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Diagnosing American Healthcare

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Diagnosing the Real Problem with Healthcare

For the last few decades, there has been an ongoing debate in America about how best to fix our healthcare system. This is to say, that the vast majority of us realize that our system is broken. I want you to put from your minds your political ideologies and affiliations. Forget about conservatives or liberals, corporatists or socialists, republicans or democrats. The truth is, politicians, whatever their party, are by their very nature whores, because the environment of American politics is one where only whores can survive. In order to get elected to office, a successful candidate must launch a massive ad campaign which both widely publicizes their name and platform, while smearing their opponents. To do this requires an exorbitant amount of money, so much so, that it becomes virtually impossible to raise the funds without prostituting yourself to special interests, and the second that happens, you no longer represent the American people, you represent your corporate masters.

Keeping this in mind, it's no wonder nothing meaningful has been done about healthcare in America. We continue to spend more per capita on healthcare than any other country, while being 38th worldwide in life expectancy. The proposed solutions from either side of the political isle are mediocre at best, and they can't even be enacted, because both sides strive ceaselessly to sabotage the other for petty political reasons, though an honest assessment shows that the republicans share the majority of the blame in that respect. So what are the solutions offered up by our leaders? Well, republicans by and large don't seem to have any, with two notable exceptions, one of which is "tort reform." This would entail higher regulation on patient's rights to sue their doctors, to reduce frivolous lawsuits. The argument goes, that if we can significantly reduce the number of frivolous lawsuits brought against doctors and hospitals, then they wouldn't need to purchase so much malpractice insurance, allowing them to charge their patients less. Democrats oppose this, because law firms donate generous amounts of money to democratic politicians, who in turn, serve them over the people. But would tort reform even work? In America, everything is run like a business, which is intrinsically problematic (this is another topic entirely), and businesses are perpetually seeking ways to cut costs while raising prices. Healthcare, unfortunately, is no different, and there is little to indicate that this would drive down healthcare costs at all. Even if it did, it would be tantamount to throwing a deck chair off of the sinking Titanic.

The other idea brought up by republicans is to open up health insurance across state lines, so that health insurance carriers can compete nationally. It is argued that this would greatly benefit states where only a few companies exist, and that this would create competition, which would benefit the consumer. This would also allow companies to buy out and merge with others, potentially leading to huge monopolizations. This approach is also opposed by democrats, it seems for no other reason than because it's supported by republicans. All in all, it stands to do more good than harm, though like tort reform, it's just too little too late.

So, what solutions are proposed by the other side? Well, liberal democrats, progressives, and socialists - who, contrary to popular belief, are not all synonymous - believe in a single payer system, where the government supplies free healthcare for all, effectively eliminating the health insurance industry. The downside? Well, where do you think the money for that comes from? Higher taxes. Still, nearly every country with a single payer system is healthier by every measure than America, and results like these cannot simply be ignored.

Single payer healthcare is irrelevant though, because the American people are too easily manipulated by corporatist puppets in the media, and are made to be frightened of "big government,"  so that a single payer system, it seems, will not be widely embraced in the foreseeable future. So, the idea that democrats brought to the table was the "public option," which was a government run health insurance provider to be introduced into the market to compete with private carriers. But even this tame, watered down option was defeated, not due to lack of public support, but due to the tireless opposition of republicans, and the typical spinelessness of democrats. To no one's surprise, health insurance companies donate vast amounts of money to republican politicians.

The so called "heathcare reform" that ended up passing congress amounted to stricter regulations on the health insurance industry, along with a mandate that all Americans must purchase health insurance by the year 2014. If you may excuse my vulgarity, the democrats basically smacked the health insurance industry on the wrist with a ruler, then took them out back and gave them a blowjob.

What's really wrong with all of these ideas is that they only treat the symptoms of our broken system. I am a strong advocate of the "root cause," school of problem solving. We should try to control the damage and pain caused by the symptoms of a problem, but the majority of our efforts must go into finding the root cause and fixing the problem at its source, thereby preventing future symptoms. To do this often requires one to step back and look objectively at the big picture. I contend that there is a causal chain of problems, and that when we trace the chain back to the source, we can truly fix our broken system.

The first step to finding the right answer is to ask the right question. So what really is wrong with our healthcare system? Well, health insurance companies charge high, ever increasing premiums, then do everything in their power to weasel out of paying their customers' medical bills. This is indeed a serious problem. Why do health insurance companies do this? Because medical bills are ludicrously expensive. But why are medical bills so unreasonably steep? Because doctors must make a living. But why do doctors and hospitals need to charge such outrageous amounts of money to make a living? Because doctors enter into the medical field with upwards of $500,000 of debt. Why do doctors have so much debt? Because doctors require eight years of schooling, and with prestigious schools costing 40-50,000 dollars a year, few can afford to pay these fees upfront, forcing them to take out student loans, where they end up paying up to 50% more in interest. But why is higher education so expensive? This is finally the right question to be asking. This is the source of all the problems. Most doctors don't become doctors for the money - there are much easier ways to get rich - they become doctors because they want to help people. If doctors don't have to enter into their field hundreds of thousands of dollars in debt, they won't need to charge such excessive amounts of money for their services, and when medical bills are made affordable, health insurance will become largely unnecessary, and the demand for it will diminish. The question isn't "who should pay for healthcare?," it's "why is healthcare so expensive in the first place?"

Education, it has been argued by many, is a human right that should available to anyone who seeks it at an affordable cost, as should healthcare. The two are connected, and to make healthcare affordable, we must make education affordable. 40,000 dollars for a year of college is not affordable, nor is it reasonable. Everyone needs to make a living, but the costs that go into a college education are, at every turn, overpriced to the point of insult.

What congress should be regulating more strictly are colleges, universities, and student loan companies. We need caps on how much students can be charged for tuition and text books, on student loan interest rates, and we need to expand greatly upon the template of community colleges. No one, save for the very poorest among us, should have to take out a loan to get an education, and when we can enact high quality education at genuinely affordable prices, it will grow and heal our country not just in our healthcare, but in all facets of our lives.
Another important question we should be asking is "why are we so sick?" Americans need to make lifestyle changes as individuals to become healthier people, if we are to have a sustainable healthcare system. This means getting a proper night's sleep, not frying everything you eat, and getting regular exercise. Two out of three American adults is overweight, and one in three is obese. More than half of all medical problems stem from this.

The Journal of the American Medical Association - Prevalence and Trends in Obesity Among US Adults, 1999-2008.
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