Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation
My mom and dad used to tell me, "You can't kid a kidder," as a way to impress upon me that they could probably tell when I was trying to be less than honest with an explanation for my behavior. They also said that when they felt someone was being a bit too creative with an advertising pitch. My dad was, after all, a pharmaceutical route salesman who knew a little bit about pitching things for profit.
As I have experienced the US health care system over my almost six decades of life, it seems to me that much of what is offered as health care is coming more and more in the form of sales pitches to gain my business and less about gaining my trust for solid health advice so I make sound decisions about care and treatment. Drug ads on television and in print media are the most obvious example but there are many others.
Rarely does my husband come home from a medical appointment without a new pamphlet in hand about the latest treatment available for a health concern. It is so tempting when you are hurting or don't feel good to reach for whatever might seem the quickest, least difficult means to feel better. Depending on my own insurance coverage situation, I have had some pretty aggressive offerings of some treatments I would later learn might have been more harmful than helpful to me. If a provider has invested in the latest equipment and personnel to offer a highly profitable treatment, that provider was very likely to suggest its use to patients.
What's the other old saying? "To a hammer, everything looks like a nail." In the realm of profit-making in the US system, we need only check out the proliferation of MRIs and other high-tech testing to see where some hefty profits are being made. Another valuable piece of home-grown advice my dad offered me was to be careful about taking every piece of medical advice on its face value. He said, "You know, Donna, a surgeon only makes money if he (she) cuts." I never have forgotten that simple message, and though I have known some wonderful and ethical surgeons, I have also run into my share of providers rather transparently motivated primarily by making money. It is rather easy to tell, though many may think with the shiniest and most posh settings that we will without question allow our bodies to be used to make the money to pay for all the lushness.
I have also often heard people blame patients and their families for asking for expensive tests, treatments, and medications. And it is often true that people may demand these things. But much of the time they have already been "softened up" by the advertising and other media that looks like legitimate health reporting but is really thinly disguised pitch pieces. Sometimes people have been made fearful of not using expensive care or made to think they aren't doing everything to help a loved one if they don't help that person get the suggested treatment. The demand is created for the newest and the sometimes the most experimental methods when something much less costly and even much less invasive would often work as well or even better. It is horrific to think about the lack of human decency that sometimes plays into this system When big money is involved, some pretty sleazy things can happen.
This is another way that an improved and expanded Medicare for all for life system would benefit us all in the US. Taking the massive profit-making incentives out of the system as much as possible would allow providers to be fairly compensated for the care they deliver without having to build in extra costs for all the administration and promotion. It would also give us a much better shot as patients of being offered the appropriate care based on the best evidence instead of the highest earnings for either the providers, the pharmaceutical companies or the private insurance carriers. We could use the innovative treatments when they were the best choice to help us get and stay well but not as the first choice simply because they would make someone else richer.
You see, I was listening when my mom and dad were teaching me. And I know when someone is trying to sell me something. It feels so very different than when someone is caring for me to make me better. I want a system that honors health care not "wealth care."
Today's count of the health care dead and broke for profit in the U.S.:
The 2013, to date, U.S. medical-financial-
industrial -complex system dead: 23,134
The 2013, to date, U.S. health care system
** These figures are calculated based on the Harvard University studies on excess deaths in the U.S. due to lack of insurance coverage or the ability to pay for needed health care, and the Harvard University study that calculated the high percentage of personal bankruptcies attributable to medical crisis and debt in the U.S. 123 people die daily due to lack of coverage or cash to pay for care; 1,978 go bankrupt every day due to medical crisis and debt though the majority had insurance at the time their illness or injury occurred. This statistic is also based on the 1.2 million bankruptcies in the U.S. in 2012, according to the U.S. Bankruptcy Court, and calculating those medically-related bankruptcies from that number.http://www.healthcareforallcolorado.org/endorse_right_to_health_care
Visit Donna Smith, American SiCKO, at her blog site: http://donnasicko.blogspot.com/
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