America’s Health Care System- which Obama supports


Note: This post is a more in depth analysis of the healthcare problem, which Kimchi talked about here.

Why is the health care system so bad in America? When and how did it start?  Here is a brief analysis:

This is the pay or die health care system used in America that is supported by both Democrats and Republicans.

The United States currently faces a crisis with the rising costs of health care but lacks a proper solution for its self-induced problem of inflating prices for profit. Because of the country’s emphasis on a capitalist free market economy, non profit hospitals that were once concerned about social services to provide help are now concerned with reaping benefits. Instead of viewing patients as diseased people in need of medical attention, doctors dehumanize them into becoming clients for their business. Such treatment of individuals is a result of the corporatization of Medicine that affected both the attitudes of physicians and the government in terms of restricting access to health care. There has been a shift in the power of who controls the medical system from physicians to businessmen that create policies to extract benefit from increasing the need and cost of medical services prescribed to a patient. In addition to the increase of services, because of modern technologies advancement, newer machines are more expensive, which places burden to patients who must compensate for those new gadgets. In effect, the weak structure of the American medical system which does not concern itself with public or preventative health but rather views health care as privilege has lead to a wide disparity amongst those insured and the mortality rates of those uninsured America must resolve the situation by altering the way businesses dominate the current medical model and the system by moving the power back to health care providers.

Since health care is not treated as an ordained right but an honor for a patient, the access of many citizens to it has been restricted. Critics argue that “our health care arrangements are not considered to be a national health care system in any sense” because it does not attempt to allow admission for services or restrict cost containment or help the quality of care received. (Budrys, 109) Federalist attempts at regulating medical coverage for the poor only resulted in the creation of Medicaid and Medicare in 1965. “The reasoning was that expansion would result in an increased availability of medical care or all who needed it.” (Budrys, 110) Though Medicaid is structured to be a “public health insurance program for people over sixty five plus some categories of younger disabled people” it requires the government to produce the money in order to put into existence such programs. In order to compensate for certain costs, Medicare, a different system not restricted to the poor was created.

“Medicare is a “Medicare has two parts: the hospital portion Part A which is free to enrollees, and the medical portion part B which covers doctors’ fees and requires enrollees to sign up. There is a monthly charge for Part B that is deducted from a person’s social security check. Medicare does not cover all costs. There is a copayment for medical care and no coverage for pharmaceuticals and many other necessities. Accordingly, many people buy additional insurance which as come to be called Med-gap. Private insurance companies sell Medi-gap policices but these are not like other privatized policies. There are ten different plans, labeled A-J., that vary in how much they cover and how much they cost.” (Budrys, 111)

The increasing complexity of the health care system in the United States has created a frenzy in which insurance companies will fund services only if they are profitable and will force a patient to pay for services HMO’s do not think require as much medical attention as perhaps a common disease like diabetes. Many suffer from this decision to include certain diseases because if there is no access to the required health care, many are forced to become bankrupt seeking treatment.

Instead of realizing that health care is a complete system that relies on the government’s support, politicians would rather not risk their popularity for a universal health system, and will only for the sake of speaking, promote a less expensive system. However, “US social policies have no concept much less accommodation for a total health care system. The development and possible effectiveness of social policy are ultimately a political process in which powerful interest groups vie to define their agenda.” (Freund, 254) Recipients of Medicaid are often stigmatized as being abusers of taxpayers money and labeled as “welfare cases” that detract people from wanting to use services that may help them. America’s avarice driven medical care, geared only toward profits “fits the ideal type of a laissez faire health care system only in that health care has become highly commodified, and the drive for profits is, indeed a central dynamic making it even more difficult to control or plan to meet the entire society’s needs.” (Freund,257) Not only does the country’s political ideology cause a problem for providing accessible health care, but because capitalism offers no concern for the populous it neglects to be apart of public or preventative medicine. Western medicine’s weight on the actual disease and not on preventing it “ is itself the political product of the relative muscle of various groups.” Attempts to set a broader agenda for the health of the nation are contested by powerful interest groups benefiting from the present pattern spending of medical care.” (Freund 254) America’s negligence toward creating an equal opportunist society, in which the total population is entitled to medical coverage, has made it susceptible to ravenous insurance companies.

There has been a shift in power from health care providers being in charge of administering medical provisions, to companies whose objective is to reap profit. It is a fact that within a globalized economy, any country “paying for citizen well being reduces corporate profit and international competitiveness.” (Freund, 259) However, even though all nations struggle with this problem to “provide for their citizens well being” the United States stands apart in that, it has never “had an adequate safety net to protect its citizens.” (Freund, 259) Since America is so careless toward its citizens, it almost promotes corporations to feel guiltless when taking power from nonprofit hospitals. This removal of power from physicians and its movement into the hands of business owners has created a “Doctor’s loss of autonomy and control of patients’ care” (Freund, 267). Previously, doctors who lived in communities would charge fees for their services accordingly to their patient’s income. If the patient could not pay, then the doctor would assume that a probono case would increase his respect within the neighborhood, but this social exchange of help for status has declined. (Freund, 264)

Instead, doctors have teamed with insurance companies who now pay their salaries and in turn are beginning to commit white collar crimes such as over billing of patients, perverse incentives and other forms of medical malpractice. The structure used to be that physicians were paid on a fee for service payment but “few contemporary doctor patients relationships are so simple” because majority of physicians are paid “through third parties such as the government or insurance companies.” (Freund, 267) Now physicians inject their fees with “perverse incentives” which are “built in financial encouragements to treat the patient inappropriately by increasing services, overprescribing medications and diagnostic tests, or to choose treatment sites according to physician rather than patient interests” which perpetuate malpractice toward patients which isn’t necessarily regulated. (Freund, 267) The next form of abuse by doctors is receiving “secondary income from the treatment” which happens when physicians own or have investments in a facility such as an imaging company or nursing home, they profit any time they refer a patient to one of those sites. (Freund, 267) While many clinics and hospitals are overpriced, many also reduce the quality of their care in order to gain even more capital. In an example regarding a dialysis center, it “maintained profits by reducing their operating costs, they substituted less skilled staff for RN’s, used dangerously obsolete dialysis equipment, and reused dialyzer fluids on multiple patients.” (Freund, 273) These criminal acts continue because rather than police and place fines on companies that mistreat clients, the government turns its face toward such acts because as long as insurance companies take the responsibility of providing coverage, they also have unrestricted freedom.

There is a need for better management that will not only identify malpractice against patients, but will challenge the current structure that physicians and businessmen have crafted. The fact that it was thought that only doctors could review one another has allowed American medical boards to relax in their system of authorizing disciplinary action against physicians. There is an idea that because only another doctor can comprehend the profession and challenges another one faces, there are no other qualified personnel to oversee the actions of physicians. This idolizing status given to physicians needs to be abandoned, for it is giving doctors special rights to abuse patients. The lack of regulating medical management, has lead to specialists claiming the right to overcharge.

“The oversupply of specialists has not led to competitive pricing. Indeed, rather then competition driving physicians’ fees down” the higher number of physicians has kept prices soaring because they claim the since each has fewer patients, they must compensate by having higher rates. (Freud, 269) Physicians are no longer heroes that society turns to for help, but have become charlatans, who base their prestige on self-righteousness and argue that because of their talents, they have the right to sell themselves at inflated prices to the public.

Other less obvious sources of the increasing health care costs is the rise of technology in producing new medication but also improved better software and machines. In effect, the “proliferation of sophisticated and expensive technologies has” been aimed at purchasing new expensive instruments which are not fully utilized. (Freund, 320) For instance an MRI machine may be purchased by several hospitals and only needed rarely could be shared within an area but since this reduces how the hospital appears; they have to overcharge in order to appear progressive, and as a better prospect for being a primary health care provider. With the rise of new technology, there has also been an increase in the type of drugs that are manufactured. Since insurance companies assume the right to set prices for services, as well as place time constraints on the length of time a physician can spend with a patient. Doctors are pressured to treat their patients with a quick cure, such as a pill that will eliminate symptoms, but not stop the illness necessarily. This has lead to an increase of expenditures for prescription drugs” which rose in “1999 by 19.2 percent, 17.3 % in 2000” only augments the suffering of patients who pay for services and drugs out of pocket but are not actually receiving proper treatment for their illness, and may need to return later.

There needs to be an awakening of the inequality within the medical system, that even with the enormous amount of spending the American government spends on health care, it is not managed as effectively as it should. There should be a standard by which services can be charged, and if it is going to be dependent on health insurance companies, they should not find methods of over pricing. Furthermore, there needs to be less discrimination in insurance companies for those with chronic diseases like asthma or diabetes; it should not be granted only to “healthy people”. There should be a reemergence of nonprofit hospitals that are created in order to assist in the general well being of the public and not for the profit of its staff. It is necessary to deconstruct the power of the current medical structure from being overtaken by entrepreneurs, for health and social services are not of capitalist nature. Though a nationalized health care system has its drawbacks, such as faulty method of administering priority to its patients, the American medical system needs to assume responsibility for its citizens. In a country that requires its workers to undertake any risk and treats them as slaves to the state, it is ironic that it is not willing to extend any concern for the protection of its assets. The power of health insurance companies needs to be restored to that of physicians or at least organizations that are concerned with an egalitarian society that promotes health coverage not as a privilege but as a right in order to erode social inequalities.

~ by Curry on November 16, 2008.

9 Responses to “America’s Health Care System- which Obama supports”

  1. Thus the reason I voted Obama…

  2. Terra, Obama supports this current pay or die system. That is the point we’re trying to make…

  3. Yes and no? He supports giving everyone the ability to get insurance… Better than the current system, not a perfect fit… I like capitalism in general, but I would prefer to have insurance… I would also prefer that when my daughter grows up she isn’t without insurance, as she will have a preexisting condition… All of which would help?

  4. Hi Terra,

    Every candidate technically supports giving everyone the ability to get insurance, but that doesn’t actually mean you are getting health care. Nor does it guarantee availability. It is still considered a service citizens are privileged to obtain—not entitled too. Residents of America pay high taxes but we do not see a return on those taxes, you and your daughter should be granted health care since you provide service for the government by your work and by taxes, why then is the social contract you participate in not helping you? Also, you mention pre-existing condition, if you do manage to get insurance and you appear to have a condition, you will be denied coverage. Health insurance covers individuals who do not need to use it.

    I am happy to explain elaborately if you like. = ) For your comment regarding capitalism, capitalism is fine but in America we see casino capitalism. Also, Adam Smith, father of capitalism, also warned that people should be weary of lobbyists, which is exactly what has happened. The system now caters to lobbyists like Kaiser and big HMO’s not to physicians or patients.

    Wouldn’t you want the money you pay to the government to be covering you? You work hard and you’ve done your civic duty, shouldn’t we as citizens also have standards placed upon our government?

  5. I actually don’t work 🙂 (I have to say that so I am not telling you things that aren’t true, or so that assumptions aren’t made.) My household does work, and does pay taxes, but I am a stay at home mother that is attending school (criminal justice.)

    I studied Obama’s plan and that of McCain to see which would be more helpful, as medical help is in dire need in my household. I have conditions that I cannot currently treat as I do not have insurance, and I can’t afford them, plus if I could they are pre-existing. Then earlier this year my 14 year old daughter was diagnosed with AIHA (which can be reoccurring, and life threatening, but we won’t know if hers is reoccurring until or unless it happens again.) My children have health insurance, but once they are older they will have to get different insurance (thus she wouldn’t be covered for her AIHA.)

    Before I start with my understanding (based on lots of research), I will say they are campaign promises, so it is still debatable as to if they will happen. However, I am willing to throw a “leap of faith” because it is needed.

    McCain promised a $5000 tax credit for insurance (for me without my family coverage is about $900 a month).

    Obama promised to eliminate pre-existing conditions from being considered though legislation, thus making insurance more viable for the sick, not only the healthy. Then he promised to also have that insurance include preventive care, so that we don’t have to get sick in order to “get” healthy. Last but not least he promised to get this via an insurance similar to the one that congress here gets in the US.

    Now I will grant you that neither plan completely agrees with what you are saying (and I am not completely disagreeing) needs to be addressed. However, with the two options given I think that Obama has a better plan then McCain?

  6. Lesser of two evils doesn’t solve anything, it perpetuates the problem.

    Secondly, your perception of preventative care and the reality in terms of dealing with health insurance is very different. Within Western Medicine there is no actual practice of preventative medicine, the only types of medicine to actually have that in place is eastern medicine like Ayurvedic and TCM. You may not know this, I’ve studied medicine.

    Thirdly, when dealing with insurance companies, the way plans are set up is such that if you want “preventative” care to be covered, then higher things like surgeries, exams, etc are not covered. Instead you are liable to pay $10,000 and then about 20-40% of the remaining cost will be covered by the company. Unless you choose to go with an HMO plan in which case they will only allow you to work within their network like kaiser, generally speaking those HMO’s do not carry preventive care and their premiums begin at $980 a month. Also, these numbers are higher if you have a dependent-like your daughter.

    Look at our post on HR 676, or type that in, that would be better research than whatever crap is out there. That is the measure to apply universal coverage to Americans, why don’t you fight for that instead of lesser of two evils?

  7. It might not solve anything (I gave you that already), but realize that most people in the US believe that socialized medicine is horrible. They think it makes doctors complacent, and will drive down the market, and therefore throw us into third world medicine. (I do not agree with this, but it is what most people think.) Yes, I chose the lesser of two evils. Those are the only two options at this moment in time.

    Take a look at his promises:

    It might not even help me, but it has more of a chance than that of the other option.

  8. it is a crazy what a system we have! but you know healthcare is not something easy. France is one of the biggest healthcare spenders and yes, they live better but … is it really worth it? is it really worth crippling the government?

    at the end of the day what’s certain is you can’t have it all: you can’t have a free world class healthcare and free world class education and free world class opportunities and.. so on. you just can’t. you gotta make choices.

    what governments can do is make those choices easy and least painful.
    now if we didn’t need to fight wars in every corner of the war we could possibly afford better healthcare for example 🙂

  9. Hi again Terra,

    Americans really need to get over the fear of “socialized medicine”.Actually, single-payer is NOT socialized medicine at all; it’s public funding but private delivery. On top of that, according to many recent polls, a majority of doctors and a majority of Americans want single payer. You can read about it here, in Kimchi’s post on healthcare.

    Hey Nick, That is true, if we didn’t need to fight wars, we would have more money than anywhere else. France is not crippled, and not by its healthcare. French citizens do not want the American life style which is good, they are not perfect in terms of lack of civil rights but their government institutions are much more advanced than ours. By the way, this is also something Kimchi touches on in his post.

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