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America's Health Care Identity Crisis


About every July 4th or after a presidential election writers try to explain the American Identity. Some of them, especially of late, conclude that the American Identity is in crises. America does not know who she is. Others say America knows who she is—she is freedom of speech, religion, and opportunity. America is individualism. If there is an American Identity crisis, it is because we have replaced these freedoms with government interference.

There's no denying American democracy is under attack, but ironically our present debilitating state has crystallized our identity. As the famous quote by Carl Jung, "you are what you do, not what you say you'll do." America is and has always been what it does, not what it says.

America is a place where:

  • Slumlords rent substandard, barely habitable housing to the poor because people will pay to live there
  • Payday lenders, check-cashing centers and prepaid debit card providers keep the working poor in a cycle of debt offering services traditional banks will not
  • Children, under strict rules, receive summer meals from food trucks
  • Families wait days to receive free dental care at tent clinics where buckets of pulled teeth pile up
  • Hospitals charge the poor and uninsured full price for the same medical care the rich and insured receive at a steep discount
  • A cancer-stricken Senator who's been on the receiving but never the giving end of compassion, votes to put in motion a vote that will make health care more expensive for the poor, sick and elderly
And yes America is still a preferable place to live than just about any other country in the world. We still have a far superior economic and political system than most. But that is why conservative efforts to leave the poor at the mercy of health insurance companies and so-called free-market health care are so frustrating.

Avik Roy, Paul Ryan, Mike Pence, Tom Price and other conservatives talk about the freedom people will have to buy only the health insurance they can afford even if it's crappy coverage. That's the equivalent of saying that it is okay for families to pay rent at market rates for a house without a working toilet, broken windows and holes in the walls. These guys use the traditional definition of American Identity, freedom, to justify withholding legitimate government services and investment in its citizens.

Conclusion

Why doesn't America cringe at the thought of buckets full of rotten teeth and decide that's not what America is? Why doesn't America say that even though there is a market for a specific service, we won't let the lucky take advantage of the unlucky? Why isn't America ashamed that it believes more in the principle of freedom to die prematurely than providing basic health care to everyone?

America talks a good talk about democracy and freedom, but the world sees all the bad stuff too. They see the wretched conditions of America's poor communities. They see poverty, gun violence and a country unwilling to solve its health care access and cost problems. They see America for what it does, not what it says.
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The Health Care Industry-The Solution Or The Problem?

It is no secret that I am not a fan of the American health care system or health care professionals. I even dislike TV medical dramas. All that hero-worshipping makes me sick. Yeah, I said that.

But before you condemn me you should know that I am not alone in my dislike and distrust of the American health care system and doctors. Surveys show that a majority of Americans share my negative sentiments about both. And it makes perfect sense that the medical establishment has lost its halo. In fact, it is about time.

Doctor Worshipping Is Dead

For all the criticism the White House gets for the Affordable Care Act (aka Obamacare), people are starting to wonder what were the “healers” doing these many decades to improve medical care access and affordability? Nothing. The media coverage and political fighting about Obamacare, and high deductible health plans put a spotlight on the many shortcomings of the current health care system. More people now see the
health care establishment as part of the health care cost problem, not as a neutral third party bullied by government and insurance companies.

The positives of receiving good medical care (as an individual) no longer negate the ills inherent in the entire system. The health care establishment finds itself in a
you’re either part of the solution or part of the problem moment. And not surprisingly, the system doesn’t get it. They think they can lobby, whine or bully their way back into the good graces of society. It’s not working.

People Want Doctors To Take Responsibility For National Health Care Issues Continue Reading...

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Why I Fear The American Health Care System

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I’m not bragging when I say that I’ve been blessed with good health. I’m extremely grateful that I am healthy, pain- and disease-free for almost 50 years. However, my good health is not all about luck. I don’t smoke, I don’t drink alcohol, I move around throughout the day and I cook most of my meals. Lately, I’ve upped my health game by cutting out sugar and other food additives. I’m earning my good health because I’m afraid of illness and disease. I don’t want to be at the mercy of the American health care system.

The Darker Side Of Health Care

This week I had an opportunity to witness a part of our health care system most of us rarely think about, but should. Rehabilitation and nursing home care. It was an educational but difficult experience for me.

I was visiting an elderly aunt undergoing rehabilitation following the amputation of her leg. Despite the gravity of her situation her rehabilitation has been successful in that she is strong enough to hop around on one leg. She believes that with a prosthetic leg or braces to assist her in walking, she is capable of living independently once again. But there she sits, with no idea of if or when she will receive this final
treatment. And she doesn’t sit alone. This place was full of individuals in various states of rehabilitation; however, most of the patients are there for custodial care.

Throughout my near daylong stay at this facility, I saw dozens of individuals in wheelchairs. Others were confined to their beds most of the day. These are the individuals with serious cognitive disabilities. There were as many staff members as patients—including certified nurse aids (CNA), registered nurses (RN), licensed practical nurses, medical doctors, social workers, dietitians, physical, occupational and speech therapists, and recreation therapists.

This was American health care in action and it left me feeling hopeless and scared.

Is This Even Health Care? Continue Reading...

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Do Employers Have A Moral Obligation To Stop Offering Health Insurance?

Who should have health insurance and why is a matter of intense debate in this country. Some people believe that only those who can afford to purchase insurance should have it. Others think that it is an absolute right of every American. And many people, depending on their own situation, fall somewhere in between these two views. But is this the health care debate we should be having?

Conservative Segregated Health Insurance

Two weeks ago Speaker of the House of Representatives,
Paul Ryan, proposed putting people with preexisting medical conditions in state-run high-risk pools. A tried and miserably failed "solution" for people insurance companies don't want to insure adequately, if at all. Ryan wants to segregate those with high cost medical care expenses from those with little to no cost. That means the healthy and mostly younger crowd will pay a lot less for their health insurance and the unhealthy and mostly older people will pay a lot more, or go without coverage.

Progressive Segregated Health Insurance

This week, Democratic presidential candidate,
Hillary Clinton, proposed allowing individuals as young as 50 to buy-in to Medicare. A never tried but often discussed plan that would help those who are not quite old enough for Medicare, ineligible for Medicaid, but can't afford private insurance coverage, if not provided by an employer.

Private Insurer Segregated Health Insurance

And it’s not just politicians that want to segregate the health insurance market more than it already is, private companies want a piece of the action too.
Zoom+, a medical and dental care provider and, more recently, health insurance company, targets well-off millennials for their services and plans. Zoom claims millennials are an underserved market but the fact that they do not accept Medicare or Medicaid patients in their practice proves the real reason behind their youthful approach to health insurance is money. Millennials, on average, don’t need as much medical costly medical care as Medicare and Medicaid enrollees do. And Zoom+ is just one of several insurers try to carve out the millennial crowd. Continue Reading...

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What's Wrong With Blaming Doctors For Their Mistakes?

You constantly hear from doctors that they are overworked, over-managed and overwhelmed by bureaucracy and patient expectations. That government and hospital administrators interfere with their relationship with their patients. Is all of this whining legitimate or are doctors trying to deflect from their own failures? Well, some of the whining is legitimate but a lot is not. Doctors and other medical care providers still have ultimate responsibility for patient care and they alone are failing to provide the level of care they claim to aspire to.

Currently, the health care industry is plagued by failure:

These are all health care crises doctors play a primary role in perpetuating. And despite the direct link between their prescribing practices and conduct, they refuse to accept most of the blame. If a patient dies because a doctor forgot to include critical information on the chart, it's an issue of too much paperwork and too little time to complete it. If a patient becomes addicted to painkillers prescribed by their doctor or bacterial infections become harder to treat, it's because the patient insisted on getting the prescription.

It couldn’t possibly be because doctors prescribe painkillers and antibiotics as a matter of course... Even my vet gave us antibiotics for our dog even though she said she had no idea what was wrong with her. It's just what doctors do despite all of the research and the warnings on overprescribing.

We Need Health Care Regulators and Policymakers To Put Patients First

It's frustrating to witness doctors harming people and blaming it on bullies, be they government or their own patients. But it is even more frustrating to witness the indifferent response by government policymakers and regulators, the health care industry and the general republic. However, the average citizen cannot take on the medical establishment without government intervention (although many of them would side with their doctor over government on this or any issue). Still, you would think that after learning that medical error is the third leading cause of death in this country…

  • Congress would hold a hearing to determine a cause and propose policy solutions
  • The White House would call for an emergency health care summit and propose policies to address these issues
  • The candidates for President of the United States would say, forget affordable health care, we need care that does not indiscriminately kill
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It’s Not Skepticism Or Caution That Keeps Us From Upending Our Bloated Health Care System, It’s Unwillingness

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Democratic presidential candidate, Bernie Sanders, relentlessly scoffs at the idea that Wall Street is Too Big To Fail. But it is his proposal to provide Medicare For All that exposes the real industry that is, in many people’s mind, Too Big To Fail—health care. A recent Washington Post article all but admits this and the Post is not alone in its thinking.

Throughout this very long campaign cycle countless politicians, policy wonks, economists, writers and everyday people have characterized Medicare For All as unrealistic or in Hillary Clinton’s recent words, “…too good to be true...” Seriously, how many euphemisms can opponents use to say what they’re really thinking—the health care industry is such a big part of our economy that we can’t change it. They are, however, right about
health care being a large part of the U.S. economy in terms of money and jobs.

  • Health care expenditures make up 17.5% of the nations gross domestic product (GDP). That means it is basically about 20% of the entire U.S. economy
  • We spent a little over $3 trillion for health care in 2014
  • The health care industry employs over 13 million workers and is the largest private sector business sector
Everything Is Too Tricky…

It’s one thing to be concerned about the impact on the economy if the health care industry undergoes a major overhaul overnight, it’s another to think we should take a break from addressing health care’s growing affordability issues. However, it seems that every proposed change to make our health care system more transparent, accountable and affordable is met with excuses or snark.

Electronic Health Records (EHR) – too expensive to purchase; time-consuming to evaluate and implement; have privacy and system compatibility issues; lack protections for proprietary information

Drug Price Controls – stifle innovation; scare away investors; halt production

Price Transparency – ignores quality standards; too difficult to determine; ignores geographical price differences; limited number of shoppable services to make a difference

Mission Accomplished… Continue Reading...
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