,

I think the issue is a joke, Is our own government good for free health care? Do they pay the doctors fees? Do they pay for the Hospital fees? No we do! If it is good enough for them, its good enough for the people who elected them? No! This is just another way to keep from the real issues... where is the change. What happened to "Yes we can". Why are we still at war? It has come to Yes, we cant, and no we wont!

Ok, up to 30% is insurance

Ok, up to 30% is insurance overhead. I guarantee another 10% is patient idiocy. How much more gun and car and drug violence do we have than Europe ? That's small change. I've seen zero violence in my practice and daily I see some idiot go to the ER for no good reason (mainly to get narcotics on a flimsy reason). The ER visits are equivalent to my yearly physician salary, or close to the cost of non-chemotherapy medication costs. (note, my practice is perhaps not typical; I had someone collapse on the floor demanding narcotics this week... no general doctor keeps those in his office; the week before I had a drugged out 40 year old urinate over my entire office).

I'm afraid i can't cite the

I'm afraid i can't cite the source for this, but my favorite analogy is that madating the purchase of health insurance by those who can't afford it, as a solution for the 48-50 million uninsured, is like mandating the purchase of a home as a solution for the homeless.

Europe is a bunch of

Europe is a bunch of socialistic democratic republics. How can they provide health care at a lower cost? How do they get lower drug prices than we do? Why can't we?

We don't want it bad enough to do what they did to get it .

The problem with American

The problem with American healthcare is the same as the problem with American Banks...government intervention. The US government offers tax incentives to employers to offer healthcare, these incentives only make a difference to larger corporations, this leaves a smaller segment of the population then would occur in a free market (without tax credits for having health insurance) without either employers who offer insur. or with no regular job at all...and supply and demand being what it is, it is less profitable for insurance companies to target these individuals then it is selling blanket polices to corporations. The solution is to abolish government tax credits but allow a states to set up minimum coverage that its occupants have to purchase, like car insurance, individuals buying a policy. Will insurance be higher for people who have health disabilities YES! but the increase in number of people covered should offset it, plus abuse of the system will decrease ie people being seen for common everyday ailments like the common cold w/o complications

which increases the overall

which increases the overall burden of healthcare on all the holders of that policy plan without increasing your life quality one bit.