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28
Sat, Jan

Our Health Care System Is Broken—Fixing It Is Not Hard

HEALTH CARE - Americans are being slammed by a “tripledemic” this holiday season as three major respiratory illnesses—COVID-19, influenza, and respiratory syncytial virus (RSV)—are spreading at indoor gatherings. Hospitals are once more in danger of running out of beds, and the Biden administration has revived a program to mail out free at-home COVID-19 testing kits. It seems that the United States has learned nothing from the early months of the pandemic when our health care system broke along the fissures created by corporate models of profit-based medicine.

Take the current shortage of antibiotics and other medications. Axios reported that “Parents have been calling [pharmacies and other health care providers], distraught over the trouble they’ve had securing everything from Children’s Tylenol to amoxicillin to Tamiflu.” Hospitals are also running out of drugs. The reason for this is that the pharmaceutical industry, which operates adjacent to the health care industry, functions on thin margins, producing just enough inventory based on projections in order to maximize profits and not overproduce items that may remain unsold. But when a crisis hits, the projected supply is outstripped by demand.

Another example is that of Ascension, a company most of us have never heard of but one that the New York Times described as “one of the country’s largest health systems.” Although it is technically a nonprofit company, Ascension operates like a for-profit corporation, cutting costs by cutting staff. This has left existing staff overstretched and exhausted, leading to mass resignations of nurses and other medical staff. According to the Times, “When the pandemic swamped hospitals with critically ill patients, their lean staffing went from a financial strength to a glaring weakness.”

Meanwhile, for those people lucky enough to have private or public health care coverage, out-of-pocket health costs have risen sharply. The U.S. Centers for Medicare and Medicaid Services (CMS) released figures for 2021 showing that Americans spent an average of $12,914 per person for health care costs that were not covered by their plans. This is equivalent to 18.3 percent of the national gross domestic product (GDP).

Almost everyone agrees that our health care system is in dire need of an overhaul. But rather than seeing it as a problem that needs solving simply and efficiently, the system has become a target for capitalist opportunism. The technology industry, which has sold society the lie that it can innovate a solution to any problem, has tried and failed to solve health care. For example, in 2018 Google decided to get in on the game, launching “Google Health” as a way of “helping billions of people be healthier.” Three years later, the company gave up.

Oliver Kharraz, a former physician and the founder of Zocdoc, another tech attempt at solving the health care crisis, wrote in an op-ed on Fast Company that health care “is the problem of our generation, and if we don’t fix it then it will break the bank, our health or both.” Admitting that so far, technological approaches have not worked, Kharraz said, “It is tempting to fix the symptoms, but ultimately, we must address the underlying cause.” Unfortunately, being invested in a private, for-profit mindset prevents Kharraz and others like him from seeing the situation in anything other than capitalist terms.

But there is a simple mathematical formula that appears to elude the world’s most brilliant minds: Taxpayer funding minus health care costs equals a net positive remainder. Recast as a word problem, this means that people pool their money together so that their representatives spend it on their health and well-being.

After all, this same formula is applied to other issues that political leaders consider important, such as war fighting—known more commonly by the term “national defense.” Each year Congress appropriates more and more taxpayer money toward military spending, and this year was no exception. Lawmakers in mid-December approved a whopping $858 billion military spending bill—an 8 percent increase over the previous year. It is a mind-bogglingly large figure—close to a trillion dollars.

Conservative politicians (whether Democrat or Republican) roll out endless objections to government funding of health care and squabble over the Affordable Care Act, single-payer health care, Medicare spending, and more. But they manage to set aside their differences when it comes to applying the same idea of taxpayer funding to military spending.

This is not surprising. Conservatism is aligned with national and personal self-interest. Government spending on the Pentagon ensures American military supremacy. But government spending on health care means spreading the wealth among people based on collective concern for public health.

It turns out that conservative politics—based on individualism and selfishness—is bad for everyone’s health. A Harvard study examining the correlation between lawmakers’ voting records and the COVID-19-related mortality rates of their constituencies came to a stark conclusion. The Washington Post summarized the results: the rates of death from COVID-19 “were 11 percent higher in states with Republican-controlled governments and 26 percent higher in areas where voters lean conservative.”

What this means is that state-level policies that strip funding from welfare and social programs, in combination with behavior influenced by conservative politicians such as forgoing masks and vaccines, can result in poor health outcomes.

Offering a contrast is the United Kingdom’s national health care system. A federal system like the UK National Health Service (NHS), flawed as it is, was able to enact broad, protective measures during the COVID-19 pandemic that saved lives. Meanwhile, in the U.S., a sprawling and fractured profit-driven system in combination with myriad local public agencies was unable to agree on which measures to adopt. One American infectious disease expert, William A. Haseltine, explained in the Hill in 2021 that given the U.S. health care system’s lack of “federal authority to enact nationwide policy, it is unsurprising that a period of immense political polarization, as we are witnessing today, leaves public health matters divided across party lines rather than scientific consensus.”

The good news is that there is a public appetite for adopting the simple equation of using taxpayer funds to cover health care—as long as the idea is not labeled as progressive. The Intercept reported that voters enthusiastically passed a slew of progressive-leaning health care initiatives across the country during the November 2022 midterm elections.

As the Intercept noted, the example of Dunn County, Wisconsin, is particularly instructive because a voter-passed initiative excluded language commonly associated with progressive Democrats such as “single payer” or “Medicare for all.” Instead, the ballot measure asked voters a very simple question: “Shall Congress and the President of the United States enact into law the creation of a publicly financed, non-profit, national health insurance program that would fully cover medical care costs for all Americans?”

A majority agreed with this idea. Although the measure was a symbolic one, the fact that voters from a rural Midwestern county support their taxes being used to fund their health care is a positive sign.

The existing corporate model of treating our health care needs purely through the lens of supply and demand, profit and loss, is utterly broken. We don’t need any more examples of crisis-related breaking points. And we certainly don’t need tech bros agonizing over complex ways to exploitatively extract profits from our need to see a doctor. There is a simpler, easier way to fix this mess. 

(Sonali Kolhatkar is an award-winning multimedia journalist. She is the founder, host, and executive producer of “Rising Up With Sonali,” a weekly television and radio show that airs on Free Speech TV and Pacifica stations. Her forthcoming book is Rising Up: The Power of Narrative in Pursuing Racial Justice (City Lights Books, 2023). She is a writing fellow for the Economy for All project at the Independent Media Institute and the racial justice and civil liberties editor at Yes! Magazine. She serves as the co-director of the nonprofit solidarity organization the Afghan Women’s Mission and is a co-author of Bleeding Afghanistan. She also sits on the board of directors of Justice Action Center, an immigrant rights organization.)

 

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