FacebookTwitterGoogle+RedditEmail

The Actually Existing Health Care System

There is nothing inherently wrong with spending 17 per cent of GDP on health care if the result is a really healthy population. Just like there is nothing wrong with a “big” budget deficit if the money goes to making good jobs for working people, cleaning up their cities and environment and bettering schools instead of making rich financiers richer.  But given the fact that countless pregnant women go without sonograms, diabetes is near epidemic proportions, dialysis patients on average die within five years (in Japan they live 20) and, most significantly, the number of primary care doctors remains very low — taking preventive care off the agenda for most — the US health care system is a travesty.

Medicare is the point only if you let private health care off the hook.  We know that President Obama did exactly that when he invited in insurers earlier this spring and announced their voluntary commitment to cost containment (only to have them repudiate his interpretation of their comments within days) and you go before the nation in a news conference, July 22, and devote the presentation to existing government programs.

American health care is reeling because it is a profit center where gouging is the norm.  For-profit clinics and hospitals print money, paying out hefty dividends and huge salaries to management.  Not-for-profits operate along similar lines.   Ask Michelle Obama, who pulled down a reported $400,000 a year at a Chicago hospital doing non-medical work.  But that’s just a small piece of the action.

There is so much gouging, so much greed and gross profiteering, that you have to wonder why Bernie Madoff didn’t go that route and save himself a lifetime in prison.  Among the worst abuses was the conversion of non-profit insurance companies to for-profit institutions over the last decade.  The CEOs of numerous insurers walked away with hundreds of millions of dollars, each.  United Healthcare’s boss got close to a billion bucks for handing over the reins… until an outcry by consumer groups led to a reduction– to $800,000,000.  That’s a lot of money not going to underserved children. The sale of one Preferred Provider Network, Multiplan — nothing more than a sophisticated referral system — to private equity firm, Carlyle Group, a few years back netted the owner close to a billion bucks.   The top HMO chiefs have pulled down hundreds of millions of dollars year after year — again, nothing directly to do with getting people medical care.  If you start adding up the fees, options, salaries and other bounty extracted from the health care system by the top one hundred individuals associated with it over the last decade, some good portion of the $1 trillion now cited as needed by President Obama would be tallied.   To add insult to injury, a new Harvard study reports that the majority of people going bankrupt from medical costs are, in fact, insured.  What makes them go bust is that their insurance policies are “an umbrella full of holes”.

Fraud is pervasive in health care.  No surprise in a country where, according to Monthly Review, a hefty percentage of rents and dividends go unreported to the IRS.  Or where armies of accountants figure out how shift income off balance sheets.  Or where bond raters created a AAA-rating for subprime loans (when they were, in fact, junk bonds) and brokers traveled the world selling these debt instruments as top-rated.

But even if the system were cleansed of all the health fraud we would still be in a terrible mess in a despicably stratified health care system where discrepancies in longevity within our population run to 20 per cent.  The fact is that more and more data come out proving that in the US more care does not equate to better health.  Talk about a can of worms.

This brings us to Medicare, a system of reimbursement to medical institutions and professionals.  When made into law there were howls against it.  Over time it caught on.  The medical establishment does not like Medicare because it pays 20 per cent less than private insurance.  Pure and simple.  Medicare is actually the best thing going and were the White House to spearhead a plan to expand Medicare coverage much could be accomplished.

It doesn’t help Medicare when Congress passes a law forbidding it to negotiate for lower prices from the pharmaceutical industry.   Even JP Morgan/Chase’s Jamie Dimon would salute that lobbying effort. No other industrial country in the world holds back from using its market power to get drugs cheaper.   And it doesn’t help when a company like Amgen, the preeminent biomed firm, introduces a drug like Epoetin — an enhancer of red blood cell growth — and charges Medicare billions and billions for it, making Amgen investors ridiculously rich, and our Treasury a lot poorer.  Why did Medicare agree to pay Amgen such lofty prices for that drug?  Suffice it to say that the door between industry and the upper echelons of Medicare is a revolving one.

In principle, Medicare makes the most sense of anything going in the US health system.  And if it were to be run more efficiently, and the prices charged by the health industry strictly controlled, progress would be made.  But to simplistically suggest that the country is going broke because of Medicare (and its sister legislation, Medicaid) without identifying the culprits, without looking over the payable invoices does us all a disservice.

With his fanatic commitment to free markets President Obama’s stated commitment to working families unravels with every passing day.  Word is that the good people in Washington are starting to glaze over, as this president’s capacity for talk — and serving corporate interests — seems to have no bounds.

CARL GINSBURG is a tv producer and journalist based in New York. He can be reached at carlginsburg@gmail.com

 

 

 

 

 

 

 

 

More articles by:

CARL GINSBURG is a tv producer and journalist based in New York. He can be reached at carlginsburg@gmail.com

February 19, 2019
Richard Falk – Daniel Falcone
Troublesome Possibilities: The Left and Tulsi Gabbard
Patrick Cockburn
She Didn’t Start the Fire: Why Attack the ISIS Bride?
Evaggelos Vallianatos
Literature and Theater During War: Why Euripides Still Matters
Maximilian Werner
The Night of Terror: Wyoming Game and Fish’s Latest Attempt to Close the Book on the Mark Uptain Tragedy
Conn Hallinan
Erdogan is Destined for Another Rebuke in Turkey
Nyla Ali Khan
Politics of Jammu and Kashmir: The Only Viable Way is Forward
Mark Ashwill
On the Outside Looking In: an American in Vietnam
Joyce Nelson
Sir Richard Branson’s Venezuelan-Border PR Stunt
Ron Jacobs
Day of Remembrance and the Music of Anthony Brown        
Cesar Chelala
Women’s Critical Role in Saving the Environment
February 18, 2019
Paul Street
31 Actual National Emergencies
Robert Fisk
What Happened to the Remains of Khashoggi’s Predecessor?
David Mattson
When Grizzly Bears Go Bad: Constructions of Victimhood and Blame
Julian Vigo
USMCA’s Outsourcing of Free Speech to Big Tech
George Wuerthner
How the BLM Serves the West’s Welfare Ranchers
Christopher Fons
The Crimes of Elliot Abrams
Thomas Knapp
The First Rule of AIPAC Is: You Do Not Talk about AIPAC
Mitchel Cohen
A Tale of Two Citations: Rachel Carson’s “Silent Spring” and Michael Harrington’s “The Other America”
Jake Johnston
Haiti and the Collapse of a Political and Economic System
Dave Lindorff
It’s Not Just Trump and the Republicans
Laura Flanders
An End to Amazon’s Two-Bit Romance. No Low-Rent Rendezvous.
Patrick Walker
Venezuelan Coup Democrats Vomit on Green New Deal
Natalie Dowzicky
The Millennial Generation Will Tear Down Trump’s Wall
Nick Licata
Of Stress and Inequality
Joseph G. Ramsey
Waking Up on President’s Day During the Reign of Donald Trump
Elliot Sperber
Greater Than Food
Weekend Edition
February 15, 2019
Friday - Sunday
Matthew Hoh
Time for Peace in Afghanistan and an End to the Lies
Chris Floyd
Pence and the Benjamins: An Eternity of Anti-Semitism
Rob Urie
The Green New Deal, Capitalism and the State
Jim Kavanagh
The Siege of Venezuela and the Travails of Empire
Paul Street
Someone Needs to Teach These As$#oles a Lesson
Andrew Levine
World Historical Donald: Unwitting and Unwilling Author of The Green New Deal
Jeffrey St. Clair
Roaming Charges: Third Rail-Roaded
Eric Draitser
Impacts of Exploding US Oil Production on Climate and Foreign Policy
Ron Jacobs
Maduro, Guaidó and American Exceptionalism
John Laforge
Nuclear Power Can’t Survive, Much Less Slow Climate Disruption
Joyce Nelson
Venezuela & The Mighty Wurlitzer
Jonathan Cook
In Hebron, Israel Removes the Last Restraint on Its Settlers’ Reign of Terror
Ramzy Baroud
Enough Western Meddling and Interventions: Let the Venezuelan People Decide
Robert Fantina
Congress, Israel and the Politics of “Righteous Indignation”
Dave Lindorff
Using Students, Teachers, Journalists and other Professionals as Spies Puts Everyone in Jeopardy
Kathy Kelly
What it Really Takes to Secure Peace in Afghanistan
Brian Cloughley
In Libya, “We Came, We Saw, He Died.” Now, Maduro?
Nicky Reid
The Councils Before Maduro!
Gary Leupp
“It’s All About the Benjamins, Baby”
FacebookTwitterGoogle+RedditEmail