Here Comes Trouble: Stories from My Life

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Donna Smith

Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation

October 16th, 2010 12:08 PM

Sleeping Free of Healthcare Fear

Stress kills. Stress makes people sick. So wouldn’t it make sense that a reduction in stress might actually save lives? How about families? And jobs? And freedom from want and fear? It makes perfect sense.

But that’s not what we’re all about in the United States. We don’t believe in reductions in stress because stress is profitable for our healthcare industry and lots of folks are getting very wealthy selling us ideas about ways to reduce stress and treating our stress-related and stress-magnified illnesses and injuries.

While those of us who support a progressively financed, single standard of high quality care for all might sometimes target all of our rage and disbelief on the for-profit insurance companies – and so often with good reason – the reality is that helping us to achieve better health is not necessarily the goal of our profit-driven system. Especially at a time when people are struggling to pay their basic expenses, keeping the profit flowing in the healthcare industry means keeping demand high or raising it even higher. In a market-driven system, keeping the market healthy is what matters.

So, this morning I woke up in Canada. I slept so soundly that I could scarcely believe I had been in yet another hotel room. After months and months of heavy travel and hotel rooms from coast to coast, I have grown used to waking fitfully to see the digital numbers on the alarm clock creep slowly through many a restless night. But here I slept peacefully. Here I did not fear that if I fell ill in the night or injured myself that I’d need to prove my financial worthiness before seeking care. And that is calming.

Sometimes in the United States we hear people say that if we had a more Canadian style system that people would overuse and misuse and abuse the healthcare system and drive costs even higher. I really doubt that. I suspect just the opposite. I suspect most folks would feel like I did – more calm and less fearful. I did not wake this morning in Canada with an immediate urge to go to the doctor for tests and treatments. And I suspect with less stress and worry, we’d all be a little healthier and use the healthcare system only when we truly needed to and perhaps a whole lot less.

Another thing I noticed here in Canada is how nice it is not to have all the pharmaceutical ads on television. No bathtubs out in a field in the moonlight with folks in need of medication to enhance their sexual performance. No depressed folks staring blindly into the cameras with the drug ad telling us all how much better we’d be with their particular drug. And I still hear story after story from folks who find drug prices drastically lower in Canada. All those ads are adding huge costs to our prescription drugs and creating demand for them too. In the U.S., the companies can charge whatever the traffic will bear for medications, so they have a very clear interest in seeing that prices and demand for their products stay high and go higher.

Keep us stressed, keep us drugged, keep us spending – those are the mantras of many of the profit-takers among the healthcare providers in the United States. Those healthcare giants give cover to the for-profit health insurance companies who then claim they are simply trying to “hold the line” for policyholders when they question and deny claims or exclude some treatments and conditions from coverage. The health insurance companies make huge profits by collecting more in premiums than they pay out in claims. So, their interests are best served by having fearful people buy their policies as protection against any healthcare crisis when in reality the insurance industry will protect itself over protecting policyholders any old time. Then they will pay or deny the percentage of claims required by law but never more as making that healthy profit is their reason for being.

The market is the customer in our free-market healthcare system, not the patient or the doctor. The market is what matters. Maintaining, protecting and growing the market can only be achieved by having enough well people buying insurance (and mandating that they buy it if necessary), enough sick people with a payment source seeking treatment and enough providers to ensure the cash flow through providing enough profitable care and prescribing enough of the profitable drugs. It’s all about the money. It is not about healthcare. Supply and demand. It’s the market, baby, it’s the market.

What would happen here if we had a healthcare system with appropriate financial policy instead of a market-driven system? Our system is so drunk on profits that it breeds the kinds of decisions that make a company like CVS sell cold medicines to meth-makers in huge quantities until they get caught or in another example makes huge profits for unscrupulous syndicates of phony providers who sell unnecessary treatments to patients and then bill the Medicare program for millions. A system based on the market and on profit is sick from top to bottom and from the inside out.

I note I didn’t see the news story in the United States about CVS and its $75 million fine for selling the meth-making cold medicine – and doing so wildly in the Los Angeles area with full knowledge of the highest executive at CVS. I saw that story on TV here in Canada. I did see the story on U.S. television about the syndicate of Medicare fraud and abuse criminals – that story feeds the ridiculous propaganda about Medicare being the problem and an example of government’s inability to weed out fraud rather than showing the criminals who perpetrate such crimes. It is similar to our ability to have someone like Rick Scott on the ballot in Florida as the Republican candidate for governor though it was the same Rick Scott who was at the helm of HCA-Columbia when the company committed the largest Medicare fraud ever against the U.S. government and all of us as taxpayers. We blame Medicare instead of looking at where the blame needs to be – on the Rick Scotts of the nation who would seek profit and wealth over all else and who would break the law to achieve it.

What would happen if we valued patients and their outcomes? What if we valued good health and sound treatments? What if we had a single standard of high quality care for all funded fairly and pooled in one single payment fund?

Maybe we’d sleep better. Maybe we’d be healthier. Maybe we’d be less stressed. Maybe we’d grow up a bit as a nation and allow wiser minds and gentler hearts to truly design a more sound policy for providing the human right to healthcare instead of feeding the hungry profit beast that is our healthcare market. It makes sense to me that if we want to assure our position among the nations on earth where free people have the right to live free from want and free from oppression, we’d better get going and supply the right to healthcare to coincide with the demand for freedom from the economic stranglehold of the market-based healthcare mess we’ve got. Then we could all sleep a little tighter.

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