Healthcare Bloat, Inefficiency
& Sheer Corruption
No Corruption (Photo credit: Ann Douglas)
There are many healthcare examples of how things go awry when government regulatory functions are co-opted by those they’re intended to regulate. The FDA, of course, jumps immediately to mind.
The Medicare pay scale for doctors – called the Relative Value Unit, or RVU, Scale – in which specialist doctors “advise” Medicare on what their specialties should be paid is another blatant, though more obscure, example.
This self-serving mechanism keeps American specialists overpaid – at multiples of what their equally well-trained peers earn in other developed countries – while primary care physicians remain relatively underpaid. This payment disparity perpetuates our imbalanced supply of physicians that drives so much of our medical misuse.
Both examples reflect a medical profession – and a healthcare system – more focused on preserving the incomes and profits of its suppliers than the safety and well-being of its patient-consumers.
This fundamental corruption lies at the core of our healthcare dysfunction in America. And it’s loudly reflected in the industry’s pitiful 51% efficiency rating and the third or more of our healthcare spending that isn’t necessary.
The cost of continuing to subsidize this bloated medical-industrial infrastructure literally threatens to bankrupt us – making the much-maligned military-industrial complex look like a paradigm of virtue in the process.
Where’s Ike When We Need Him?
And if you think that’s overstatement, consider the fact that our healthcare system spends three times as much on political lobbying to preserve its lucrative status quo as the military-industrial complex. They’re not spending all those billions on lobbyists to protect patients – patient safety being a rather low priority – but to protect their profits.
The recent – and way too-long – article by Steven Brill in TIME (linked to above) goes into elaborate detail about how hospitals inflate prices with no connection to their costs. Many of the examples cited make the Defense Department’s hundred-dollar hammers look like bargains.
President Dwight Eisenhower delivers his farewell address. (Photo credit: Wikipedia)
Even if you’re not one of the millions of uninsured and underinsured Americans victimized by these unscrupulous hospital billing practices, I defy you to read this TIME article and not be outraged. And these are mostly “non-profit” hospitals that get away with billing and collection practices that’d make Tony Soprano blush (see “Tony Soprano, M.D.?“).
Do we have to wait another four years and hope an outgoing President Obama will revise President Eisenhower’s prescient warning about the “military-industrial complex” as he left office to reflect our corrupt medical-industrial complex?
And can we afford to wait another four years?
Lipstick on a Pig
Yet despite this pervasive corruption – from hospital billing practices to medical research to all the fundamentals of American healthcare I discuss in Our Healthcare Sucks – healthcare still mostly gets a pass in our media coverage. We’re constantly treated to photo-ops of politicians catering to their local medical leadership as drivers of their local economies and blazers of medical innovation essential to overcoming disease and enhancing the human condition.
Give credit where credit is due: These boys and girls sure know how to spin it.
And our media generally regurgitate the hyped-up – and often misleading – press release announcements of research results that are often tainted. They do so because they’re understaffed and largely reliant on medical advertising revenues for their survival. In other words, they’re co-conspirators in this tale of healthcare corruption and public deceit.
So it should come as no surprise that no one sees fit to question the logic of continuing to pour trillions into an industry whose gross inefficiency, core corruption and lobbying clout promise only continued misuse of whatever actual innovations may materialize.
Time For A Time-Out?
At what point do we say “Time out! Let’s get our act together and properly utilize what we already have before we spend another dime on expanding it”?
And while we’re at it, let’s pull the plug on allowing hospitals to keep ripping-off patients with after-the-fact bills laden with double-billing and other fraudulent practices that now account for almost two-thirds of personal bankruptcies in America?
Think about it. Healthcare is the least efficient and most corrupt industry in America (see Our Healthcare Sucks for the evidence). Yet all we do is keep throwing more money at it while its fraudulent practices drive more and more Americans into bankruptcy.
This makes us the laughing stock of the developed world when it comes to healthcare.
At a time when the rest of the world is questioning our ability to govern ourselves rationally, what must they think of our allowing – and enabling – our healthcare system to literally deconstruct our economy?
Dying for Profits
Not only do we fail to undertake the kind of aggressive measures needed to put a stop to it – and Obamacare is a weak-kneed substitute for that – but we routinely gloss over our medical mishigas and perpetuate the illusion that our healthcare system is somehow a positive force for our economy because of its incessant growth.
But it’s that very growth – built on the shifting sand of deceitful billing practices described in detail in the TIME article and in many posts here – that will bring this country to its economic knees if we don’t find a way to stanch the bleeding.
Yet the notion of calling a temporary “cease fire” in the war on cancer – barely more successful than the futile war on drugs – is regarded as sheer heresy. What, after all, would all the entrepreneurs and the venture capitalists who fund them do with themselves?
They’d move on to greener pastures is what they’d do – except there are no greener pastures now than healthcare. Where else can they find a jackpot that pays hundreds of thousands of dollars a year for a single patient to buy some time with another new cancer drug? There’s gold in them there hills, son.
And that is the problem needing solution.
Saving lives just shouldn’t be so damn profitable.
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