Tuesday, April 14, 2020

Can "Sickcare" Survive the Pandemic?

Like the rest of the financialization machine, sickcare was never sustainable.
What was once known as healthcare in the U.S. has largely been replaced by sickcare: healthcare was focused on restoring and maintaining health and was owned and managed by community-based non-profit hospitals.
Sickcare is focused on extracting the maximum revenues and profits from managing the chronically ill, and is owned by Corporate America. Sickcare, by its very nature, stripmines the entire nation to maximize its profits, and does so dishonestly, with obtuse billing, overbilling, prescriptions for costly medications whose side effects and efficacy have been gamed/obscured, and so on.
Since sickcare profits from chronic illness, America is now chronically ill. Since sickcare profits from over-medicating patients, America is now chronically over-medicated.
As Jim Kunstler observed, sickcare is a racket, which Jim defines: "By racket, I mean an enterprise organized explicitly to make money dishonestly." Ruin Nation.
There are still vestiges of healthcare in the U.S., but these are being undermined, marginalized or eliminated by the financialization machinery of sickcare. Financialization is the disease that has consumed America, hollowed it out and left it unable to discern the consequences of a financial system that has become neofeudal, parasitic and predatory. One such consequence has been the slow decay of healthcare and its transformation into sickcare.
A correspondent who is a physician recently explained the structure of sickcare.
1. Businessmen understand healthcare is the best industry to financialize:
A. it sells a product that generates its own demand
B. is run by no-nothing doctors who let their worldview get in the way of maximizing shareholder value
C. is a direct conduit to the holy grail--Federal dollars
2. Businessmen get on board
3. Businessmen begin applying business principles to healthcare
4. Businessmen kick cranky doctors off board who get in the way
5. Businessmen hollow out health system as they extract every nickel in value; compensation, no bid contracts, feather bedding
When the inevitable pandemic hits, their hollow organizations don't have the resources to cope, even though that is their core function--remember, this pandemic is NOT a 'black swan,' black swans come out of no where. This was perfectly predicable and there was plenty of warning.
6. The lack of credibility in leadership accelerates the pandemic effects. The doctors who could lead have been marginalized so they can only have impact on the tactical side, rather than in leadership.
Look for wholesale leadership changes with maximal visibility among major health systems as they bring in outsiders to try to re-assert their credibility.
Spoiler Alert: It won't work.
These hospitals are gaslighting their staff that previously recommended levels of PPE (personal protective equipment) was overkill and that the staff can do just as well with reduced levels of protection.
The staff smell the fire and are behaving accordingly.
No sign of leaders doing personal care in reduced PPE.
Do they not teach leadership in B-school anymore? If you don't share the risk with your troops (the more intimately, the better) you lose credibility. If there ever is an actual reckoning, the leaders are going to regret not emptying a few bedpans.
I have come to the conclusion that our nation and society is no longer nimble enough to survive.
That's sickcare in a nutshell. Like the rest of the financialization machine, sickcare was never sustainable. The pandemic is merely the catalyst that is stripping away the PR illusions that have cloaked the looting, the fraud, the racketeering and profiteering, and the betrayal of everything healthcare once stood for.
Money and Work Unchained $6.95 (Kindle), $15 (print) Read the first section for free (PDF).


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