Guest Post by Paul Craig Roberts
Whose interests are served when Pelosi sells out health care and Pompeo sells out peace?
The US health system is the most high cost and dysfunctional health care system in the world. The reason is that it is privatized. In the rest of Western civilization the system is socialized.
The reason health care is socialized in civilized countries is not only to provide health care to citizens who otherwise could not afford it, but also to reduce the cost. In a privatized system, a profit has to be turned at every level: the general practitioner, the specialist, the diagnostic facility, the ambulance service, the emergency room, the hospital, the hospice, the health insurance company. All of these levels of profit build up the cost.
In the hybrid system with which the US is afflicted, regulation drives the cost even higher. It is not only government regulation because of Medicare and Medicaid, but also private regulation imposed by private insurance companies. In America, alone in the world, medical care comes second to paperwork.
Doctors working in medical clinics have to dictate the results of each patient seen, the diagnosis, the treatment, and so forth, in sufficient detail to satisfy the payer of the bill, whether public or private. The dictation time eats into the doctor’s treatment time. In other words, the paper work requirements reduce the amount of time the doctor has to see patients. The paperwork also requires nurses to organize and compile it. And this is not the end of it.
Health care corporations employ people to monitor the doctors to make sure the physican dictates enough to create a record that Medicare, Medicaid, or the private insurance company will accept as evidence of billable service.
Even a libertarian economist who views the massive costs upon costs of the American system cannot find any economies to attribute to private enterprise.
In a socialized health care system, none of the many levels require a profit in order to continue to operate. As there is no billing of Medicare, Medicaid, and private insurance companies by private corporations, there is no need for the high cost of preventing fraud. Nurses and doctors can attend to patients instead of paperwork. Of course, in any system cost-saving regulations can expand cost-producing bureaucracies, and no system will work well without moral and virtue rules that instill a compassionate and responsible attitude on the part of health care providers.
There is no doubt whatsoever that the cost of health care in the US would diminish dramatically if the US had a socialized health care system in which there is no profit, no paperwork, only health care. And this is why it will not happen.
In the US system, health care is profitable to private interests. They are concerned with their profits, not with the cost of health care to people. It is profitable to all the fraud prevention, public and private, bureaucracies. It is profitable to the members of the US Senate and House of Representatives, as private health care companies are major donors.
If you doubt this, consider that Democrats, or many of them, say that they are for a single payer health care system, by which they mean a socialized health care system in which there is no profit and no regulatory cost. But they are not really in favor of such a system as the Speaker of the House, Nancy Pelosi’s health policy aide made clear to private insurance company executives. Pelosi’s health care adviser, Wendell Primus, pledged Democratic Party support to the insurance industry in the fight against single-payer health care. https://theintercept.com/2019/02/05/nancy-pelosi-medicare-for-all/?utm_source=The+Intercept+Newsletter&utm_campaign=0df09bdfa1-EMAIL_CAMPAIGN_2019_02_09&utm_medium=email&utm_term=0_e00a5122d3-0df09bdfa1-131966649
Pelosi’s plan is to achieve “universal coverage” via the Obama Affordable Care Act. This misnamed legislation achieves health coverage for Americans by mandating that they purchase private insurance policies for their health insurance. Many Americans have not, because the premium, together with the deductible and co-pays are so high that few can afford to use the policy. The perfect deal for a health insurance company is to collect a premium on a policy whose deductibles and copays make it too expensive to use.
What we need to ask outselves is: Why can’t we Americans get affordable health care? A socialized system could pay high salaries to doctors and nurses to guarantee their commitment. Their education could be subsidized. Pharmaceutical companies can be nationalized. Scientists dedicated to finding cures don’t care who they work for. The entrepreneural argument is a red herring.
The answer is that government does not serve the citizens. Government is just another private business that serves those whose campaign contributions put senators, representatives, and presidents in office. What liberals, conservatives, and libertarians do not understand is that government is a private activity like a capitalist business, not a public organization.
Government is just another privatized sector. It serves those who pay. As people needing health care can seldom pay, the system is in the hands of the private insurance companies.
The only “health care reform” that America will ever have is the reform that drives the cost of healthcare even higher.
Pelosi’s sellout to the insurance companies is more evidence that the concept of “public goods,” that is, the government’s provision of goods and services to citizens, needs rethinking. For example, consider national defense. In what sense is the massive US military/security complex budget a public good as contrasted with taxpayer-provided profit to a small number of subsidy-seeking private corporations? In what sense does US foreign policy serve the public as opposed to the armaments corporations, oil companies, and Israel Lobby? It is impossible to look at the US government budget and not see that it feeds private interest groups with strong lobbies.
Consider the symbiotic relationship between foreign policy and the military/security budget. The massive Pentagon budget and the massive power of the CIA and NSA require a dangerous enemy. Thus, US foreign policy creates the “Russian threat,” the “Chinese threat,” the “Iranian threat,” the “Al Qaeda threat,” the “ISIS threat,” the “Saddam Hussein threat,” the “Gaddafi threat,” the “Assad threat,” and now the “Maduro threat.” In order to maximize profits, the military/security complex increases the risks of war. In other words, the profits come at an expense greater than the budget imposed on taxpayers. In the case of war with Russia, the cost is the destruction of life on earth.
Propaganda serves the same role in democracies as it does in dictatorships. The public have to be deceived in order for citizens to accept an agenda that serves others than themselves. The public’s patriotism and gullibility pave the way for propaganda’s success. Currently Secretary of State Mike Pompeo and National Security Adviser John Bolton are preparing the public for US military intervention in Venezuela with false claims that Cuba has taken control of Venezuela’s security apparatus, and Hezbollah and Iran have active cells operating in Venezuela. This alleged risk to America has “to be taken down” in Venezuela and “all across the globe.”
https://www.blacklistednews.com/article/70923/pompeo-attempts-to-link-iran-hezbollah-to-crisis-in.html
All over the Western world the public has been sold out by government; yet only in France is there effective protest.
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There are so many errors in this article it would take days to refute each one. PCR isn’t worth the time.
Here’s the main one: “The reason is that it is privatized. In the rest of Western civilization the system is socialized.”
When I was a kid (I’m 62), medicine was mostly private. The doctor came to the house when we were sick. I don’t remember any waiting rooms. We weren’t rich – maybe lower middle class – but my folks paid cash for all the medical bills. Look where we are now with government footing almost all the bills (what PCR calls “private”).
What an idiot.
Here’s another one: medical providers won’t have to document their services, ’cause gubment is paying.
Mr. Roberts must have been asleep in class recently,
because now we’re on the subject of Jews.
Jews, and lame declarations of fake National Emergencies.
If you think “healthcare” is expensive now, wait till it’s “free”.
Taxes will have to be raised to confiscatory levels.
The most egregious aspects of “socialized healthcare” will be the “wait” for services, and the fact that some government official will make your healthcare decisions for you–some lifesaving drugs and services will be deemed “too expensive” and unavailable. Woe to you if you are elderly…you will be denied lifesaving treatments-euthanasia as a government mandate.
Not only that, but, if you choose to obtain your healthcare services in another country, you will be prohibited from doing so. Look at the two infants who were denied the right to travel for healthcare that the British National Health System was unable to provide, despite the offshore healthcare services being provided at no cost to the parents. The National Health System refused to “allow” the infants to receive treatment in another country, and essentially held the infants “hostage”.
Add to that, experimental treatments will not be allowed, no matter the possible efficacy and success.
Is this what we want?
As an aside, in most countries with “socialized medicine”, supplemental (private) insurance is still necessary, in order to get decent “healthcare”.
The author’s premise on “socialized medicine” is all wrong. “Obamacare” was meant to fail and push the USA into a socialized medicine system, like Great Britain…luckily, the “mandate” was partially reversed and the damage minimized.
All one has to do is look at Canada and the long waits for medically necessary procedures. Despite having first-rate medical personnel, the Canadian system has trouble working, even with the much smaller Canadian population.
The thing that always seems to be left out of the debate is the legal costs.
Thanks to the bullshit legal system, you can sue your doctor for making you healthy, not making you healthy, not making you healthy enough, or just because.
I knew a doctor whose patient sued him and all her other docs for being part of a unified conspiracy to cause her back pain. The case went all the way to the NC supreme court. That shit should have been laughed out of the courthouse when it was filed. All the tort cases by the ambulance chasers are why you pay $500 for an aspirin.
You also pay for the illegal criminal aliens who get free care in the E-room at your expense. You pay because they won’t.
And you pay because the govt requires hospitals to care for the indignant indigent. My buddy is an EMT and his stories of taking care of worthless system riders are horrifying. Like the song said, 911 is a joke in your town. Drunks call 911 to get a ride to the hospital, since it’s across the street from the liquor store. Bums call 911 to get a warm bed for the night. Fatass couchsurfers call 911 to have someone to talk to. One fatass living in a lazyboy would call 911 to get someone to come out to get him a glass of water from his fridge. Once called, they must go. And system riders know how to claim “He’s not breathing! He’s blue! I think his heart stopped!” to get bumped to the top of the line for care.
You also pay for government, who regulate medicine to death. A lot of the regs came about in the Depression under that tyrant, FDR. FedGov dictates everything and even works to limit beds and how many hospitals there are. Never mind they have no interest, power, or responsibility for healthcare. They control it. My doctor friend explained the hell he went through trying to get his hospital to get a CAT scan in the 1970s. He had to pitch the hospital board for it and they refused because DC wouldn’t allow it. And DC didn’t. SO he and other doctors pooled their funds, started a private corporation, and bought their own CAT scanner.
When he retired, he told me he was thankful he was out-he wouldn’t want to be a doc starting out today.
If you want a system that works, you have to stop providing care to those who can not or will not pay. Let charities do that shit. If you want a system that works, you need to get the fedgov out of it.
Short answer: Not you.
Hey PCR, I see you have plenty of time to write about government wrongdoing and left/right crap that everybody already knows about, but no time to write in support of immediate 30 round-pitchforks and torches?
I’ve got an idea.
My proposed wall is FREE
My proposed wall is PROVEN
My proposed wall is HIGHLY EFFECTIVE
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Before 1973 it was illegal to make a profit off of healthcare. It wasn’t single payer then. It wasn’t no Obamacare then. It wasn’t socialized medicine then. So what happened that made it the most expensive and least quality that it is today?
And you could discharge medical bills in a bankruptcy filing.
You still can. And the filings are greater now than they have ever been, because the cost is so high even with insurance.
A New Study Discovers Two-Thirds Of All Bankruptcies In The United States Are Primarily Caused By Medical Bills
http://theeconomiccollapseblog.com/archives/a-new-study-discovers-two-thirds-of-all-bankruptcies-in-the-united-states-are-primarily-caused-by-medical-bills
No, you can’t. Look it up. You go bankrupt because your medical bills are so high you can’t pay your other bills. But medical bills are not discharged.
I believe you are correct. Student loans, medical bills, and soon to be every fucking thing else: non-dischargeable in bankruptcy.
Please substantiate your claim that it was illegal to make a profit off of healthcare before 1973. I find such a claim preposterous.
And the quick and easy answer to your query is GOVERNMENT. Medicare in 1965 and HMOs in the early 1970s, combined with other government interventions, put 50% of ALL healthcare dollars in the hands of the government at one point or another in the cycle. EVERYTHING government touches goes up in price and down in quality for many reasons, but the primary of which is the lack of a sound price/value system.
There are many nails in this coffin and they were hammered in over an extended period of time.
Sort of like: drip, drip, drip.
In the days when many Blue Cross/Blue Shield organizations covered much of the country things went pretty well. Once the HMOs took hold the promised benefits seemed to come slowly, if at all.
Paradox: medical science has improved significantly; medical insurance has struggled.
The huge upcharge in billed amounts is frequently reported to be part of a collusion between providers and insurers. Hospitals often charge 10X their cost; the insurer reduces the allowed amount at a previously negotiated rate and both parties are happy. The insured patient then pays per the polcy’s coverage terms. The huge upcharge is designed to squeeze the uninsured. Hospitals know that a few of the uninsured will actually pay the entire lug and that is why the huge upcharge exists. They expect most of the uninsured to not have that luxury. If the uninsured has steady income they will put that person on a payment plan-often for an extended period of time. Price negotiation if usually possible, but most of the time does not reach the discount that insurers get. More hospitals are increasingly taking ruthless stances with the uninsured patient with limited ability to pay. Apparently not all hospitals are as egregious, but fewer and fewer appear to be willing to write off as much as in the past. The problem starts with the huge upcharge that is ethically questionable. My gut tells me that more and more hospital administrators call it “following best practices”.
Beat the scam by staying healthy; easier said than done. Or, get elected to Congress.
Managed care took shape slowly and in a variety of forms for decades, then hit critical mass in 1973, coincident with passage of the HMO Act of 1973 championed by Edward Kennedy.
Ask any old codger who had decent insurance coverage what it was like through the late ’60s and then again starting in the mid-to late ’70s. Yes, the response qualifies as anecdotal evidence; get 100 responses and there likely will be a trend observed. Frequent negative claims experiences started showing up around then; subtle changes in relationships with what used to be called “the family doctor” and is now called the “primary care physician” started being noticed. Sometimes cancer progresses slowly; the American medical system changed slowly for 60 years then started sliding downhill in the ’70s/’80s. Pick your own date and your own criteria for when it went over the cliff.
It was during that time frame that Gov. Richard Lamm (D)/Colorado made his infamous claim that”the elderly have a duty to die”. He would have been a lot better off had he said something like “I have budgetary responsibility for my state’s medical programs and the cost of care for our elderly cohort is the one that is most out of control”. Wordy, but it more accurately describes what he was facing. Being the good liberal he is, he did not have to wear the buffoon hat for very long.
As Ringo Starr famously said: “Everything government touches turns to shit”.
Connect the dots.
You completely ignored the Ambulance chasers, lawyers. The medical malpractice insurance is the greatest part of the increase in medical services overhead. Tort reform is badly needed to stop the frivolous and malicious lawsuits that are crushing doctors. Most doctors practicing NOW have 1/3 and over of their pay to cover medical malpractice insurance.
The government serves AIPAC.
Government has always ONLY served the people that put it in place and who keep it in place to serve them. That is typically the 1% or less who directly benefit from the legal monopoly on violence, the monopoly on legal theft, and the guns and force of the military and its direct use to quell competition, murder/dispose of opponents, and steal property and natural resources from others.
Government has ALWAYS been not the “root” of all evil, but the fertilizer, water, and structural support that has enabled evil to grow way beyond its unsupported size.
ObamaCare was a disaster. Now we are pushed back to the insurance company model that is unaffordable.
The high cost will make some sort of government model appealing to most people. I think it has to be nonprofit to bring costs down.
BummerCare IS a disaster. It also is part of a plan. The health insurance companies were too big to be taken down in 2010 when Nancy did not have time to read the damn bill before it was passed, plus they were still needed. The libs want Single Payer badly. They still have to figure out a way to throw the insurers under the bus and that will not be easy. Keep in mind, insurance companies are financial institutions and are not in the business of following altruistic mantras. Translated: if the policyholder gets screwed that is his problem, not ours. Big insurance companies often act just like big banks.
I