MedSmarts

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The 3 WTFs of American Healthcare

WTF, Doc?

Tuesday, November 21, 2017

US Healthcare costs as percent of GDPPolitics aside, the take-home lesson from Obamacare to date isn’t whether it’s working or not. It’s that healthcare in America is EXPENSIVE – too expensive for most Americans to afford.

All the intense focus on Obamacare and the high-deductibles and insurance premiums it entails is only revealing how expensive our healthcare truly is.

Many Americans are being forced to confront the fact that they can’t afford to get sick – even with the tax subsidies many are eligible for under Obamacare.

The high-deductible “bronze” health plans that most appear to be selecting as they enroll under Obamacare mean they still have to pay for much of their initial healthcare needs out of their own pockets – before their insurance coverage kicks in – in addition to¬†their monthly premiums.

Don’t Shoot the Messenger

Maybe it would help if they better understood why our healthcare costs twice as much as it does in other developed countries – why we’re such a nation of suckers. Obamacare’s not the reason why – this all predates Obamacare by many, many years.

Obamacare’s just the messenger, not the perpetrator – and we know the folly of shooting the messenger, don’t we? The real perp goes scott-free.

Rather than confront the real perpetrator, we’re content to shoot the messenger because it’s so much easier. It’s a more focused, timely, and politically convenient target, after all.

It should be no surprise that many of those most responsible for our ridiculously inflated medical costs are helping fuel the opposition to Obamacare. It’s Diversion Tactics 101.

Context Is Everything

To fully appreciate what’s going on in America’s healthcare morass, you need some context – big picture stuff. Otherwise, you might dismiss this as someone’s political spin or ideological paranoia.

It’s neither. It’s all-too-factual – alarmingly so. That’s why I choose not to pull any punches here.

After all, alarms are supposed¬†to be shrill…

The Three WTFs

I’m going to assume you know what WTF means (if not, Google it). I was going to go with three big battleships – because their impact is so dominant and they’re not likely to turn around quickly. But considering how breathtakingly bizarre they are in combination, “WTFs” seemed so much more appropriate.

These are three indisputable facts about American healthcare that you need to “get” in order to understand the magnitude of America’s healthcare crisis – and it has little to do with Obamacare. And, sadly, Obamacare has little to do with them, meaning it doesn’t do much about them. Yet they explain why our healthcare costs so much – and is so dangerous.

Think about them, individually and then in combination. Then ask yourself, “WTF?”

1. Healthcare is by far the most corrupt industry in America – by a mile. I document this in Our Healthcare Sucks. The bottom line is that healthcare companies – primarily pharmaceuticals, insurance companies, and hospitals – account for more fraud settlements with the federal government than all other industries combined.

This isn’t something we generally think of when we think about our healthcare. Fraud – in our healthcare? Yes, fraud in our healthcare – big time.

How big? Not only are healthcare fraud settlements greater than all other U.S. industries combined – they’re FOUR TIMES greater than all other industries combined.

The problem is its magnitude is SO enormous that – for most of us – it’s like thinking of the billions of dollars wasted every year in our healthcare system. The numbers are so big we simply can’t conceive them – so we dismiss them instead.

It’s only when you or someone you know is victimized by it – and realizes it, since so much of it remains hidden – that the message is driven home. And by then, it’s too late.

2. Healthcare is by far the biggest political lobbyist in America – The various players in the industry – doctors, hospitals, insurers, pharmaceuticals, medical device manufacturers – spend more on federal and state lobbyists, and make more political campaign contributions, than any other industry in America.

This means they’re willing to pay the price to prevent anything major from being done about fact number one. Obamacare was supported by most of these players. There’s a reason for that – and it wasn’t because their livelihoods were being threatened.

3. Healthcare treatments are responsible for more deaths every year than all other industries – and all other non-medical causes – combined. The latest estimates are that up to 440,000 Americans die needlessly every year from their medical interventions due to treatment-caused infections, medical errors, and other treatment complications.

Yes, healthcare is complicated. Many patients are at high-risk due to their medical vulnerabilities. But that’s all the more reason the industry should be bending over backwards to ensure patient safety.

It isn’t. In fact, little real progress has been made in the 15 years or so since the Institute of Medicine’s revealing report on medical errors in America, To Err Is Human (see “Patient Safety or Endangerment“).

These deaths aren’t due to patients’ medical conditions, but to their treatment – often negligent and usually dangerous. America’s healthcare industry earns only a 31% efficiency rating – abysmal by any standard (and ahead of only Serbia and Brazil in this analysis). Is it any wonder so many lives fall through the cracks of our highly fragmented delivery system?

Yet most patients – and their families – remain in the dark when someone they love dies from medical mistakes. They often wrongly attribute it to the medical condition – and usually no one bothers to tell them that, instead, they’re victims of this deadly ineptitude.

Again we have the conundrum of huge numbers. 440,000 lives lost is an incomprehensible number. Compare it to the 3,000 or so lives lost on 9/11 (see “Healthcare Mistakes: Another 9/11 Every Week“). It’s roughly 100 times the lives lost in the entire Iraq war – every year.

Big numbers – too big to comprehend. And that’s a big part of the problem.

We once considered banks too big to fail. With our healthcare, it’s too failed to fix.

The Real Catastrophe

Now think about those three big elephants in the room – all at the same time. Easily the most corrupt industry in America responsible for all those unnecessary deaths – and paying off our politicians to allow it to continue.

That’s the big picture – the sordid context of medical mayhem in which Obamacare’s being implemented. Instead of even acknowledging it, however, we’re busy pouncing on every Obamacare enrollment figure as if THAT’S what’s really sensational here.

The truth is that Obamacare’s not the catastrophe its opponents make it out to be. Our healthcare system is the real catastrophe.

Which raises the question: Why aren’t we more focused on THAT?

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