Sunday, August 19, 2012

A Sustainable National Healthcare System: Prevention Only

The current sickcare system will bankrupt the nation. One model of a sustainable national system would focus solely on providing preventative care.

Longtime readers know that I have presented various options to our costly (and therefore doomed) sickcare system. I have suggested a "cash only" system (The "Impossible" Healthcare Solution: Go Back to Cash July 29, 2009), and observed that the Veterans Administration (VA)offers a model for a national opt-in healthcare system that would offer an alternative to the hopelessly corrupt "fee for service" sickcare (Healthcare: A Large-Scale Solution January 4, 2011).

Stripped of purposefully obscuring complexity, sickcare is a system of State-sanctioned cartel skimming that redistributes the wealth of many to the hands of a few. There are many potentially sustainable alternatives, but regardless of the options offered, it is self-evident that open competition between transparent systems is necessary to provide cost discipline and encourage innovation.

In other words, one size cannot fit all, and the broader the spectrum of transparent opt-in choices, the greater the cost discipline and incentives for innovation.

Healthcare is one of those peculiarly ideological topics where people tend to conceptualize all choices as either/or: either a system is "socialized" or it is "free market" (code name for cartel skimming controlled by the State). The idea that a system of multiple options, complementary and competitive, might be the most sustainable, is difficult for many to conceptualize, much less accept.

Advocates of the Central State taking a dominant role in healthcare bear the responsibility of explaining what will limit the capture of the State's spending and power by wealthy vested interests, a process of corruption that would quickly turn any "new" system into the same crony-capitalist, unaffordable system we now have.

Apologists for the present system of State-sanctioned cartel skimming claim that Medicare, Medicaid and ObamaCare are all sustainable with what amounts to modest policy tweaks. There is scant evidence for this claim; indeed, the one thing we know is that the promises issued to the 306 million residents of the U.S. are claims on future national income and surplus that cannot possibly be met, and magical projections of unending "growth" and unlimited borrowing power for generations to come are fantasies.

Since sickcare is unsustainable, it will eventually be replaced by something that is sustainable. Our only choice is to either let the current system collapse and then start pondering sustainable alternatives, or begin an honest discussion of sustainable alternatives before sickcare implodes in insolvency.

In this spirit of openly discussing a variety of sustainable options, we present this essay by correspondent Lonn Gary Schwartz, O.D. Dr. Schwartz makes a compelling case for the view that the only truly affordable, sustainable national system is one that provides preventative healthcare only.
Here is Dr. Schwartz's essay:
The decades-long health care crisis we continue to experience in the United States is multi-faceted and highly complex, touching every U.S. citizen and every American institution. Despite the complexities, getting to the root of the problem simply requires us to confront the following realities. 
First and foremost, we can not, nor will we ever be able to arrest the aging process, eliminate illness, nor avoid death. Despite what the myriad of “Eternal Fountain of Youth,” industries puts forward, these very events define what it is to be part of the organic life-cycle on this planet.
Therefore, it would seem that we, as a society, need to let go of the illusion that we can circumvent the natural order of things. 
Secondly, each individual needs to take primary responsibility for his/her own health [care]. No more dependence on having others bail us out of poor life choices [insufficient exercise, poor diet, unstable mental/emotional/spiritual states]. No more squandering the nation’s wealth on highly destructive lifestyles and their outrageously expensive antidotes. 
Additionally, and believe it or not, the amount of social wealth that can be allocated to health care is finite. We can no longer tolerate insurance companies acting as health commissars, corporations that are a hideous synthesis of investment banker, tax collector, medical policy and decision maker, and grand financializer, indeed, the worst of all worlds. 
If we well-understand that ignoring basic vehicular maintenance leads to pre-mature wear, mechanical breakdown, and expensive repair costs, why do so many of us fail to acknowledge that a similar outcome is inevitable when it comes to our bodies?
Although volumes can be produced attempting to figure out why people do what they do [regarding their health habits], social policy need not be concerned with the reasons, but only insure that individuals take personal responsibility for their actions, and not necessarily because it will result in a better [health] outcomes or a more productive citizenry, but instead, because there are simply no other fiscally sustainable alternatives. 
The current health care system is geared to heal, repair and/or replace. Attempting to repair and re-fabricate body parts on every American within the context of the current explosion in technologic potentiality is absurd. 
Imagine the possibilities when considering the varieties medical technologies already in place; transplantation, bio-mechanics [robotics], genetic engineering, and pharmacologic, to name a few. Soon enough, you will be able to spend nearly unlimited amounts of money keeping just one person alive! 
The solution? There is only one solution and that is prevention only. And although this may seem harsh upon first consideration, it certainly seems to be closer to what Nature intended for all of Her life-forms. Regardless, it is what it is.
Whatever resources can be allocated to health care [within the context of a fiscally responsible government], should be earmarked to prevention, that is, actual health care. 
If by chance [or misfortune], you happen to contract a disease/develop a condition/be subject to an accident, then you are in the same position as people are today when there are no known treatments available. What would probably be available are low-cost conventional, alternative, and natural remedies, provided by individuals or small businesses, and payable in cash. 
In order to prevent a similar sick-care system from being resurrected, health care must be de-institutionalized. No more insurance companies, no more Big Pharma, no more corporate super hospital systems designed to turn natural events into mega-profits for the few and fiscal bankruptcy for the rest. After all, all of these institutions presently exist only through government decree. 
The results of a de-centralized system will be fiscal sanity, individual responsibility, and hopefully, a much healthier population. This is not to deny that a move toward sanity in one respect will not cause much pain and adjustment in others, but the development of just social policy must have [at its core] compassion, personal responsibility, and sustainability driving the process. 
Just as the welfare state could not save everybody from the natural forces of human social interaction, or give unqualified people mortgages in order to allow them to live “a better life,” we cannot promise to save everybody from the inevitabilities of our own natural life-cycle. 
Getting beyond this era of counterfeit debt-money, and the resulting fiscal insanity it has guaranteed, will require the acceptance of principles that were once very much a part of who we were as Americans. 
We must accept that just as real wealth is created by producing, saving, and investment guided by the principles of transparent risk/reward assessment, our good health must also be earned through sensible eating habits, adequate exercise, and some method of maintaining mental/emotional/spiritual balance. 
Better times lie ahead for those willing to take responsibility for their own wealth and their own health. After all, it is the American way.
Thank you, Dr. Schwartz. The demographic and fiscal cliff are real. Hoping that we can borrow our way to prosperity by dumping trillions of dollars into fraud, malinvestment and needless, counterproductive paperwork, tests, medications, lawsuits and procedures (i.e. sickcare) is the path to insolvency and a future that fails everyone.

In related news, Otis Brawley, M.D. recently laid bare the ill health of our healthcare system in his book How We Do Harm: A Doctor Breaks Ranks About Being Sick in America(Kindle) (print)
"I blame patients, I blame doctors, I blame hospitals, I blame drug companies, I blame insurance companies. Our health care system is messed up because the system is designed to fail, and everybody is responsible for health care failing as it is now." Dr. Otis Brawley

Resistance, Revolution, Liberation: A Model for Positive Change (print $25)
(Kindle eBook $9.95)

We are like passengers on the Titanic ten minutes after its fatal encounter with the iceberg: though our financial system seems unsinkable, its reliance on debt and financialization has already doomed it.We cannot know when the Central State and financial system will destabilize, we only know they will destabilize. We cannot know which of the State’s fast-rising debts and obligations will be renounced; we only know they will be renounced in one fashion or another.
The process of the unsustainable collapsing and a new, more sustainable model emerging is called revolution.
Rather than being powerless, we hold the fundamental building blocks of power. We need neither permission nor political change to liberate ourselves. A powerless individual becomes powerful when he renounces the lies and complicity that enable the doomed Status Quo’s dominance.

Thank you, Lynn M. (handmade potholders), for your very useful and beautifully made contribution to this site's kitchen-- I am greatly honored by your ongoing support and readership.

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