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Ognen Duzlevski

Senior tinkerer.

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There are a few times in life when you realize what a sham our healthcare “system” is. One may be when you get sick and get denied care or when you end up having to pay enormous bills, even after you spent your entire life paying insurance faithfully. For me, it was the moment I decided to strike out on my own and start an organic farm. Only then do you realize how much of your wealth goes into the void of nothingness we call “the healthcare system”. Even the cheapest premiums via “Obamacare” cost hundreds of dollars a month and you still have co-insurance, high deductibles etc.

When you look at it a certain way, you realize that the healthcare system as a whole is one giant wealth-sucking machine; it takes money from everyone and transfers it to the coffers of few. To me, it is not a debate between a single-payer vs what we have today system - to start with, we need to trim down the cost of everything. To make this point, look at all the healthcare insurers - none of them are going out of business, none of them are doing poorly. Since it is a game of math (and they control the math to their advantage), the system is tilted in their favor a priori. The insurance companies in the business of healthcare routinely post profits in the billions of dollars and their coffers are heavy. Then take a look at the hospitals, their administrators and doctors - none of them are poor, quite the opposite. According to the 2018 “Medscape Physician Compensation Report”, average salary for your basic, run of the mill family physician is a whopping $223,000, up from $217,000 in 2017. The average doctor salary across 29 specialties is about solid $300,000 per year.

You have to ask - since when did doctors become Gods? Since when did medicine become a profession that guarantees a life of luxury, unlike any other?

Furthermore, according to the Kaiser Family Foundation, about 9.1% of all Americans are involved in providing healthcare. Of course a lot of these folks are nurses, assistants and technicians and you can be sure they do not make $223,000 per year. As of 2016, there were 950,000 practicing physicians in United States, which means that they constitute 1/300th, or 0.3% of the US population at that time.

To add insult to injury, a hospital administrator earned an average of $237,000/year - and that was in 2014! Their salaries have, of course, gone up since then.

So, there we have it - 1/300th of the population (doctors), plus an ever smaller percentage of the population (hospital administrators), plus insurance companies (and don’t forget pharmaceutical companies) - are holding at least 90% of the American population hostage. Think about the enormous amount of money that gets transferred into their coffers every month, in form of premiums. As is evident by their profits, most people put into this “system” way more than they would ever take out. If the converse were true, the insurance companies would be out of business, nobody would want to be a doctor and there would be no hospitals. Pharmaceuical industry is a whole another beast, especially in United States, where they have free reign at pricing and are obviously enjoying the fruits of the insurance scheme that pays them handsomely via the policies. Even more profit if you are buying your meds out of pocket - it is always a win-win game for them.

The question then becomes - what is to be done, in a capitalist society, with this system? For very complex reasons, even uninsured folks (who are the most vulnerable) in this country do not want to dismantle this rigged game. Part of it is certainly ideology (or at least a very limited understanding of it - where pure capitalism is put on a pedestal above everything else), but part is also the intentional obfuscation of issues surrounding the “game”, perpetrated intentionally by all the players involved. Let’s face it, at the core of all this is the fact that the doctors are not going to be happy going down to $100,000/year, the insurance company shareholders will not give up their stock profits, the CEOs are not going to give up their pay and the pharma industry is not going to drop their prices just because.

However, the major question then is - can the current system of wealth extraction continue forever? After all, don’t forget that even the mighty tobacco companies had their day of reckoning. The system as it is, is killing people via restricting access to care (anyone remember the death squads so much talked about when ACA was being voted on?), it is stifling entrepreneurship (major obstacle to starting a business is what to do if you get sick) and has been routinely impoverishing people for decades. Overall, it is taking the competitive edge of the whole country away, when compared to Western Europe, Canada, South America, Asia and any other country that provides single payer, “free” medicine. After all, no matter what, you need to know that if you get sick, you will not simply die in your bed because you could not afford to see someone or get that MRI or that much needed surgery. By covering these needs, every country that provides universal medicine is also telling its people that they are free to focus on the pursuit of whatever it is that interests them. This, in turn, makes people happier and as a result, they live longer (United States is slated to fall to 64th place in the world in the life expectancy projections).

In the long run, America is looking at prospects of being a 3rd world country, by many standards. The unlimited reach of the corporate hand (via election funding, lobbying etc.), has taken jobs to poorer places (which ironically offer free healthcare to their populations), it has poisoned the land and polluted/sucked down the water aquifers, has turned “food” into a disease causing agent and is now putting the final nail in the coffin of the average American - by nickle and diming people where/when they are most vulnerable - when they are ill.

In my humble opinion, today most people suffer from the “Stockholm syndrome” in healthcare; they have been held hostage for so long (not unlike being at gunpoint, only here the threat is that you will not be able to get the care you need).

This last observation actually mostly explains why such a system is tolerated at all, especially by freedom loving, beacon-of-democracy folks who have fought and died world over to bring light to the darkness of oppression. In any other time, an oppressive scheme such as our healthcare system would be met with (at least!) tar and feathers.

So, back to the question - what is to be done with the healthcare “system” in America? I admit, I feel we have lost this battle.

P.S. There are several sad corrolaries to the above:

1) The government will be the solution for this problem. However, nobody trusts the government to do the right thing, because, well, everyone knows that politicians are owned by their corporate or private sponsors. It is a sad “Catch 22” kind of a situation. Even when the Affordable Care Act was voted on, the core problem was not solved (healthcare services too expensive, insurance companies need to be out of healthcare) - instead, to pander to the interests of those who would lose from a single payer system (it would not be the people, more like who is making money in the system now!) - the whole ACA was watered down significantly.
2) The government has no interest in feeding you healthy food, keeping you healthy, keeping your environment clean or even allowing you to be independent by running your own business. It is a strange situation really, on one hand you have this whole infrastructure such as the “Small Business Administration” or all sorts of local, state and federal government programs that supposedly are there to help a small business owner, but where it matters (healthcare) - the government is failing its people. It is everywhere you turn around - the government would rather you buy expensive and dirty electricity from your local utility, instead of subsidizing everyone to put solar panels on their roofs (not to mention such an infrastructure would be many more times resilient than what we have today), the same government would rather you be less competitive than get a college degree (where a swath of young people come out of college already debt-ridden indentured servants), so on and so on.
3) The people are robbing each other blind in the current system. The same adage from “back home” that (roughly translated) says “The sun does not come up for someone unless it sets for someone else”, applies here: a few are making boatloads of money while the rest are trying to survive, however, there are crumbles to be had between the “rest” that are dividing them enough so that the status quo prevails. In practical terms this means that I need healthcare when I need it and the nurse or doctor or insurance agent all make money on me without blinking an eye. They all know the system is bad, I know it too, but at the moment nobody cares because I am trying to survive and they are making a living. This story repeats itself daily and continues into eternity.