2-10-07 Making Healthcare Profitable
This story from Friday's L.A. Times reminds me of exactly what it is that turns my stomach about making healthcare "available to everyone".
Once upon a time in America, hospitals were non-profit, beneficent organizations. They were staffed by people who had chosen to work in medicine because they had that ingrained sense of wanting to do something in life that had meaning. Helping the sick and needy was always a virtuous purpose. The Hippocratic Oath was displayed prominently on the wall...
But then the public schools changed from being education oriented to being "career oriented" and began focusing on the idea that the best and brightest should be steered towards future careers that would maximize their earning potential. Naturally, it was seen, coincidentally, that healthcare was ramping up as a career area where really smart kids could become nurses and doctors and technicians, and make a lot of money. So, you got people who basically wanted to make a lot of money taking this career path, rather than choosing it because they wanted to help people.
Then the lawyers started going after the money, suing doctors that weren't perfect. It was such a lucrative, money-making activity that suing doctors became a legal specialty called "malpractice". The "ambulance chaser" had moved up to the big time, big bucks venue.
It got so bad that doctors found themselves in the absurd position of having to purchase "malpractice insurance," since all it would take to destroy their entire careers would be one shyster lawyer and a jury that, clearly, would not be comprised of their actual peers. After all, where the hell would they find a jury of doctors? Naturally, a jury of average folks can be presented with the results of an imperfect science, and because they believe that medicine is a perfect science, the imperfect doctor would easily be seen as deserving of punishment...
Before too long, doctors found that the cost of malpractice insurance had risen to the point where practicing medicine the old-fashioned way (one doctor, one office, with house calls) became unviable. They had to band together, forming clinics with a group of other doctors, in order to get the "group rates" for their malpractice insurance payments. It soon became obvious that the whole practice of medicine was changing in America, and the larger the group a doctor joined, the less they had to worry about insurance costs and the more they could focus on tending the sick and infirm.
The cost of everything in medicine went up. Even the ambulance guys had to be "covered" by special insurance, lest some shyster lawyer found a crack in the wall to extort even more money.
But it really started to evolve into the mess that is today after it was seen that there's a LOT of money flowing around these services. In order to have that "perfect science" deliver "perfect service" with what the public would always believe were "100% guaranteed results" they had to buy only the "best" drugs, only the most "perfectly engineered" tools, and have only the "most prestigious looking" facilities... The costs of everything took off like a rocket!
But it could've still worked if the profit mongers hadn't been able to turn the non-profit hospitals into corporate cash-flow machines. Anywhere there's money to be stolen, you'll find that monster entity called "the public corporation" moving in and raping the area "for the stockholders". Once these guys moved in and bought hospitals up, turning them into what they are today, the game was already over. In order to make medicine more profitable, you have to run it differently.
Forget the Hippocratic Oath, now you've got a quota. The cash flow machine can't continue unless the stats are always on an uptrend. The whole thing is a self-feeding mechanism focused on continued increase of profit. As long as profit continues to increase year after year, the machine just runs happily along. But as soon as the inevitable tick in the statistical graph arrives, where you couldn't squeeze another ounce of expansion, acquisition, or efficiency out the thing, and profits suddenly hit that plateau... well, now it's time to make cuts. The stockholders demand it.
Eventually, the machine will find that it is "necessary" to eliminate the pro-bono work, and this is where we start seeing stories like this.
Yes, this is the same link to the same L.A. Times story I started off with, but it needs to be read by anyone and everyone who ever thought that "healthcare" bears any slightest resemblance to a beneficent activity. It is a blood sucking, profit making activity now.
The "healthcare crisis" in America isn't about whether people can "afford" to get treatment for what ails them. It's about maintaining the current trend in this corporate nightmare, because they've reached the point where they have to physically eject anyone who has no "coverage". The basic legal structure of profit making corporations demands that they do this.
A CEO who allows pro-bono work will, by the very nature of the profit making corporation, be at risk of losing his job if he doesn't "throw the bums out" and refuse to expend the corporation's assets on these deadbeats. "Pay or go away" is, essentially, written into the legal structure of the whole thing. The stockholders will demand it.
It was inevitable, the minute that healthcare changed from being a non-profit, beneficent activity into a profit making activity. The "healthcare crisis" in America cannot be "solved" until healthcare is returned to its former status as a non-profit, beneficent activity.
The only way to make healthcare "work" as a profit making activity is to extort the money to pay for it from EVERYONE. So this seemingly high-minded idea of "universal healthcare" has nothing to do with solving the problem, it's only about raising the bar on the extortion. This is what Mitt Romney managed to get passed as legislation in Massachusetts last year, only the prospect of actually implimenting it has suddenly become a big problem.
Duh!
The only thing that this type of legislation can actually accomplish is to extort more funds, establish another revenue stream, for the corporate income of the healthcare industry. It won't actually make healthcare "available to everyone", it will only make more income available to the corporate structure that's in place.
Healthcare, in its present form, has to be made more profitable, otherwise it will continue on its present course of evolving into an even more frightening monster, where only the rich can afford to avail themselves of these services.
Anyone can see this. But the blinders on the public eye are made of this fabric that says "healthcare" is a perfect science, and that it forestalls dying, and that it has fully matured into something that can always deliver 100% predictable success. What it actually is, however, is a machine that extorts money by having the victim believe that if they don't get "the best" that medicine can deliver, then they'll die.
"Take this drug every day for the rest of your life... or else you'll probably die."
"Sign this form, and we'll perform the operation that will save your life."
This isn't science. It's marketing.
There's absolutely no slightest doubt that medicine can be a very expensive practice, but to add the burden of making big profits on top of it is the ultimate in extortion and shameful practices. This society can not bear that burden, and anyone who tells you that it can is lying. There are just some things in society that cannot be carried along in a sane manner by "free market" economic theory...
You have to draw the line on ideology versus public trust somewhere.
Once upon a time in America, hospitals were non-profit, beneficent organizations. They were staffed by people who had chosen to work in medicine because they had that ingrained sense of wanting to do something in life that had meaning. Helping the sick and needy was always a virtuous purpose. The Hippocratic Oath was displayed prominently on the wall...
But then the public schools changed from being education oriented to being "career oriented" and began focusing on the idea that the best and brightest should be steered towards future careers that would maximize their earning potential. Naturally, it was seen, coincidentally, that healthcare was ramping up as a career area where really smart kids could become nurses and doctors and technicians, and make a lot of money. So, you got people who basically wanted to make a lot of money taking this career path, rather than choosing it because they wanted to help people.
Then the lawyers started going after the money, suing doctors that weren't perfect. It was such a lucrative, money-making activity that suing doctors became a legal specialty called "malpractice". The "ambulance chaser" had moved up to the big time, big bucks venue.
It got so bad that doctors found themselves in the absurd position of having to purchase "malpractice insurance," since all it would take to destroy their entire careers would be one shyster lawyer and a jury that, clearly, would not be comprised of their actual peers. After all, where the hell would they find a jury of doctors? Naturally, a jury of average folks can be presented with the results of an imperfect science, and because they believe that medicine is a perfect science, the imperfect doctor would easily be seen as deserving of punishment...
Before too long, doctors found that the cost of malpractice insurance had risen to the point where practicing medicine the old-fashioned way (one doctor, one office, with house calls) became unviable. They had to band together, forming clinics with a group of other doctors, in order to get the "group rates" for their malpractice insurance payments. It soon became obvious that the whole practice of medicine was changing in America, and the larger the group a doctor joined, the less they had to worry about insurance costs and the more they could focus on tending the sick and infirm.
The cost of everything in medicine went up. Even the ambulance guys had to be "covered" by special insurance, lest some shyster lawyer found a crack in the wall to extort even more money.
But it really started to evolve into the mess that is today after it was seen that there's a LOT of money flowing around these services. In order to have that "perfect science" deliver "perfect service" with what the public would always believe were "100% guaranteed results" they had to buy only the "best" drugs, only the most "perfectly engineered" tools, and have only the "most prestigious looking" facilities... The costs of everything took off like a rocket!
But it could've still worked if the profit mongers hadn't been able to turn the non-profit hospitals into corporate cash-flow machines. Anywhere there's money to be stolen, you'll find that monster entity called "the public corporation" moving in and raping the area "for the stockholders". Once these guys moved in and bought hospitals up, turning them into what they are today, the game was already over. In order to make medicine more profitable, you have to run it differently.
Forget the Hippocratic Oath, now you've got a quota. The cash flow machine can't continue unless the stats are always on an uptrend. The whole thing is a self-feeding mechanism focused on continued increase of profit. As long as profit continues to increase year after year, the machine just runs happily along. But as soon as the inevitable tick in the statistical graph arrives, where you couldn't squeeze another ounce of expansion, acquisition, or efficiency out the thing, and profits suddenly hit that plateau... well, now it's time to make cuts. The stockholders demand it.
Eventually, the machine will find that it is "necessary" to eliminate the pro-bono work, and this is where we start seeing stories like this.
Yes, this is the same link to the same L.A. Times story I started off with, but it needs to be read by anyone and everyone who ever thought that "healthcare" bears any slightest resemblance to a beneficent activity. It is a blood sucking, profit making activity now.
The "healthcare crisis" in America isn't about whether people can "afford" to get treatment for what ails them. It's about maintaining the current trend in this corporate nightmare, because they've reached the point where they have to physically eject anyone who has no "coverage". The basic legal structure of profit making corporations demands that they do this.
A CEO who allows pro-bono work will, by the very nature of the profit making corporation, be at risk of losing his job if he doesn't "throw the bums out" and refuse to expend the corporation's assets on these deadbeats. "Pay or go away" is, essentially, written into the legal structure of the whole thing. The stockholders will demand it.
It was inevitable, the minute that healthcare changed from being a non-profit, beneficent activity into a profit making activity. The "healthcare crisis" in America cannot be "solved" until healthcare is returned to its former status as a non-profit, beneficent activity.
The only way to make healthcare "work" as a profit making activity is to extort the money to pay for it from EVERYONE. So this seemingly high-minded idea of "universal healthcare" has nothing to do with solving the problem, it's only about raising the bar on the extortion. This is what Mitt Romney managed to get passed as legislation in Massachusetts last year, only the prospect of actually implimenting it has suddenly become a big problem.
Duh!
The only thing that this type of legislation can actually accomplish is to extort more funds, establish another revenue stream, for the corporate income of the healthcare industry. It won't actually make healthcare "available to everyone", it will only make more income available to the corporate structure that's in place.
Healthcare, in its present form, has to be made more profitable, otherwise it will continue on its present course of evolving into an even more frightening monster, where only the rich can afford to avail themselves of these services.
Anyone can see this. But the blinders on the public eye are made of this fabric that says "healthcare" is a perfect science, and that it forestalls dying, and that it has fully matured into something that can always deliver 100% predictable success. What it actually is, however, is a machine that extorts money by having the victim believe that if they don't get "the best" that medicine can deliver, then they'll die.
"Take this drug every day for the rest of your life... or else you'll probably die."
"Sign this form, and we'll perform the operation that will save your life."
This isn't science. It's marketing.
There's absolutely no slightest doubt that medicine can be a very expensive practice, but to add the burden of making big profits on top of it is the ultimate in extortion and shameful practices. This society can not bear that burden, and anyone who tells you that it can is lying. There are just some things in society that cannot be carried along in a sane manner by "free market" economic theory...
You have to draw the line on ideology versus public trust somewhere.
posted by Jeff Barnard at 8:17 AM
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