Gutless Leadership and Health Care Suicide
January 23, 2010 by Will Marre
One of my close friends is a hospice volunteer. Lately he is supporting a vibrant, full-of-life 80-year-old woman who’s got a bad heart and who’s chosen to die as fast as possible. She’s in an independent care facility that costs a lot so she’s decided to voluntarily starve herself to shut off expenses so she can leave some money to her full-grown children. I know. He’s tried to talk her out of it, but she’s determined. She wants to die because she can’t afford to live. Welcome to America.
Meanwhile our leaders do anything but lead. The Democrats are sissies. The Republicans are bullies. I think most of us are sick of toxic, dysfunctional, ego-bloated politicians pretending to lead our nation.
As I have stated months ago, as well as many great comments from the rest of you, (see Outraged at the Politics of Health Care and Will Marre’s Radical Solution to Health Care) the fundamental problem with a financially unsustainable health care system is that the profit motive is its key driver. This creates a crazy maze of confusion, waste, cost, and suffering. Today’s price of health care is driven by cartels and rich interest groups who compete like Gladiators for a piece of yours and my pie.
- Thanks to the near elimination of antitrust safeguards, 7 big private insurers control over 80% of health insurance in our nation. These companies are designed to take in as much money as possible from you and pay out as little as possible. They make the insurance claims process confusing and time consuming for patients and doctors, which increases costs and time. This also discourages many people and even physicians from making totally legitimate claims, which increases profits by tens of millions annually. Of course we also know that insurance company claims representations are rewarded for denying claims or finding unethical loopholes to deny payments for treatments to insured persons for trivial reasons causing systematic suffering and in some cases avoidable deaths. Lately insurance companies have been raising premiums in huge chunks to make as much as they can before they are regulated. The obvious conflict between investor interests and our nation’s health care is so great it is breaking our economy.
- Drug companies have created a closed, unfree market in the U.S., which allows them to charge many times, often 10 times, more for a drug than it costs in other western countries. The idea that Merck drugs in Canada may not be as safe as the same drug in Minnesota is an insult to all of us. The argument that American consumers need to pay higher prices to support U.S. drug companies’ research is simply wrong. U.S. drug companies spend much more on consumer advertising than all of their drug research combined. If business believes in free markets and globalism, then let’s have it. Free trade and a common world price for all drugs.
- The medical profession has too many incompetent doctors doing procedures they shouldn’t be doing simply because these procedures pay well. It has long been known that the most expensive and difficult procedures are done at the lowest total cost and have the best results when they are done in well-equipped hospitals that specialize in those treatments by doctors who do hundreds of those procedures per year. If you need a heart bypass, go somewhere where they do hundreds of them. These “Centers of Excellence” save money and lives. The medical profession also needs to do a much better job of getting rid of incompetent doctors that cause the majority of malpractice claims. It would also be wise to establish special health courts to curb the abuses of trial-lawyers who game the system to win big awards on the basis of emotion rather than science and responsibility.
I could go on, but who would listen?
The core solution I believe is a universal insurance exchange that is set up as a national non-profit co-op “owned” by all American citizens run by competent executives and properly rewarded employees who have one goal—make sure that the most people have access to the best health care. This can be done with excellence and efficiency. Employees should be rewarded for quality and keeping people healthy not for denying sick people coverage.
We need something more than the best we get from compromising with the huge health care industry that has spent $425 million lobbying against us in the past 4 months. There is a role for private insurance companies, but we must level the playing field by creating a force of citizen power to create realistic and sustainable economics for health care. (The rest of my proposals are in previous blogs.)
Today our health care strategy is a mess because we are trying to turn a rusting ocean liner into a rocket ship. No matter what modifications we make to the rapidly sinking boat, it will never fly.
We must have a whole new system. One that gives people choice and confidence. One that rewards people for healthy lifestyles. One that is uniquely American. Not run by the government but by well-informed citizens who can blend the best of our fierce independence, distrust of bureaucracy and our collective heart for our common good.
I do not claim to have all the answers. But I am disgusted with Democrats who turned what should have been a health care revolution into a poison stew of who-knows compromises. The “brand” of the Democrats is whiny, victim, poor me thinking. They are also ready to compromise because they have no visible backbone and few ideas they are ready to fight for. The Republicans sicken me. Their “brand” is arrogant know-it-alls who only want to lower taxes, fight wars, remove regulations and promote a new aristocracy. Their “I’ve-got-mine and no-one’s-going-to-tell-me-what-to-do” mind set is a cowboy philosophy completely at odds with the higher purpose of society.
As far as health care goes, I am most impressed with Jesus’ advice. When the Samaritan came upon an enemy who was left for dead by the side of the road, he didn’t say, “Well, he probably deserved it.” Instead he took him in and got him medical attention and paid his bills. It seems clear to me that moral maturity demands we seek to reduce all avoidable suffering. If that were our motive and we didn’t compromise with the moneychangers, we just might come up with something simple, practical and affordable.
I, for one, don’t want the status quo. I don’t want some two-bit, best-I-can-get superficial leftovers approved of by the special interests. I am sick of hearing what’s possible.
What I want is a radically new way of looking at this challenge and the leadership courage to make our country a better place to raise our children.
How about you?
–Will Marre
My idea for healthcare is for the Fast Food and Drug industries to pay for all our medical expenses since they have taken over how we eat and how we think.
Respectfully,
Kevin
I really don’t think the story of the 80 year old woman with a bad heart is an indictment of health care in America. The story doesn’t indicate she can’t afford to continue on but that she has chosen to leave money for her adult children. Technology has given us the ability to prolong life in many terminal cases. I want to live every minute that I can but at some point I may need to evaluate the situation and make decisions. No health care system can afford to keep everyone alive as long as technically possible. Instead of the patient deciding whether to spend the money to keep herself alive it will most likely be a regulation/bureaucrat that will make the decision.
My solution is simple – tax fast food, junk food like chips, soda, cookies, etc, along with cigarettes and booze and put it in a pot that is divided up by the states based on population size to fund state-run health care plans. So those who have unhealthy habits will pay proportionally more based on their consumption. The states will run the plans, as the federal government cannot be trusted to manage our money.
Health care should shift to a preventative model. Doctors should be coaches, not drug pushers, and be rewarded based on how many of their patients lose weight, lower their cholesterol and blood pressure, quit smoking, etc.
Pharmaceutical drugs and procedures that treat symptoms while allowing people to continue their poor health choices should also be taxed.
However, as long as we have government that represents the corporations and not the people, they will continue to pi$$ on us and tell us that it is raining.
I supported Obama and I think he personally has his heart in the right place but he has no power to do anything as he is surrounded by lackeys. You are so right in your assessment of Democrats and Republicans. Two sides of the same worthless coin.
We need a revolution. Hopefully a peaceful one.
Rock on Will!
We do need a total revamp of the system beyond just insurance reform (and the current bill doesn’t even do this well). We need a centralized (not necessarily single payer but with costs determined centrally e.g Germany or similar system or like the French system which is single payer-the government) system, eliminating all the complicated billing and paperwork. And, most importantly, it should be non-profit. We can not afford profit-taking. But our ‘capitalism run amok’ system dictates that corporation profits reign supreme-forget serving the people.
If health care facilities were more centralized (I’ve heard raves about the centralized facilities in, of all countries, Thailand), people wouldn’t have to run all over to get their health needs met. They wouldn’t have to deal with complicated paperwork/billing when they are incapacitated.
We need to do something about litigation which increases the costs of everything from equipment to supplies to hospitals. Litigation is not just about physician malpractice although that needs to be addressed though mediation rather than lawyers taking 50% profit.
I have emailed, called, talked with people, and written articles. But people just get caught up with a few issues such as: big inefficient government (bureaucracy is a legitimate concern that needs to be dealt with), having company insurance that they don’t personally pay-at least not full cost-for (what about empathy for others, working or unemployed?), abortion (let people make their own choice), and undocumented immigrant issues (Congress needs to address but I fear that corporations actually want undocumented workers for their own profits).
If this country is ever going to thrive, we need to get back to the our founding values and get over the “get money, power, stuff for me and forget my neighbor” mentality. I don’t see how we can progress with our two party system that votes everything on party lines. Why do we even need a Congress? People could vote on the Internet (Come on, it’s not ‘rocket science’.). But without basic values our children’s future is bleak. Will, your efforts are admirable but things are just going downhill.
Obama needs to take strong stands, be less conciliatory (the two parties won’t budge-get rid of both) and ask for more than he wants because concessions always are made. He made the traditional cabinet/government people appointments rather than choosing persons outside of government that could bring new vision. He can’t stick with the past to improve the future.
And most of all, people practice what your values or religion teach. Forget about politics; Republicans, Democrats, or Libertarian. If people really did this, we could transform government.
I once injured my left knee when the chain on my bicycle slipped and I fell to the ground, knee first. I remember an older lady who saw me limping about a week later and said “oh, he has a bad knee.” I looked at her and said, “I don’t have a bad knee. I have an injured knee.”
I’m a chiropractor. People might come to me and tell me they have a “bad” back. What’s bad about it? Is it deformed? Is it degenerated? Degenerated is not “bad,” its just neglected and abused. “Misbehaving,” is a better description. Bad? No. The person who owns the back is misbehaving (neglect and abuse), a lifestyle choice, and blames it on their back. I’d like to tell people to stop blaming something else for your current problem, and instead do something constructive. You don’t have a “bad” back. You might have an injured back, but us chiropractors know the injury is repairable by natural means, if it is not totally destroyed.
The medical model of “you have a bad” body part, implies that your body is not capable of repair, without drugs or surgery. What a BS paradigm!!! This paradigm and entrenched belief system is why we have disease care and crisis care as the main type of care in this country. What we have is not “health” care. I practice health care in my office, and it has nothing to do with telling people they have a bad anything.
To me the disease care paradigm is broken, and to mandate that everyone be tied into such a broken system is really a tragedy. People are brainwashed into believing that their body is incapable of anything. That’s why you think you need that prescription medicine they advertise on the TV. Wo! I don’t believe that for a second. Our bodies ARE capable. Other catch phrases that you hear that brainwash you into believing that your body is incapable of any healing are: genetic, and old age. Age does not cause degeneration, it only predisposes someone to degeneration. So when age is “blamed” for someone’s problem, run to a doctor with a different paradigm. Maybe (gasp!) a chiropractor.
The reason the lady in this example wants to do what she is doing is because of her beliefs. When medicine fails, and the patient is told that they just have a “bad” body part, most people will have little or no hope left. However, that would only be a decent conclusion within the confines of the medical paradigm of disease care. Outside of that paradigm, a different conclusion might be made. We’ve really been brainwashed to believe that modern medicine (as drugs and surgery) is the best, and ONLY answer for issues of health decline. It certainly is the most expensive.
Action Steps: 1. Regulate insurance companies by making them non-profit (even not-for-profit is a step in the right direction). 2. Ban prescription drug commercials from the general media (just like it used to be). 3. Drastically curtail government grants to more “for profit drug development” because the big pharma companies will be able to use ALL the money they saved from all that advertising and put it directly into their own research and development. 4. Make government grants available for research that cannot be patented and owned by a single entity (duh!). So we’ll give you the money to do the research, and come out with something constructive, but we’re not going to just give you money so that you can do research -so that you can make more money- and not even pay us back.
Will has some great ideas about this topic. He is helping us to think about it for ourselves, instead of just relying on news media, and political rhetoric, and I think this is a great service to us all.
What is the definition of a real tragedy? A bus full of lawyers going over a cliff with two empty seats on the bus. Why? Because lawyers have their hands in every aspect of health care representing and lobbying for the drug companies, insurance companies and the equipment manufacturers. But how could that ever be a conflict of interest?
Workable successful solutions are already working very well in many countries around the world, but our Congress loves to re-invent the wheel and proceed as if they are starting from scratch instead of having the answers already available. The successful systems are non-profit, the coverage and procedures are the same for all meaning that you don’t have 50 different insurance companies with all different types of plans and all different fee structures (a huge, huge administrative cost contributor to todays health care system). Then we have to eliminate having different plans and cost structures for health care from state to state, why does it cost more in New Jersey than in Pennsylvania and why can’t an insurance company in Pennsylvania sell a policy to someone in New Jersey (no damn competition increases costs to us and insurance company profits). And yes the trial lawyers (as always) need to be controlled or every other cost control effort will be for naught.
Regarding the Democrats Vs. the Republicans – both are gutless and have forgotten who they really represent (and it is not who they serve and suck up to regularly – the lobbyists and special interests with the checks in their grimy hands). And since when did being either a Democrat or a Republican mean you checked your commonsense and integrity at the door before entering the hallowed halls of Congress. I think they are all brainwashed and due to the size of their egos and constant media attention are more interested in photo ops and interviews than actually doing anything of substance. We cannot continue to allow them to do what they want rather than what we want and need done as a country. They currently have us all up to our asses in alligators in every direction we turn and it is high time that stops and NOW!
Taking profit out of the system is not the answer.
Letting freedom progress is.
Example. Let alternative methods of treating diseases flourish without fear of the AMA taking a doctors license. Then the cost of healthcare would drop 10 fold because most of the alternative “cures” that work, are very inexpensive.
Take the Rudolf Breuss Cancer Cure. It has been proven to work on over 44,000 people, and is very inexpensive. Every disease has an inexpensive cure, if inventors and practioners were not silenced by the power of the socialistic governments, or the greed of the large corporations.
And our country was founded on the less government the better. And for 150 years it built one of the greatest nations in the world. We need to go back to that practice.
The unfortunate part is, big money is always able to buy influence. So until we get leaders in power who have enough backbone to withstand those forces, we will be run by big corporate interests.
After some more time to think about it ,here are a few more comments about Congress and the health care debacle.
A good background read: “The Healing of America” by T.R. Reid who also produced a great PBS special last year called Sick Around the World which I also recommend. Two reasons why Congress’ approach to health care reform doesn’t hold water and is totally irresponsible.
I give Congress a vote of NO CONFIDENCE across the board. They are incompetent when it comes to EXECUTION, which is a critical skill set in everything they “should” be doing everyday.
I also agree with Barry that the medical side of healthcare needs a paradigm change and I believe that can be done after the insurance side of the healthcare system is changed. Another thing which seems to have sprung up is the idea that many people are not interested in changing the healthcare system, I disagree. I believe a new healthcare system is needed but people get frustrated by the incompetence and partisanship with which it is being undertaken and therefore the idea they are not interested arises and to me that is totally untrue, especially for older citizens and those not covered by employer plans, which is a growing number every day.
Regarding Barry’s comments about drug advertising, I agree, we are constantly being bombarded in the media and I would say that the percentage of pharmaceutical ads far outnumber any other category. Let’s stop this insanity or set up a pharmaceutical channel and let them knock themselves out running only their ads 24/7(frankly we have almost reached this point anyway). If one listened to the ads you would become drug dependent convinced it is the only path to feeling good and that is as far from the truth as you can get.
Another problem is that we the people have to follow all of the government’s rules and regulations, paying taxes, etc. but the government does what it wants and is for all intents and purposes unregulated, unresponsible and unaccountable. Why is it that public corporations and many private corporations must undergo annual audits of their financial statements and financial procedures whereas the government and all of its departments and branches are totally non-transparent, hidden in the shadows and answer to no one regardless of their totally irresponsible fiscal mismanagement, fraud waste and abuse in everything they control. If we must follow the rules why not them? And how did we get here? We have met the enemy and it is THEM.
On another note, the Haitian situation is totally heart wrenching, and it appears that it already is showing signs of no one driving the boat. Tons of money is being donated and collected but I say be very careful of who you send it to and how and to whom it will eventually go. Hurricane Katrina is the model we do not want to duplicate but if our incompetent government is a major player, beware of bigger disasters. Also someone needs to develop a long term plan for Haiti’s future that will assure sustainability and will not lose momentum and interest after the sensational news aspect of it wears off and the media have moved on to other stories. The Haitian’s deserve better after suffering such an unthinkable, devastating disaster which I’m sure none of us can really contemplate or imagine having to cope with. It really will be about Hope long term and without it and a viable plan to clean up, rebuild and re-establish their society and lives and ability to make a living and educate their children, what will they have except having been exploited as just another headline for the media and a photo op for many other wannabes and politicians. This time needs to be different, just like more and more events converging on all of us. We need to stop and figure out how these things must change us and what we must change going forward about ourselves and our society and especially our governments. The future is now in this moment and there is no tomorrow except that which we create NOW!
Has the Supreme Court of the United States of America effectively killed any hope of meaningful healthcare in the U.S. by permitting corporations to spend freely with campaign contributions? I fear the onslaught of money pouring into Congressional coffers and the resultant end of health care legislation.
Are you fighting a hopeless cause?
I just want you all to know that I feel honored that you take the time to engage in this thoughtful and honest discussion. Your ideas and comments always make me think more deeply and
consider issues with added richness. It makes wonder that if we independent thinking people can come up with more sensible ideas than those who govern what is up? We continue to accelerate in the wrong direction. For now we must continue to speak up. I am sending this blog and all your comments to each member of congress. Yes, it alone won’t do much but the voice of millions of independent minds will eventually have it’s impact. They want us to give up. We can’t.
Mark, alternative medicine has a place in health care, but it is far from a complete solution. I had (she’s now deceased) who passed away from breast cancer after refusing recommended care and choosing alternative care only until it was too late. She regretted her decision.
Some alternative care is helpful, but some is hocus-pocus. How does the average person distinguish one from another? We need both but under the care of a knowledgeable physician who can guide one to the best combination of treatments.
The health care situation is complex; there are no simplistic solutions. But like another poster mentioned, other countries have implemented health care that most of their residents are happy with. Even if their solutions are not perfect, they are far better off than we are.
Conventional vs. Alternative is really not the issue. The 5 year survival rate (considered as a success) for breast cancer in America is still only about 50% under conventional medicine. (about the same as it was 40 years ago). Sorry to hear of your loss, Ned. Even if she had gone full-out with conventional medicine, your loved one had a 50/50 chance. I’m sure we are all sorry to hear of your loss.
The 1st way to go with alternative is a licensed professional, and lots of questions. However, since Medical doctors are not trained in alternative medicine, and are largely taught a paradigm of treating the symptoms of established disease with drugs, surgery, and radiation in one form or another, you cannot use their opinions as a gatekeeper for alternative care. Just because they know something about the body, does not qualify them to make decisions about something they were never even taught in school. It would be like making dentists the gatekeepers of podiatry. They are both doctors, with similarities, but completely different scopes of practice.
I think this can be going way off topic though. I think we can agree that more research dollars could be more constructively put into alternative medicine – not to be at war with diseases, but to better uncover the causes of diseases. Not to promote one system only – pharmaceuticals and just the detection of disease – but to explore different ways of determining the the deviations from optimal health, and what we can do proactively. This alone would be a huge paradigm shift, and a way of moving away from a broken “health-care” system that is running into some major limits, and running out of time.
I think we could agree that the not-for-profit, or non-profit status if insurance companies is important. Why? because otherwise, individual human beings might be looked at as a commodity.
Again I propose a week long conference, colloquium or summit for the “Dream Project”. We need to come together in a less silent way and show our mass support for some of these ideas.
Guest speakers, workshops, debates, action groups…
How can we rally the “Dreamers” together and give ourselves more “Volume”?
Summer of 2011 in San Fran? Seattle?
I hope I hear back from readers or the Marre camp…
One thought is to have a government funded program which provides stop loss coverage above a set amount to any insurance company who complies with some government standards such as no pre conditions, etc.