Why Healthcare Is So “Complicated”

photo by frankieleon
published March 9, 2017

Everyone has heard the following:

In every other developed nation, healthcare is a public service

For most practical purposes, that’s true.

So why don’t we have universal healthcare?

Because health insurance is a highly-profitable business. Tremendous wealth equals lobbying power. Whatever healthcare laws Congress come up with they have to keep the people at the top of the health insurance industry wealthy or they risk losing enormous contributions to their individual campaigns.

We the people come second.

If they cared about us first, hospitals wouldn’t be universally understaffed with medical personnel. At any given moment in a hospital there are likely as many administrators trying to shoehorn the care a patient needs into a byzantine insurance apparatus as there are doctors and nurses trying to keep patients alive.

Our health is a business, and those who most profit from that business have lobbyists putting billions a year into Congress.

Literal → Billions

Single Payer Healthcare would be amazing, but it’s not going to happen

Maybe not never, but a single payer system would mean the existing health insurance industry, and perhaps the majority of its 2.5 million employees, would be out of work. There would still be private health insurance for those who could afford it, and there’d be equivalent positions for some of those 2.5 million people in the new federally-run system, but an entire industry would be transformed. Private health insurance would become a boutique industry instead of the juggernaut it is now. There can’t be anyone currently making a fortune in healthcare that wants this to happen.

So what? Automation eliminated millions of jobs in other industries and nobody cared.

Well, nobody in power cared. As millions of people were replaced by industrial robots, the industries continued to exist and the people who owned companies within those industries continued to make fortunes. If millions of individuals lose their jobs but a few individuals at the top do not lose their profits, that’s “progress.”

If single-payer could be instituted in a way where all the people at the top of the health insurance industry still made truckloads of money it’d be done already

They don’t care about their own workforce anymore than they care about us. They might say they do, and might point to those millions of jobs, but it’s that huge, lumbering apparatus and its countless plans and provisions and programs, that requires a staff of millions. Single payer healthcare would replace the apparatus and make the positions occupied by the millionaires obsolete.

Two-Tier protects the rich

Two-Tier is what they’re pushing. It means you’ve got bargain basement universal coverage, but quality coverage is still up to the individual, regardless of income. That’s what they mean when they say universal “access” like they’re doing the country a favor. Access is meaningless. I have access to a hundred thousand dollar car, but I will never be able to afford one.

Under the Two-Tier system proposed by the GOP, the poor are screwed. They’re covered if they get hit by a car, but for ongoing conditions and medications, it’d be brutal. Have fun dying from a manageable condition because you can’t afford the treatment. We gave you access! It’s your fault you’re poor. Maybe you should have skipped that iPhone.

The middle class is pretty screwed too. They’ll be able to afford coverage, but just barely in some cases. If they have an ongoing condition they can likely count on a sizable chunk of their income going towards staying alive. The people who aren’t screwed are the super rich people who own these insurance companies, and the lawmakers who make billions a year to keep those people happy.

That’s the Republican agenda right now, protecting the super rich and providing the minimum possible coverage to get their constituents to shut-up and vote for them in the next election. There are dog whistles about taxes paying for abortions. Not true. Here’s how funding works at Planned Parenthood. There’s smoke and mirrors about health savings accounts. Ludicrous for anyone living on a low income and still pretty idiotic for those in the middle class. Skip the retirement, save for your healthcare?

Worst of all they tell millions of voters that their care is so expensive because they’re paying for poor people. That’s only true in a truly perverted sense. They’re paying to keep the rich wealthy. The scraps that are left over go into actual healthcare. It’s not enough so they raise your taxes and/or premiums to keep from going into their own pockets.

Our taxes pay for hundreds of things that do not directly benefit us though. The amount it would take to fund quality, universal healthcare is insignificant in comparison to a single military aircraft. Ever flown in one of those? Me neither, but my taxes paid for them and I have no problem with that. I also have no problem with someone who makes minimum wage having universal health coverage if it means I pay a little more in taxes a year.

Corporate interest in healthcare isn’t all bad

I’m a pretty big fan of pharmaceutical companies. No, really. Pharmaceutical companies get demonized too, but people tend to forget that they develop live-saving drugs. One of them has changed my life forever. I may send them a Christmas card this year.

Where they get a bad reputation is when they inflate drug prices. Mine is on the list of offenders. Certain drugs used to treat narcolepsy cost taxpayers millions a year. Rheumatoid Arthritis drugs are up there too. There are dozens of conditions that require prohibitively expensive drugs that make government subsidies a must. The government then turns a blind eye to the price gouging. If the government is footing the bill, it really means taxpayers are. The same way that we pay for billion-dollar experimental aircraft that blow up in the second test flight.

Let’s talk about that price gouging

It takes a boatload of money to develop new drugs. Half the time a pharmaceutical company puts a ton of money in and the drug just never works. It’s a total wash. Years of study and billions of dollars and nothing to show for it.

Plenty of new drugs save lives. By the time companies have invented these damn things, and tested them, they’ve got a bizarrely short timeframe to make back what they put in. When the patent expires, generics can be made, and it’s game over for the inventors. Does anyone voluntarily pay more for the non-generic just because it says Pfizer on the side?

It’s like if Bill Gates forever lost the rights to Windows after 7 years and there were 10 identical versions of Windows on the market for a fraction of the price. Seriously? Aren’t drugs intellectual property? Why the hell can’t we reevaluate drug patent law so there’s a long game for pharmaceutical companies? If that thing they developed is theirs forever, they won’t have to try to make a forever amount of cash in a few years.

I’m sure it’s way more complicated than that, but it seems crazy to me

The United States might make a lot of  pharmaceutical millionaires, but we also make the most advances in medicine. This is an industry that needs a lot of financial resources. It’ll benefit all of us eventually. You may be healthy now, but you’re aging like everyone else. Sooner or later you’re going to have trouble with something, and won’t it be nice at 70 to hear, “You know if you’d come in with this condition twenty years ago you’d be dead in a week. Now you just take one of these everyday and live out your natural life.”

I know it seems like all I said was health insurance companies are bad and drug companies are good. Actually, that’s pretty much exactly what I said. What I meant on a fundamental level though was that as long as healthcare continues to be a business, people will never be as important as the bottom line. That seems like an unsolvable conflict of interest for our lawmakers, but we’ve got to talk about what’s really going on instead of buying the bullshit that divides us.

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