Friday, December 04, 2020

Healthcare Crisis

The US healthcare system is set up to make money, not to take care of people.  That is one reason why hospitals are having so much trouble dealing with the COVID-19 pandemic. 

To start with, the US limits the number of doctors it trains to keep their salaries high.  It brings in foreign trained, foreign doctors to do the dirty work in emergency rooms and family clinics, so that American doctors can do the highly paid specialist work.  If American medical schools trained more doctors, Americans would have better healthcare.  The focus of doctors on money is illustrated by how many have been implicated in the use – illegal and legal – of painkillers like Oxycontin, how many doctors accept gifts or paid speaking (vacation) opportunities if they prescribe a certain, expensive drug.    

Secondly, American hospitals are set up to maximize profits, not to improve the healthcare they provide.  The buildings, staffing, administration are all organized for profit, not for care.  Just in time inventories and small staffs do not work well for epidemics. 

The health insurance industry adds further distortion to the healthcare business.  It means that consumers don’t care about the cost because insurance pays most of the costs.  All the negotiations are between the insurers and the providers, without any consumer input. 

This business model has left the healthcare industry unprepared for a pandemic where the treatment is not cost effective, i.e., lots of expensive treatment for poor people.  But if the poor people are not treated, they will spread the infection to everybody else.  Most of the patients are old and sick, requiring extensive care, while the virus hardly affects young, healthy people. 

The clearest indication that the American healthcare system is in a mess is the fact that it is one of the main campaign issues in every election.  Obamacare would not be such an issue if the overall healthcare system were not so messed up.  Americans are afraid to criticize their doctors because they fear that if they do, their doctors will let them die screaming in pain.  However, they do criticize the general healthcare system of which the doctors they fear are a critical part.  Healthcare is always the number one issue in elections because people think it is bad. 

Those highly paid, American trained specialists are good at treating the illnesses in which they specialize, orthopedics, cardiology, cancer, etc., but they are less good at keeping their patients heathy, because there’s no money in healthy patients who don’t visit the doctor.  The American healthcare system maximizes treatment, not health.  Healthy patients are bad for doctors’ bank accounts. 

Individual doctors should be aware that they are part of a corrupt system that s not taking care of the American people.  They may be rich financially, but they are ethically poor. 

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